spinal surgical disease Flashcards
(9 cards)
What conditions can mimic spinal disease and must be ruled out?
Aortic thrombus, hindlimb orthopaedic diseases (e.g., hip dysplasia, bilateral cruciate disease), and abdominal pain misinterpreted as spinal pain.
How should spinal pain be differentiated from abdominal pain during examination?
Perform careful abdominal palpation without applying counter-pressure on the spine.
Why is deep pain perception assessment important in spinal evaluation?
It helps differentiate the severity of spinal lesions; absence of deep pain indicates a poorer prognosis and more urgent need for surgery.
Outline the spinal injury grading system and associated management.
Grade 1: Pain only – strict rest and analgesia.
Grade 2: Ambulatory paresis – conservative or non-urgent surgery.
Grade 3: Non-ambulatory paresis – surgery recommended, but not emergent if deep pain intact.
Grade 4: Deep pain positive plegia – immediate referral recommended.
Grade 5a: Deep pain negative plegia <48h – urgent surgery required.
Grade 5b: Deep pain negative plegia >48h – poor prognosis, surgery only for committed owners.
What precautions should be taken when imaging suspected IVDD cases?
Handle patients extremely carefully during anaesthesia to prevent further extrusion of disc material and worsening of spinal cord compression.
Why are steroids generally avoided in the emergency management of spinal disease?
Due to minimal evidence of benefit and the potential for significant adverse effects.
How often should neurological status be monitored in hospitalised spinal patients?
At least every 4 hours, including assessment of ambulation, bladder function, and deep pain perception.
Why should repeated deep pain testing be approached with caution?
Frequent noxious stimuli can cause substantial trauma to digits; it’s best to document which digits are used to avoid repeated trauma.
What imaging modality is definitive for differentiating types of spinal myelopathies?
MRI is required for definitive diagnosis of compressive vs non-compressive myelopathies like FCE or disc extrusions.
