Wobbler Syndrome, Atlanto-Axial Instability and Other Conditions Flashcards
When is a dorsal laminectomy mainly used?
When ventral slot decompression procedure is not feasible or effective.
When might a ventral slot might not be appropriate; making dorsal laminectomy more suitable? (2)
Compression of spinal cord is:
- Dorsal
- Dorsolateral
Lesions a dorsal laminectomy can be indicated? (4)
Dorso-lateral compression
Arachnoid cyst
Neoplasia
Lateralised cervical lesion.
What are arachnoid cysts?
Fluid filled cavities that develop in the arachnoid membrane, one of three layers of membrane that covers the spinal cord (and brain)
What structure needs to be preserved with Hemilaminectomy of cervical spine?
Dorsal spinous process
Hemilaminectomy can be considerably more challenging in the cervical spine. Why? (2)
location of the venous sinus and vertebral artery
Disc-Associated Wobbler Syndrome (DA-CSM)
Which breeds is this more commonly seen in? (2)
Dobermann
Dalmation
Disc-Associated Wobbler Syndrome (DA-CSM)
Mean age?
7-8 years
Disc-Associated Wobbler Syndrome (DA-CSM)
Other than the predisposed specific breeds, what breeds may it also be seen in?
Large breed e.g. labrador
What is the defining feature of Disc-Associated Wobbler Syndrome (DA-CSM)?
Hansen type II disc protrusion
Other than disc protrusion, what other features of Disc-Associated Wobbler Syndrome (DA-CSM) cause additional dorsal cord compression? (3)
- Hypertrophy of the dorsal longitudinal
- Hypertrophy of interarcuate ligaments,
- Often hypertrophy of the synovial membranes of the articular facets
What are primary abnormalities of bone associated wobbler syndrome associated with?
Developmental vertebral abnormalities
What are the most notable abnormalities noted with Bone-Associated Wobbler Syndrome? (6)
- stenosis of the vertebral canal
- malformations of the facet joints leading to OA,
- instability,
- secondary synovial membrane hypertrophy
- dorsolateral cord compression
- canal stenosis.
Most commonyl affected breed with Bone-Associated Wobbler Syndrome?
Great Dane
Bone-Associated Wobbler Syndrome; typical onset of age?
Young; under 3 yo
Several studies have demonstrated that improvement in, or at least stabilisation of, the neurological status of dogs with DA-CSM (disc-associated cervical spondylomyelopathy) is possible with conservative management. What does this entail? (2)
- Analgesia
- Exercise prevention
The surgical approach in dogs with wobbler syndrome depends on (2)
- Cause
- Location of compression
In young dogs with bone associated wobbler syndrome causing cervical stenotic myelopathy with compression due to articular facets overgrowth; what is recommended?
direct decompression with a dorsal laminectomy
Possible surgical options for disc-associated wobbler syndrome? (5)
- direct decompression (removal of the disc protrusion via a ventral slot),
- stabilisation (with or without distraction,
- concurrent removal of the protrusion,
- attempt to promote fusion of the vertebrae)
- cervical disc arthroplasty.
Broadly speaking; treatment options for disc associated with wobbler syndrome?
Conservative vs surgical
What advantages does a cervical disc arthroplasty provide for dogs with Wobbler syndrome? (3)
- It is a motion preservation technique.
- It provides spinal cord decompression and dynamic distraction.
- It can be used for the treatment of multiple cervical disc lesions, both adjacent and non-adjacent sites.
Define HNPE.
Hydrate nucleus pulposus Extrusion
HNPE differs from other forms of compressive myelopathy, why?
The extruded disc material is gelatinous or liquid rather than solid or calcified
Possible treatment options for; Hydrated Nucleus Pulposus Extrusion (HNPE)?
Conservative vs surgical
HNPE; does conservative or surgical have a better outcome?
Similar outcomes.
C1-C2 Luxation/Atlanto-Axial Instability.
What factors give a more favorable outcome with surgery? (3)
Age at onset of clinical abnormalities (less than 24 months),
Duration of clinical abnormalities (less than 10 months)
Alower preoperative neurological grading
C1-C2 Luxation/Atlanto-Axial Instability. What is a paramount with surgery and correlation to a good outcome?
Surgeon experience
C1-C2 Luxation/Atlanto-Axial Instability. What episodes may an o describe?
Seizure like
Possible complications following atlanto-axial stabilisation? (5)
- Pressure sores
- Fracture luxation
- Bronchopneumonia
- Laryngeal paralysis
- Seroma
