DOI QR코드

DOI QR Code

Preliminary study of presumptive intradural-intramedullary intervertebral disc extrusion in 20 dogs

  • Kim, Jaehwan (Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University) ;
  • Kim, Hyoju (Helix Animal Medical Center) ;
  • Hwang, Jeongyeon (Helix Animal Medical Center) ;
  • Eom, Kidong (Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University)
  • Received : 2019.09.05
  • Accepted : 2020.04.24
  • Published : 2020.07.31

Abstract

Background: Intradural-intramedullary intervertebral disc extrusion (IIVDE) is a rare condition of intervertebral disc disease. However, the diagnosis of IIVDE is challenging because the prognosis and imaging characteristics are poorly characterized. Objectives: We aimed to describe the clinical and imaging characteristics of tentatively diagnosed IIVDE in dogs to assess the prognostic utility of neurological grade and magnetic resonance imaging (MRI) findings. Methods: Twenty dogs were included in this retrospective cohort study. Results: Nonchondrodystrophic breeds (n = 16) were more predisposed than chondrodystrophic breeds. Most dogs showed acute onset of clinical signs. Neurological examination at admission showed predominant non-ambulatory paraparesis (n = 9); paresis (n = 16) was confirmed more frequently than paralysis (n = 4). Follow-up neurological examination results were only available for 11 dogs, ten of whom showed neurological improvement and 8 showed successful outcomes at 1 month. The characteristic MRI findings include thoracic vertebra (T)2 hyperintense, T1 hypointense, intramedullary linear tracts with reduced disc volume, and cleft of the annulus fibrosus. None of the MRI measurements were significantly correlated with neurological grade at admission. Neurological grade did not differ according to the presence of parenchymal hemorrhage, parenchymal contrast enhancement, and meningeal contrast enhancement. Neurological grades at admission showed a statistical correlation with those observed at the 1-month follow-up (r = 0.814, p = 0.02). Conclusions: IIVDE is a rare form of disc extrusion commonly experienced after physical activity or trauma and most frequently affects the cranial-cervical and thoracolumbar regions of nonchondrodystrophic dog breeds. Neurological score at admission emerged as a more useful prognostic indicator than MRI findings in dogs with suspected IIVDE.

