DOCSLIB.ORG

Canine Thoracolumbar Intervertebral Disk Disease: Diagnosis, Prognosis, and Treatment*

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Canine Thoracolumbar Intervertebral Disk Disease: Diagnosis, Prognosis, and Treatment* 3 CE CREDITS CE Article Canine Thoracolumbar Intervertebral Disk Disease: Diagnosis, Prognosis, and Treatment* ❯❯ John F. Griffin IV, DVM Abstract: Thoracolumbar intervertebral disk disease (IVDD) is a common, important cause of ❯❯ Jonathan M. Levine, DVM, paraspinal hyperesthesia, pelvic limb ataxia, paraparesis, paraplegia, and urinary and fecal in- DACVIM (Neurology) continence in dogs. A companion article reviewed pathophysiology, epidemiology, physical ex- ❯❯ Sharon C. Kerwin, DVM, amination, and emergency medical therapy. This article addresses the diagnosis, prognosis, and MS, DACVS treatment of dogs with thoracolumbar IVDD. ❯❯ Robert C. Cole, DVM, DACVR horacolumbar intervertebral disk better positioning and higher-quality radio- Texas A&M University College Station, Texas disease (IVDD) is a broad term, graphs but may not be necessary. Survey Tencompassing disk degeneration radiography can be conducted under anes- and clinical neurologic disease due to disk thesia immediately before myelography and herniation. Canine IVDD is the most com- can identify the primary site of disk hernia- mon cause of thoracolumbar myelopathy tion in 51% to 61% of cases; its ability to with paraspinal hyperesthesia.1,2 A thor- identify secondary sites of disk herniation ough understanding of diagnostic modali- is less reliable.2,6 Surgical outcome is poorer ties, prognosis, and treatment options is in dogs treated surgically on the basis of At a Glance crucial to medical decision making and survey radiography alone compared with comprehensive care. dogs that undergo myelography.7 Diagnostic Evaluation Radiographic signs suggestive of inter- Page E1 Diagnostic Evaluation vertebral disk herniation include narrowing Definitive Treatment The preanesthetic evaluation of dogs with or wedging of the disk space, decreased Page E4 suspected disk herniation should include size of the intervertebral foramen, reduced P r o g n o s i s a complete blood cell count, serum chem- space between articular facets, and min- Page E6 istry panel, urinalysis, and thoracic radi- eralized disk material in the vertebral Postoperative Care ography in geriatric dogs to evaluate canal or overlying intervertebral foramen6 Page E8 cardiovascular structures and rule out (FIGURE 1). Spondylosis deformans, while Pharmacotherapy for pulmonary metastatic nodules. A urine potentially associated with disk protrusion, Neurogenic Bladder culture should be obtained in dogs with is not seen with increased frequency at Dysfunction urine retention, regardless of whether sites of disk extrusion.8 Survey radiography Page E10 pyuria is present.3–5 does not confirm the presence of spinal cord compression or localize lesions accu- Radiography rately enough for surgery. Surgical localiza- Vertebral column radiography should be tion must be established by myelography, performed in all dogs with suspected IVDD. computed tomography (CT), or magnetic Vertebral column radiography is helpful resonance imaging (MRI). Because these in ruling out diskospondylitis, trauma, or tests are expensive, require anesthesia, vertebral neoplasia. Anesthesia allows for and may have side effects, they are gener- *A companion article, “Canine Thoracolumbar Intervertebral Disk Disease: Pathophysiology, Neu- rologic Examination, and Emergency Medical Therapy,” is also available on CompendiumVet.com. CompendiumVet.com | March 2009 | Compendium: Continuing Education for Veterinarians® E1 ©Copyright 2009 Veterinary Learning Systems. This document is used for internal purposes only. Reprinting or posting on an external website without written permission from VLS is a violation of copyright laws. FREE CE Canine Thoracolumbar IVDD: Diagnosis FIGURE 1 ally reserved for surgical candidates and cases in which other medically treatable etiologies have been excluded. Myelography Myelography has been the mainstay of local- ization of spinal cord compression caused by intervertebral disk herniation in veteri- nary medicine.9–13 Myelographic and surgi- cal findings have a strong correlation, with myelography correctly identifying the site of Lateral survey radiographic image showing narrowing of the space intervertebral disk herniation in 85.7% to 98% between articular facets at L1–L2 and L2–L3. Note the appearance of of cases.14–16 Myelography also aids in deter- mineralized opacity in the vertebral canal dorsal to the L1–L2 intervertebral disk mining the lateralization of disk extrusions space (arrow). The intervertebral foramen at L2–L3 is difficult to see. causing myelopathy.17 Compressive lesions may be seen