Intradural Disc Extrusion in a Dog

Authors

  • Angel Ripplinger Programa de Pós-Graduação em Medicina Veterinária, Serviço de Neurologia e Neurocirurgia, HVU, Centro de Ciências Rurais (CCR), HVU Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
  • Graciane Aiello Programa de Pós-Graduação em Medicina Veterinária, Serviço de Neurologia e Neurocirurgia, HVU, Centro de Ciências Rurais (CCR), HVU Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
  • Mathias Reginatto Wrzesinski Programa de Pós-Graduação em Medicina Veterinária, Serviço de Neurologia e Neurocirurgia, HVU, Centro de Ciências Rurais (CCR), HVU Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
  • Marcelo Luís Schwab Programa de Pós-Graduação em Medicina Veterinária, Serviço de Neurologia e Neurocirurgia, HVU, Centro de Ciências Rurais (CCR), HVU Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
  • Júlia da Silva Rauber Programa de Pós-Graduação em Medicina Veterinária, Serviço de Neurologia e Neurocirurgia, HVU, Centro de Ciências Rurais (CCR), HVU Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
  • Dênis Antonio Ferrarin Programa de Pós-Graduação em Medicina Veterinária, Serviço de Neurologia e Neurocirurgia, HVU, Centro de Ciências Rurais (CCR), HVU Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
  • Julya Nathalya Chaves Programa de Pós-Graduação em Medicina Veterinária, Serviço de Neurologia e Neurocirurgia, HVU, Centro de Ciências Rurais (CCR), HVU Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
  • Alexandre Mazzanti Universidade Federal de SantPrograma de Pós-Graduação em Medicina Veterinária, Serviço de Neurologia e Neurocirurgia, HVU, Centro de Ciências Rurais (CCR), HVU Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.a Maria http://orcid.org/0000-0002-1330-2142

DOI:

https://doi.org/10.22456/1679-9216.100838

Abstract

Background: Intervertebral disc extrusion is an important cause of spinal cord dysfunction in dogs. Intradural localization of the extruded disc material is rare, and is generally associated with a traumatic event or with recurrence of disc extrusion at a previously affected site. We report the clinical presentation, diagnostic workup, and treatment of a dog with intradural intervertebral disc extrusion not preceded by a traumatic event.

Case:  A 6-year-old male Dachshund was referred for neurological evaluation due to acute onset of hind-end paralysis preceded by claudication of the left hindlimb. The patient had been receiving conservative treatment to no effect. Neurological examination revealed asymmetric non-ambulatory paraparesis, absence of postural reactions and decreased muscle tone in both hindlimbs, a bilaterally diminished patellar reflex, and a hindlimb withdrawal reflex which was normal on the right and greatly diminished to absent on the left. The lower back was tender to epaxial palpation. Plain radiographs of the lumbar spine in the lateral projection showed calcified material within the spinal canal between the third and fourth lumbar vertebrae. Myelography was suggestively abnormal at the same level, with epidural leakage of contrast at L3-L4. Considering the clinical history, breed, age, neurological signs, and radiographic findings, intervertebral disc disease was suspected despite the inconclusive myelography findings. A dorsolateral lumbar hemilaminectomy was performed. Intraoperatively, the diagnosis was confirmed by visualization of a discolored spinal cord and absence of extradural material. The intradural space was accessed via durotomy. A firm, straw-yellow material was seen compressing the spinal cord and removed. Subsequent histopathological examination confirmed that this material consisted of extruded intervertebral disc contents. Postoperatively, the patient underwent physiotherapy and achieved a satisfactory recovery.