Keywords

References

  1. Brisson BA. Intervertebral disc disease in dogs. Vet Clin North Am Small Anim Pract. 2010;40(5):829-858. https://doi.org/10.1016/j.cvsm.2010.06.001
  2. Jeffery ND, Levine JM, Olby NJ, Stein VM. Intervertebral disk degeneration in dogs: consequences, diagnosis, treatment, and future directions. J Vet Intern Med. 2013;27(6):1318-1333. https://doi.org/10.1111/jvim.12183
  3. Heblinski N, Schmokel H. Our approach to intervertebral disc disease in dogs: a review of the current literature. J Vet Sci Med Diagn. 2018;7(1):1-9.
  4. De Risio L. A review of fibrocartilaginous embolic myelopathy and different types of peracute non-compressive intervertebral disk extrusions in dogs and cats. Front Vet Sci. 2015;2:24. https://doi.org/10.3389/fvets.2015.00024
  5. Sanders SG, Bagley RS, Gavin PR. Intramedullary spinal cord damage associated with intervertebral disk material in a dog. J Am Vet Med Assoc. 2002;221(11):1594-1596. https://doi.org/10.2460/javma.2002.221.1594
  6. Kitagawa M, Okada M, Kanayama K, Sakai T. Identification of ventrolateral intramedullary intervertebral disc herniation in a dog. J S Afr Vet Assoc. 2012;83(1):103.
  7. McKee WM, Downes CJ. Rupture of the dura mater in two dogs caused by the peracute extrusion of a cervical disc. Vet Rec. 2008;162(15):479-481. https://doi.org/10.1136/vr.162.15.479
  8. Roush JK, Douglass JP, Hertzke D, Kennedy GA. Traumatic dural laceration in a racing greyhound. Vet Radiol Ultrasound. 1992;33(1):22-24. https://doi.org/10.1111/j.1740-8261.1992.tb01951.x
  9. McConnell JF, Garosi LS. Intramedullary intervertebral disk extrusion in a cat. Vet Radiol Ultrasound. 2004;45(4):327-330. https://doi.org/10.1111/j.1740-8261.2004.04062.x
  10. Alisauskaite N, Spitzbarth I, Baumgartner W, Dziallas P, Kramer S, Dening R, et al. Chronic posttraumatic intramedullary lesions in dogs, a translational model. PLoS One. 2017;12(11):e0187746. https://doi.org/10.1371/journal.pone.0187746
  11. Kent M, Holmes S, Cohen E, Sakals S, Roach W, Platt S, et al. Imaging diagnosis-CT myelography in a dog with intramedullary intervertebral disc herniation. Vet Radiol Ultrasound. 2011;52(2):185-187. https://doi.org/10.1111/j.1740-8261.2010.01755.x
  12. Liptak JM, Allan GS, Krockenberger MB, Davis PE, Malik R. Radiographic diagnosis: intramedullary extrusion of an intervertebral disc. Vet Radiol Ultrasound. 2002;43(3):272-274. https://doi.org/10.1111/j.1740-8261.2002.tb01002.x
  13. Tamura S, Doi S, Tamura Y, Takahashi K, Enomoto H, Ozawa T, et al. Thoracolumbar intradural disc herniation in eight dogs: clinical, low-field magnetic resonance imaging, and computed tomographic myelography findings. Vet Radiol Ultrasound. 2015;56(2):160-167. https://doi.org/10.1111/vru.12213
  14. Fenn J, Drees R, Volk HA, De Decker S. Comparison of clinical signs and outcomes between dogs with presumptive ischemic myelopathy and dogs with acute noncompressive nucleus pulposus extrusion. J Am Vet Med Assoc. 2016;249(7):767-775. https://doi.org/10.2460/javma.249.7.767
  15. Henke D, Gorgas D, Flegel T, Vandevelde M, Lang J, Doherr MG, et al. Magnetic resonance imaging findings in dogs with traumatic intervertebral disk extrusion with or without spinal cord compression: 31 cases (2006-2010). J Am Vet Med Assoc. 2013;242(2):217-222. https://doi.org/10.2460/javma.242.2.217
  16. De Risio L, Adams V, Dennis R, McConnell FJ. Association of clinical and magnetic resonance imaging findings with outcome in dogs with presumptive acute noncompressive nucleus pulposus extrusion: 42 cases (2000-2007). J Am Vet Med Assoc. 2009;234(4):495-504. https://doi.org/10.2460/javma.234.4.495
  17. Mari L, Behr S, Shea A, Dominguez E, Johnson PJ, Ekiri A, et al. Outcome comparison in dogs with a presumptive diagnosis of thoracolumbar fibrocartilaginous embolic myelopathy and acute non-compressive nucleus pulposus extrusion. Vet Rec. 2017;181(11):293. https://doi.org/10.1136/vr.104090
  18. De Risio L, Adams V, Dennis R, McConnell FJ, Platt SR. Association of clinical and magnetic resonance imaging findings with outcome in dogs suspected to have ischemic myelopathy: 50 cases (2000-2006). J Am Vet Med Assoc. 2008;233(1):129-135. https://doi.org/10.2460/javma.233.1.129
  19. Sample SJ, Racette MA, Hans EC, Volstad NJ, Holzman G, Bleedorn JA, et al. Radiographic and magnetic resonance imaging predicts severity of cruciate ligament fiber damage and synovitis in dogs with cranial cruciate ligament rupture. PLoS One. 2017;12(6):e0178086. https://doi.org/10.1371/journal.pone.0178086
  20. Chokshi FH, Sadigh G, Carpenter W, Allen JW. Diagnostic quality of 3D T2-SPACE compared with T2-FSE in the evaluation of cervical spine MRI anatomy. AJNR Am J Neuroradiol. 2017;38(4):846-850. https://doi.org/10.3174/ajnr.A5080