Extrusão de disco intervertebral caudal (coccígea) em um Basset Hound: primeiro relato de caso / First report of caudal intervertebral disk extrusion in a Basset Hound

Relata-se o primeiro caso no Brasil de doença do disco intervertebral (Hansen tipo I) entre as vértebras caudais (coccígeas) em uma cadela Basset Hound com seis anos de idade, castrada, pesando 16kg e com histórico de dor durante defecação e manipulação da região pélvica associada à inabilidade de mover, elevar ou abanar a cauda. Na radiografia simples, observou-se opacidade do forame intervertebral entre a quarta e a quinta vértebra caudal. O animal foi submetido à laminectomia dorsal modificada, seguida de fenestração do disco intervertebral afetado. Decorridos 15 dias da cirurgia, a paciente não demonstrava sinais de dor ao defecar e realizava movimentos de abano de cauda, mas ainda com desconforto na palpação e sem elevação da cauda acima da coluna vertebral, o que foi resolvido após 30 dias do procedimento cirúrgico. A relevância do caso está na inclusão, mesmo que rara, da doença do disco intervertebral caudal no diagnóstico diferencial em cães com dor durante a defecação e manipulação da cauda, sendo o exame radiográfico uma ferramenta auxiliar importante para o diagnóstico definitivo e o plano terapêutico.(AU)

We report here the first case in Brazil of an intervertebral disc disease (Hansen type I) between the caudal vertebrae (coccygeal) in a six-year-old Basset Hound dog, castrated, weighing 16 kg and history of pain during defecation and manipulation of the pelvic region, associated with the inability to move, raise and shake its tail. In the radiography survey, an opacity of the intervertebral foramen between the fourth and fifth caudal vertebra was observed. The animal underwent a modified dorsal laminectomy followed by fenestration of the affected intervertebral disc. After 15 days following surgery, the patient showed no signs of pain when defecating and was able to perform the tail wag movements, but with discomfort on palpation and could not rise the tail high up the spine, which was resolved after 30 days of surgery. The relevance of this report is the inclusion, even if rare, of the caudal intervertebral disc disease in the differential diagnosis in dogs with pain during defecation and handling of the tail, and the radiographic survey is an important auxiliary tool for definitive diagnosis and treatment plan for this disease.(AU)

Avaliação clínica de cães com doença do disco intervertebral (Hansen tipo I) submetidos à descompressão cirúrgica: 110 casos / Clinical evaluation of dogs with intervertebral disc disease (Hansen type I) submitted to surgical decompression: 110 cases

O objetivo deste estudo foi identificar cães com doença do disco intervertebral toracolombar (Hansen tipo I) submetidos ao tratamento cirúrgico em um serviço de rotina em neurologia de um hospital veterinário universitário no período de 2006 a 2014, e obter informações a respeito da idade, do sexo, da raça, local da extrusão, interpretação da mielografia, avaliação dos graus de disfunção neurológica, recuperação funcional desses cães e observar a ocorrência de recidiva dos sinais clínicos da doença. A raça mais frequente foi Dachshund (69%), seguida dos cães sem raça definida (14,5%). Os locais mais afetados foram entre T12-T13 (31,9%) e L1-L2 (19,1%). Dos 110 cães, 74 (67,3%) tiveram melhora dos sinais clínicos após o procedimento cirúrgico, sendo 54 (49,1%) considerados satisfatórios e 20 (18,2%), parcialmente satisfatórios. Destes cães, seis (8,1%) cães estavam em grau II, 19 (25,7%) em grau III, 35 (47,3%) em grau IV e 14 (18,9%) em grau V. Pode-se concluir que o tratamento cirúrgico promove recuperação funcional satisfatória na maioria dos cães com extrusão de disco toracolombar. O prognóstico para recuperação funcional após o tratamento cirúrgico é tanto melhor quanto menor for o grau de disfunção neurológica e o percentual de recidiva é baixo em animais submetidos a este tipo de terapia.(AU)

The aim of this study was to identify dogs with thoracolumbar intervertebral disc disease (Hansen type I) submitted for surgical treatment on a routine service in neurology in a university veterinary hospital in 2006-2014, and to get information about age, sex, breed, site of extrusion, interpretation of myelography, evaluation of the degree of neurological dysfunction, functional recovery of these dogs, and to verify the recurrence of clinical signs of disease. The most common breed was Dachshund (69%), followed by mixed breed (14.5%). The most affected sites were between T12-T13 (31.9%) and L1-L2 (19.1%). Of the 110 dogs, 74 (67.3%) improved clinical signs after surgery, 54 (49.1%) satisfactory and 20 (18.2%), in part satisfactory. From these dogs, six (8.1%) dogs were in grade II, 19 (25.7%) in grade III, 35 (47.3%) in grade IV, and 14 (18.9%) in grade V. It can be concluded that satisfactory surgical treatment promotes functional recovery in most dogs with thoracolumbar disk extrusion. The prognosis for functional recovery after surgical treatment is better the lower the degree of neurological dysfunction and the recurrence percentage is lower in dogs subjected to this type of therapy.(AU)

Aplastic articular facets in a dog with intervertebral disk rupture of the 12th to 13th thoracic vertebral space.

