Spinal Disorders

Question 1

Fibrocartilaginous Embolism (FCE)

Answer 1

Peracute, exercise at onset, non-painful.
Usually young, non-chondrodystrophic breeds.
No evidence of compression. Infarct visible on MRI.
Px good if deep pain perception preserved. Can improve dramatically in 1st 7d.

Question 2

Discospondylitis

Answer 2

Infection in IV disk & adjacent vertebrae by haematogenous spread, penetrating wound or FB, iatrogenic (sx).
CSs: spinal pain, fever.

Question 3

Steroid-responsive meningitis-arteritis

Answer 3

CSs acute - febrile, anorexia, back pain 50% concurrent polyarthritis.

Question 4

Acute severe spinal cord injury may be due to

Answer 4

External trauma
Vascular processes - FCE
Inflammatory - acute myelitis
Degenerative - IVDD

Question 5

Spinal cord injuries can include:

Answer 5

1. contusion - injury disrupting blood supply - vasogenic & cytotoxic oedema.
2. compression - extruded disk material/disrupted bone.
3. laceration - axonal transection, disruption of blood supply
4. ischaemia - trauma, thrombosis, embolism, contusion

Question 6

Chronic compression can cause

Answer 6

demyelination and eventual axonal loss

Question 7

primary spinal cord injury

Answer 7

the direct effects of trauma - little chance to influence this

Question 8

secondary spinal cord injury

Answer 8

Can occur for wks/months following injury - disruption of blood supply, ischaemia, reperfusion injury.

Question 9

If just pelvic limbs are affected

Answer 9

The injury must be caudal to T2

Question 10

Cervical injuries

Answer 10

Unusual for a patient to be presented alive if deep pain perception is lost with a cervical injury. Further prognostic info not possible from cx.

Question 11

Thoracolumbar injuries

Answer 11

Major indicator is the presence/absence of deep pain.

DP -ve with IVD extrusion ~55% chance of return to ambulation.
Significantly lower with trauma - consider early euthanasia.

Question 12

Survey radiographs

Answer 12

ALWAYS take orthogonal views to avoid missing a subluxation

Question 13

Neuroprotection in actuellement severe SC injuries

Answer 13

ensure adequate oxygenation and MAP

Question 14

Vertebral fractures and laxations

Answer 14

Where deep pain preserved deemed inherently stable - can try medical management. Confinement ± external splinting.
3 compartment model for vertebrae - if only one compartment affected stability should be preserved.