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Flashcards in 33.LS_spine Deck (17):
1

termination of the spinal cord in large dogs, average dogs, and small dogs/cats

large to giant breeds--L4dogs < 15 kg --L6toy breeds/cats--L7dural sac continues for 1-2 cm caudally

2

pathological changes associated with degenerative LS stenosis and contributing spinal compression (figure 33-3)

1. buldging disc or annulus fibrosis2. thickening of dorsal annulus fibrosis3. mechanical instability with sublux/lux L7-S1 (can see spondylosis deformans)4. osteophyte around article processes/joints5. thickened joint capsule6. thickened ligamentum flavum

3

define intermittent claudication

clinical signs associated with LS diseaseparoxysmal manifestations consistent with lower back or limb cramping, pain or weakness resulting from vascular compromise or compression of nerve roots of the caudal equina

4

define patellar pseudohyperreflexia

dog with sciatic nerve deficits should be LMNBUT extensor or UMN nerves still intact leading to falsely exaggerated patellar reflex bc of loss of antagonistic muscle groups to the extensor m group

5

ddx for LS disease

1. discospondylitis2. meningitis/meningomyelitis3. traumatic--fracture/luxation4. anomaly/malformation5. ortho dx --hips, ccl, mpl, iliopsoas, gracilis myopathy6. neoplasia7. polymyositis8. polyarthritis9. polyneuropathy10. degenerative myelopathy11. ischemic neuropathy12. prostatic, urethral, anorectal diseases

6

most informative wave on EMG studies of LS disease

F wave which evaluates motor pathways of ventral nerve roots and peripheral motor axons

7

radiographic imaging studies for LS disease

1. survey films2. linear tomography3. venography4. myelography5. discography/epidurography__________________________6. CT (extended will accentuate compression)7. MRI

8

where is the most common location of osteochondrosis lesion to be seen in the LS spine

DORSAL aspect of cranial S1 end plate(figure 33-7)

9

percentage of good outcomes with medical mgmt 2-4 months

50%

10

disc related LS stenosis treated with epidural 1 mg/kg methylprednisolone outcome

79% clinical improvement3 injections given every 2weeks and 6 weeks following first injectionmethylprednisolone 1 mg/kg epidurally w fluoro guidance(VCOT 2009)

11

most common surgical approaches for LS disease

**1. dorsal decompression L7-S1 +/- discectomy**2. dorsal decompression L7-S1 +/- distraction and fusion3. foraminotomy--endoscopically assisted, thru minilaminectomy--thru ilial window (avoids dorsal destabilization)

12

anatomic borders for dorsal laminectomy of L7-S1

lateral limits are the axial border of the articular processcranial and caudal limits are performed until normal structures are visible

13

distraction of L7-S1

performed if overriding of L7-S1 articulation is seen, collapse and motion are ID'd during sx1. distract b4 fusion with lamina spreaders (distract until normal position of L7-S1 facets)2. debride cartilage3. cancellous bone graft from ilial wing placed4. stabilize with pins PMMA, lag screws, SOP, intervertebral bolt (spondylofitz bolt) w pins/screws PMMA

14

direction of cortical screw insertion for stabilization of L7-S1

fuse cd L7 process to cranial S1 processcortical screw should be placed in lag fashion (risk fracture of process if screw is too large)directed ventrolateral 30-45 degrees

15

surgical success rates of LS laminectomy and discectomy

73-79% (~75%)

16

recurrence of clinical signs for LS patients withlaminectomy and discectomy

18% btwn 6-36 months

17

T/Fthe duration of preoperative urinary incontinence but NOT duration of fecal incontinence was the only variable that influenced surgical outcome of LS patients

TRUEpoor outcome was 5.88 times higher in LS dogs with urinary incontinence for longer than 1 month compared to dogs with urinary continence for less than 1 month

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