Discussion: 

The most common cause of paraparesis in chondrodystrophic dog breeds is intervertebral disc extrusion. Intradural extrusion of the intervertebral disc is a rare phenomenon, often associated with vigorous exercise that causes laceration of the dura mater, allowing penetration of disc material into the intradural space. Although there were no classic signs of intervertebral disc disease on plain radiography, radiopaque material was visible within the spinal canal, which can occur in cases of calcified intervertebral disc extrusion. Myelography was inconclusive, but the decision was made to operate nevertheless, considering that the patient had not responded to conservative treatment and that surgical
treatment is the most suitable approach for dogs with non-ambulatory paraparesis or paraplegia secondary to intervertebral disc extrusion. The surgical technique consisted of a hemilaminectomy and durotomy. Our diagnostic suspicion was confirmed intraoperatively, as in most cases of intradural disc extrusion in humans. Intradural disc extrusion is an
uncommon phenomenon in dogs, and the diagnosis is usually only established intraoperatively. This unusual variant of intravertebral disc disease should be included in the differential diagnosis of spinal cord dysfunction in chondrodystrophic breeds, even in the absence of a history of trauma or preexisting intervertebral disc disease. Clinical treatment appears ineffective in these cases. Conversely, surgical treatment can yield good outcomes, and even functional recovery.

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References

Arnold P.M. & Wakwaya Y.T. 2011. Intradural disk herniation at L1-L2: reporto f two cases. The Journal of Spinal Cord Medicine. 34(3): 312-314. DOI: 10.1179/2045772311Y.0000000007

Barnoon I., Chai O., Srugo I., Peeri D., Konstantin L., Brenner O. & Shamir M.H. 2012. Spontaneous intradural disc herniation with focal distension of the subarachnoid space in a dog. The Canadian Veterinary Journal. 53(11): 1191-1194.

Bergknut N., Egenvall A., Hagman R., Gustas P., Hazewinkel H.A., Meji B.P. & Lagerstedt A.S. 2012. Incidence of intervertebral disk degeneration-related diseases and associated mortality rates in dogs. Journal of American Veterinary Medical Association. 240(11): 1300-1309. DOI: 10.2460/javma.240.11.1300

Besalti O., Ozak A., Pekcan Z., Tong S., Eminaga S. & Tacal T. 2015. The role of extruded disk material in thoracolumbar intervertebral disk disease: A retrospective study in 40 dogs. The Canadian Veterinary Journal. 46(9): 814-820.

Brisson B.A. 2010. Intervertebral disc disease in dogs. Veterinary Clinics of North America Small Animal Practice. 40(5): 829-258. DOI: 10.1016/j.cvsm.2010.06.001

Coates J.R. 2000. Intervertebral disk disease. Veterinary Clinics of North America Small Animal Practice. 30(1): 77-110. DOI: 10.1016/s0195-5616(00)50004-7

De Lahunta A., Glass E. & Kent M. 2015. Small animal spinal cord disease. In: Veterinary Neuroanatomy and Clinical Neurology. 4th edn. St. Louis: Elsevier, pp. 257-303.

Hansen H.J. 1952. A pathologic-anatomical study on disc degeneration in dog: with special reference to the so-called enchondrosis intervertebralis. Acta Orthopaedica Scandinavica. 23(sup11): 1-130. DOI: 10.3109/ort.1952.23.suppl-11.01

Hay C.W. & Muir P. 2000. Tearing of the dura mater in three dogs. Veterinary Record. 146 (10): 279-282. DOI: 10.1136/vr.146.10.279

Jeffery N.D., Levine J.M., Olby N.J. & Stein V.M. 2013. Intervertebral disk degeneration in dogs: consequences, diagnosis, treatment, and future directions. Journal of Veterinary Internal Medicine. 27(6): 1318-1333. DOI: 10.1111/jvim.12183

Lamb C.R., Nicholls A., Targett M. & Mannion P. 2002. Accuracy of survey radiographic diagnosis of intervertebral disc protrusion in dogs. Veterinary Radiology and Ultrasound. 43(3): 222-228. DOI: 10.1111/j.1740-8261.2002.tb00994.x

Liptak J.M., Allan G.S., Krockenberger M.B., Davis P.E. & Malik R. 2002. Radiographic diagnosis: intramedullary extrusion of an intervertebral disc. Veterinary Radiology and Ultrasound. 43(3): 272-274. DOI: 10.1111/j.1740-8261.2002.tb01002.x