on myelography in dogs with back pain alone as a clinical sign of intervertebral FIGURE 2 disk herniation.18 Compared with CT and MRI, myelography is relatively inexpensive and does not require specialized equipment. The major disadvantages of myelography are side effects and artifacts caused by epidural contrast injec- tion. Myelographic contrast media can cause asystole, seizures, and renal failure and aggra- vate spinal cord dysfunction.19–21 Artifacts that can confound the evaluation of myelograms include epidural, central canal, and subdural filling and direct parenchymal injection.22 In Lateral myelographic image of the dog in Figure 1. Note the dorsal a comparison of CT, survey radiography, and deviation of the ventral contrast column at the L1–2 and L2–L3 intervertebral myelography for the evaluation of vertebral disk spaces. The dorsal contrast column above the L2–L3 disk space is also and spinal cord tumors, myelography outper- attenuated. formed CT in classifying intradural lesions.23 Myelographic findings suggestive of extra- FIGURE 3 dural spinal cord compression secondary to disk herniation include dorsal deviation of the ven- tral subarachnoid contrast column and thinning of the dorsal contrast column dorsal to a disk space on the lateral view2,15,16 (FIGURE 2). On the ventrodorsal view, this appears as attenuation of one or both lateral subarachnoid contrast columns2,15,16 (FIGURE 3). In acute cases, an intramedullary pattern secondary to severe cord swelling may mask the radiographic signs of disk extrusion,24 causing attenuation of both contrast columns on the lateral and ventrodorsal projections. In these situations, Ventrodorsal myelo- careful evaluation for slight axial deviation graphic image of the dog of a contrast column or comparison with the in Figure 1. Note the bilat- survey radiographs may indicate the origin of eral attenuation of the con- the disk extrusion. In addition, oblique radio- trast columns and the axial deviation of the left contrast graphic projections (left ventral–right dorsal column, suggesting a left- and right ventral–left dorsal) are useful when sided disk herniation. the lateral and ventrodorsal projections only E2 Compendium: Continuing Education for Veterinarians® | March 2009 | CompendiumVet.com FREE Canine Thoracolumbar IVDD: Diagnosis CE show cord swelling. If the disk material is FIGURE 4 located significantly lateral to midline, oblique views may show a classic extradural pattern, whereas the traditional views may only show attenuation of the contrast columns.24 Computed Tomography CT allows for assessment of extradural spi- nal cord compressive lesions.25 Herniated disk material appears on CT images as a hetero- geneous, isoattenuating-to-hyperattenuating extradural mass, depending on the mineral content of the herniated disk material.25,26 With chronicity, herniated disk material may become more homogenous and hyperattenuating as the mineral content increases25,26 (FIGURE 4). Epidural hemorrhage typically appears slightly more attenuating than the spinal cord. CT is not very effective at differentiating structures Transverse CT images of a left-sided intervertebral disk extrusion at within the dura.23 T12–T13 (arrows). (A) Soft tissue window. (B) Bone window. CT may be combined with myelography to allow visualization of the subarachnoid space, improve accuracy in differentiating intramed- not correlate with histopathologic degenera- ullary from extradural causes of spinal cord tion in dogs.30,31 In one study, MRI was 100% swelling, and definitively determine the loca- sensitive and 79% specific for detecting disk tion of herniated disk material. The advantages degeneration in nonchondrodystrophoid dogs of CT include few side effects and the ability compared with histopathology.31 The lack of to view reformatted images. CT is useful in specificity was caused by MRI findings sug- demonstrating gross morphologic changes in gesting nuclear and annular degeneration in the disk, such as mineralization, but is not a few histologically normal disks. As disk helpful in assessing subtle changes suggestive degeneration almost always precedes disk of disk degeneration.27 herniation, normal MRI findings generally confirm the absence of disk herniation at Magnetic Resonance Imaging that site.28 MRI allows early recognition and classifica- MRI is helpful in the classification of tion of disk degeneration with minimal intra- disk herniation as extrusion, protrusion, or observer and interobserver variability.28,29 The bulge.28,32 Disk extrusion (Hansen’s type I normal canine intervertebral disk has a clear IVDD) is defined as complete rupture of the demarcation between the annulus fibrosus annulus fibrosus with translocation of the and nucleus pulposus, with the nucleus pul- nucleus pulposus into the vertebral canal.28,32 posus on T2-weighted images appearing as an Disk protrusion (Hansen’s type II IVDD) is ovoid area of high signal intensity compared caused by rupture