A 6-year-old, female spayed Pomeranian was presented with acute hind-limb paraplegia with the presence of deep pain perception and urinary incontinence. Myelography showed a Hansen type I herniation of the12th to 13th thoracic intervertebral space (T(12-13)). Articular facets of the T(12-13) and T(13) to first lumbar vertebra (L(1)) were absent. The spinal cord was decompressed using a bilateral T(12-13) modified lateral hemilaminectomy (pediculectomy). The aplastic sites were associated with minimal instability of the vertebral column, and stabilization of the vertebral column was not required. Familiarity with this condition is important, because articular facet aplasia may cause vertebral instability and may require an adjusted surgical approach or vertebral reduction and fusion following decompression.

A retrospective comparison of cervical intervertebral disk disease in nonchondrodystrophic large dogs versus small dogs.

Medical records of 144 small-breed dogs (< or =15 kg) and 46 medium- to large-breed dogs (>15 kg) with surgically confirmed, Hansen type I, cervical intervertebral disk extrusions were reviewed. The most common clinical presentation was cervical hyperesthesia. The most common sites affected were the second (C(2)) to third (C(3)) cervical intervertebral disk space in small-breed dogs and the sixth (C(6)) to seventh (C(7)) cervical intervertebral disk space in the larger dogs. Following surgery, 99% of the dogs had resolution of cervical hyperesthesia and were able to ambulate unassisted. Seven (4%) dogs required a second surgery; four of these were large-breed dogs.

Hansen type I disk disease at T1-2 in a dachshund.

A 7-year-old Dachshund was presented with chronic left thoracic limb lameness and acute neurological deficits to the hind limbs following trauma. A lesion was suspected between C7 and T2 on the basis of neurological examinations. Radiography and myelography identified a calcified intervertebral disk at C7-T1 and an extradural unilateral compressive lesion at T1-2. Computed tomography scans of the cranial thoracic spine revealed extrusion of disk material from the T1-2 intervertebral space resulting in marked spinal cord compression. Intervertebral disk disease is rarely reported at this location. The neurological condition deteriorated after a second myelogram, which was done to examine the thoracolumbar spine. A modified dorsal decompression of T1-2 was performed. The dog was euthanased due to further neurological deterioration 8 days after surgery.

Hemilaminectomy for the treatment of thoracolumbar disc disease in the dog: a follow-up study of 40 cases.

A study was made of dogs with Hansen type I thoracolumbar disc extrusions that had been treated by hemilaminectomy and fenestration of the affected disc. Follow-up information was available for 40 dogs undergoing treatment over a five-year period. The follow-up period ranged from 12 to 72 months (mean 34 months). The case details and the results of treatment of these 40 dogs are presented. All dogs were graded according to the degree of neurological dysfunction at the time of initial presentation and at the conclusion of the study period. Twenty-seven dogs (68 per cent) had no detectable signs of neurological dysfunction or thoracolumbar pain at the final assessment and a further eight dogs (20 per cent) had mild ambulatory paraparesis but were regarded by their owners as functional pets. Recurrence of neurological signs consistent with thoracolumbar disc disease was seen in five dogs (13 per cent) and was successfully resolved completely in one of three dogs that were treated.

Incidence of contralateral versus ipsilateral neurological signs associated with lateralised Hansen type I disc extrusion.

Asymmetrical neurological signs were noted in 50 dogs presenting with Hansen type I thoracolumbar disc extrusion. Thoracolumbar myelograms and surgical decompression were performed in all cases. Dogs were divided into two groups (acute and chronic) based on the duration of clinical signs prior to presentation to the University of Georgia. Lateralising extradural cord compressive lesions were noted on all myelograms. In the acute group, 35 per cent of the dogs had asymmetrical neurological signs contralateral to the myelographic and surgical lesion, while in the chronic group only 11 per cent had neurological signs contralateral to the lesion. There was found to be no significant difference in frequency of contralateral asymmetrical clinical signs between the two groups (Fischer's exact test; P = 0.095). The high frequency of contralateral signs documents the importance of thoracolumbar myelography for accurate localisation of the disc material before decompressive surgery.

Thoracolumbar intervertebral disk disease in large, nonchondrodystrophic dogs: a retrospective study.

Medical records of 62 large, nonchondrodystrophic dogs diagnosed with thoracolumbar intervertebral disk disease between March 1986 and February 1996 were reviewed. Fifty-seven (92%), primarily mixed-breed dogs (mean age, 6.6 years) had Hansen type I disease. Fifty-eight percent had acute onset. The interspace between the first (L1) and second (L2) lumbar vertebrae was affected most commonly. The outcomes of the 48 dogs available for follow-up after undergoing laminectomies were evaluated. Surgical success rate and mean time to walking for nonambulatory dogs with deep pain perception was 90% and seven weeks, respectively. Thirty-nine percent had residual deficits. Following surgery, 12% had recurrence of disk protrusion/extrusion at a different site.