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Spinal Surgery II > Wobbler Syndrome, Atlanto-Axial Instability and Other Conditions > Flashcards

Wobbler Syndrome, Atlanto-Axial Instability and Other Conditions Flashcards

1
Q

When is a dorsal laminectomy mainly used?

A

When ventral slot decompression procedure is not feasible or effective.

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2
Q

When might a ventral slot might not be appropriate; making dorsal laminectomy more suitable? (2)

A

Compression of spinal cord is:
- Dorsal
- Dorsolateral

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3
Q

Lesions a dorsal laminectomy can be indicated? (4)

A

Dorso-lateral compression

Arachnoid cyst

Neoplasia

Lateralised cervical lesion.

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4
Q

What are arachnoid cysts?

A

Fluid filled cavities that develop in the arachnoid membrane, one of three layers of membrane that covers the spinal cord (and brain)

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5
Q

What structure needs to be preserved with Hemilaminectomy of cervical spine?

A

Dorsal spinous process

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6
Q

Hemilaminectomy can be considerably more challenging in the cervical spine. Why? (2)

A

location of the venous sinus and vertebral artery

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7
Q

Disc-Associated Wobbler Syndrome (DA-CSM)
Which breeds is this more commonly seen in? (2)

A

Dobermann
Dalmation

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8
Q

Disc-Associated Wobbler Syndrome (DA-CSM)

Mean age?

A

7-8 years

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9
Q

Disc-Associated Wobbler Syndrome (DA-CSM)
Other than the predisposed specific breeds, what breeds may it also be seen in?

A

Large breed e.g. labrador

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10
Q

What is the defining feature of Disc-Associated Wobbler Syndrome (DA-CSM)?

A

Hansen type II disc protrusion

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11
Q

Other than disc protrusion, what other features of Disc-Associated Wobbler Syndrome (DA-CSM) cause additional dorsal cord compression? (3)

A
  • Hypertrophy of the dorsal longitudinal
  • Hypertrophy of interarcuate ligaments,
  • Often hypertrophy of the synovial membranes of the articular facets
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12
Q

What are primary abnormalities of bone associated wobbler syndrome associated with?

A

Developmental vertebral abnormalities

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13
Q

What are the most notable abnormalities noted with Bone-Associated Wobbler Syndrome? (6)

A
  • stenosis of the vertebral canal
  • malformations of the facet joints leading to OA,
  • instability,
  • secondary synovial membrane hypertrophy
  • dorsolateral cord compression
  • canal stenosis.
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14
Q

Most commonyl affected breed with Bone-Associated Wobbler Syndrome?

A

Great Dane

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15
Q

Bone-Associated Wobbler Syndrome; typical onset of age?

A

Young; under 3 yo

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16
Q

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)

A
  • Analgesia
  • Exercise prevention
17
Q

The surgical approach in dogs with wobbler syndrome depends on (2)

A
  • Cause
  • Location of compression
18
Q

In young dogs with bone associated wobbler syndrome causing cervical stenotic myelopathy with compression due to articular facets overgrowth; what is recommended?

A

direct decompression with a dorsal laminectomy

19
Q

Possible surgical options for disc-associated wobbler syndrome? (5)

A
  • 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.
20
Q

Broadly speaking; treatment options for disc associated with wobbler syndrome?

A

Conservative vs surgical

21
Q

What advantages does a cervical disc arthroplasty provide for dogs with Wobbler syndrome? (3)

A
  • 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.
22
Q

Define HNPE.

A

Hydrate nucleus pulposus Extrusion

23
Q

HNPE differs from other forms of compressive myelopathy, why?

A

The extruded disc material is gelatinous or liquid rather than solid or calcified

24
Q

Possible treatment options for; Hydrated Nucleus Pulposus Extrusion (HNPE)?

A

Conservative vs surgical

25
Q

HNPE; does conservative or surgical have a better outcome?

A

Similar outcomes.

26
Q

C1-C2 Luxation/Atlanto-Axial Instability.
What factors give a more favorable outcome with surgery? (3)

A

Age at onset of clinical abnormalities (less than 24 months),
Duration of clinical abnormalities (less than 10 months)
Alower preoperative neurological grading

27
Q

C1-C2 Luxation/Atlanto-Axial Instability. What is a paramount with surgery and correlation to a good outcome?

A

Surgeon experience

28
Q

C1-C2 Luxation/Atlanto-Axial Instability. What episodes may an o describe?

A

Seizure like

29
Q

Possible complications following atlanto-axial stabilisation? (5)

A
  • Pressure sores
  • Fracture luxation
  • Bronchopneumonia
  • Laryngeal paralysis
  • Seroma

Spinal Surgery II (7 decks)

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