Liu C., Huang C., Lin C. & Liu K. 2011. Intradural disc herniation at L5 level mimicking an intradural spinal tumor. European Spine Journal. 20(Suppl 2): 326-329. DOI: 10.1007/s00586-011-1772-z

Mckee W.M. & Downers C.J. 2008. Rupture of the dura mater in two dogs caused by the peracute extrusion of a cervical disc. Veterinary Record. 162(15): 479-481. DOI: 10.1136/vr.162.15.479

Montavon P.M., Weber U., Guscetti F. & Suter P.F. 1990. What is your diagnosis? Swelling of spinal cord associated with dural tear between segments T13 and L1. Journal of American Veterinary Medical Association. 196(5): 783-784.

Moore S.A., Early P.J. & Hettlich B.F. 2016. Practice patterns in the management of acute intervertebral disc herniation in dogs. Journal of Small Animal Practice. 57(8): 409-415. DOI: 10.1111/jsap.12496

Olby N.J., Dyce J. & Houlton J.E.F. 1994. Correlation of plain radiographic and lumbar myelographic findings with surgical findings in thoracolumbar disc disease. Journal of Small Animal Practice. 35(7): 345-350. DOI: 10.1111/j.1748-5827.1994.tb01713.x

Öztürk A., Avci E., Yazgan P., Torun F., Yücetaş S. & Karabağ H. 2007. Intradural herniation of intervertebral disc at the level of lumbar 1-lumbar 2. Turkish Neurosurgery. 17(2):134-137.

Packer R.A., Frank P.M. & Chambers J.N. 2004. Traumatic subarachnoid-pleural fistula in a dog. Veterinary Radiology and Ultrasound. 45(6): 523-527. DOI: 10.1111/j.1740-8261.2004.04089.x

Poncelet L. & Heimann M. 2011. Intradural vertebral disc herniation in a dog. Veterinary Record. 168(18): 486a. DOI: 10.1136/vr.c6740.

Roush J.K., Douglas J.P., Hertzke D. & Kennedy G.A. 1992. Traumatic dural laceration in a Racing Greyhound. Veterinary Radiology and Ultrasound. 33(1): 22-24. DOI: 10.1111/j.1740-8261.1992.tb01951.x

Sharp N.J.H. & Wheeler S.J. 2005. Thoracolumbar disc disease. In: Small Animal Spinal Disorders Diagnosis and Surgery. 2nd edn. London: Elsevier, pp.121-160.

Shores A. 2017. Thoracolumbar hemilaminectomy. In: Shores A. & Brisson B.A. (Eds). Current Techniques in Canine and Feline Neurosurgery. Hoboken: John Wiley & Sons, pp. 179-182.

Tamura S., Doi S., Tamura Y., Takahashi K., Enomoto H., Ozawa T. & Uchida K. 2015. Thoracolumbar intradural disc herniation in eight dogs: clinical, low-field magnetic resonance imaging, and computed tomographic myelography findings. Veterinary Radiology and Ultrasound. 56(2): 160-167. DOI: 10.1111/vru.12213

Yarrow T.G. & Jeffery N.D. 2000. Dura mater laceration associated with acute paraplegia in three dogs. Veterinary Record. 146(5): 138-139. DOI: 10.1136/vr.146.5.138

Züger L., Fadda A., Oevermann A., Forterre F., Vandevelde M. & Henke D. 2018. Differences in epidural pathology between cevical and thoracolumbar intervertebral disk extrusions in dogs. Journal of Veterinary Internal Medicine. 32(1): 305-313. DOI: 10.1111/jvim.14887.

Published

2020-01-01

How to Cite

Ripplinger, A., Aiello, G., Wrzesinski, M. R., Schwab, M. L., Rauber, J. da S., Ferrarin, D. A., Chaves, J. N., & Mazzanti, A. (2020). Intradural Disc Extrusion in a Dog. Acta Scientiae Veterinariae, 48. https://doi.org/10.22456/1679-9216.100838

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