Dataset Information

Differences in Epidural Pathology between Cervical and Thoracolumbar Intervertebral Disk Extrusions in Dogs.

ABSTRACT: Although the basic pathophysiology is the same in both cervical and thoracolumbar intervertebral disk (IVD) extrusions, there are considerable clinical differences that have only been partially explained.The epidural inflammatory response differs between cervical and thoracolumbar IVD extrusions.Fifty-five dogs with cervical and 80 dogs with thoracolumbar IVD extrusions.Clinical data and histopathologic variables were investigated. Associations between severity of epidural inflammation and clinical and pathologic variables, impact of chondrodystrophic phenotype, and localization (cervical versus thoracolumbar) were evaluated statistically.Dogs with cervical IVD extrusion were significantly older (P < 0.001), had less severe and longer duration of neurologic signs (both P < 0.001), were more painful (P = 0.038), and had a better outcome (P = 0.005) than dogs with a thoracolumbar IVD extrusion. On histopathology, cervical epidural material had less severe calcification (P = 0.002) and inflammation (P < 0.001). No significant differences regarding chondrodystrophic phenotype were found.There was significantly less intensive inflammatory response in the cervical epidural space. This observation correlated positively with less nucleus pulposus calcification in cervical extrusions indicating biochemical, metabolic, and biomechanical differences between the 2 locations, which remain to be characterized in future studies.

SUBMITTER: Zuger L

PROVIDER: S-EPMC5787202 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Differences in Epidural Pathology between Cervical and Thoracolumbar Intervertebral Disk Extrusions in Dogs.

Züger L L Fadda A A Oevermann A A Forterre F F Vandevelde M M Henke D D

Journal of veterinary internal medicine 20171130 1

<h4>Background</h4>Although the basic pathophysiology is the same in both cervical and thoracolumbar intervertebral disk (IVD) extrusions, there are considerable clinical differences that have only been partially explained.<h4>Hypothesis/objectives</h4>The epidural inflammatory response differs between cervical and thoracolumbar IVD extrusions.<h4>Animals</h4>Fifty-five dogs with cervical and 80 dogs with thoracolumbar IVD extrusions.<h4>Methods</h4>Clinical data and histopathologic variables we ...[more]

PMID: 29194770

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Project description:This review discusses terminology, pathological, clinical, and magnetic resonance imaging (MRI) findings, treatment, outcome, and prognostic factors of fibrocartilaginous embolic myelopathy (FCEM), acute non-compressive nucleus pulposus extrusion (ANNPE), and intradural/intramedullary intervertebral disk extrusion (IIVDE). FCEM, ANNPE, and IIVDE have a similar clinical presentation characterized by peracute onset of neurological dysfunction that is generally non-progressive after the initial 24-48?h. Differentiating between these conditions can be challenging, however, certain clinical and imaging findings can help. FCEM can occur in both adult and immature animals, whereas ANNPE or IIVDE have been reported only in animals older than 1?year. In dogs, ANNPE and IIVDE most commonly occur in the intervertebral disk spaces between T12 and L2, whereas FCEM has not such site predilection. In cats, FCEM occurs more frequently in the cervical spinal cord than in other locations. Data on cats with ANNPE and IIVDE are limited. Optimal MRI definition and experience in neuroimaging can help identify the findings that allow differentiation between FCEM, ANNPE, and IIVDE. In animals with ANNPE and IIVDE, the affected intervertebral disk space is often narrowed and the focal area of intramedullary hyperintensity on T2-weighted images is located above the affected intervertebral disk space. In dogs with ANNPE signal changes associated with the extruded nucleus pulposus and epidural fat disruption can be identified in the epidural space dorsal to the affected intervertebral disk. Identification of a linear tract (predominantly hyperintense on T2-weighted images, iso to hypointense on T1-weighted images and hypointense on T2*-weighted gradient recall echo images) extending from the intervertebral disk into the spinal cord parenchyma is highly suggestive of IIVDE. Treatment of FCEM and ANNPE is conservative. Dogs reported with IIVDE have been managed either conservatively or surgically. Prognostic factors include degree of neurological dysfunction (particularly loss of nociception) and disease-specific MRI variables.

Dataset Information

Differences in Epidural Pathology between Cervical and Thoracolumbar Intervertebral Disk Extrusions in Dogs.

Publications

Differences in Epidural Pathology between Cervical and Thoracolumbar Intervertebral Disk Extrusions in Dogs.

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