Load more

Recommended publications
  • Nervous System Lymphoma with Sciatic Nerve Involvement in Two Cats Diagnosed Using Computed Tomography and Ultrasound Guided Fine Needle Aspiration
    VlaamsVlaams DiergeneeskundigDiergeneeskundig Tijdschrift,Tijdschrift, 2014,2014, 8383 Case report 107107 Nervous system lymphoma with sciatic nerve involvement in two cats diagnosed using computed tomography and ultrasound guided fine needle aspiration Diagnose van zenuwstelsellymfoom met aantasting van de nervus ischiadicus met behulp van computertomografie en echogeleide dunnenaaldaspiratie bij twee katten 1G. Gory, 1J. Couturier, 1E. Cauvin, 2C. Fournel – Fleury, 1L. Couturier, 1D.N. Rault 1 Azurvet, Referral Center in Veterinary Diagnostic Imaging and Neurology, Hippodrome, 2 Boulevard Kennedy 06800 Cagnes-sur-Mer, France 2 VetAgro-Sup – Campus Vétérinaire de Lyon, 1 Avenue Bourgelat 69280 Marcy L’Etoile, France [email protected] A BSTRACT Two cats were presented with a recent history of difficulty in walking and jumping. Neurolo- gical examination was consistent with a lumbosacral or a sciatic nerve lesion in both cases with an additional C6-T2 spinal cord segment lesion in case 2. Differential diagnosis included neo- plastic, inflammatory/infectious (neuritis, meningomyelitis, discospondylitis) and compressive disc disease. Computed tomography (CT) revealed an enlarged, contrast enhancing sciatic nerve from the L7-S1 intervertebral foramen, to the distal third portion of the femoral shaft. In case 2, CT also revealed an enlarged femoral nerve and an extradural mass causing mild compression of the spinal cord at T1-2 and T3-4. Ultrasonography allowed to perform fine needle aspiration of the affected sciatic nerve. Cytology was highly suggestive of indolent, small cell lymphoma in case 1, and confirmed a high-grade lymphoma in case 2, both belonging to the large granular lymphoma subtype. SAMENVATTING Twee katten werden aangeboden met een recente voorgeschiedenis van problemen met stappen en springen.
    [Show full text]
  • Lumbar Spondylosis Page 1 of 3
    Lumbar Spondylosis Page 1 of 3 Today News Reference Education Log In Register Lumbar Spondylosis • Author: Bruce M Rothschild, MD; Chief Editor: Allen R Wyler, MD more... Updated: Jan 23, 2013 Background Lumbar spondylosis, as shown in the image below, describes bony overgrowths (osteophytes), predominantly those at the anterior, lateral, and, less commonly, posterior aspects of the superior and inferior margins of vertebral centra (bodies). This dynamic process increases with, and is perhaps an inevitable concomitant, of age. Anteroposterior view of lumbar spine. Vertical overgrowths from margins of vertebral bodies represent osteophytes. Spondylosis deformans is responsible for the misconception that osteoarthritis was common in dinosaurs.[1] Osteoarthritis was rare, but spondylosis actually was common. Lumbar spondylosis usually produces no symptoms. When back or sciatic pains are symptoms, lumbar spondylosis is usually an unrelated finding. Past teleologically misleading names for this phenomenon are degenerative joint disease (it is not a joint), osteoarthritis (same critique), spondylitis (totally different disease), and hypertrophic arthritis (not an arthritis). For further reading, please see the Medscape Reference article Lumbar Spondylosis and Spondylolysis. http://emedicine.medscape.com/article/249036-overview 5/5/2014 Lumbar Spondylosis Page 2 of 3 Contributor Information and Disclosures Author Bruce M Rothschild, MD Professor of Medicine, Northeast Ohio Medical University; Adjunct Professor, Department of Biomedical Engineering, University of Akron; Research Associate, University of Kansas Museum of Natural History; Research Associate, Carnegie Museum Bruce M Rothschild, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Rheumatology, International Skeletal Society, New York Academy of Sciences, Sigma Xi, and Society of Skeletal Radiology Disclosure: Nothing to disclose.
    [Show full text]
  • Genetic Counselling Improves the Molecular Characterisation of Dementing Disorders
    Journal of Personalized Medicine Review Genetic Counselling Improves the Molecular Characterisation of Dementing Disorders Stefania Zampatti 1, Michele Ragazzo 2, Cristina Peconi 1, Serena Luciano 1, Stefano Gambardella 3,4, Valerio Caputo 2 , Claudia Strafella 1 , Raffaella Cascella 1,5, Carlo Caltagirone 6 and Emiliano Giardina 1,2,* 1 Genomic Medicine Laboratory UILDM, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; [email protected] (S.Z.); [email protected] (C.P.); [email protected] (S.L.); [email protected] (C.S.); [email protected] (R.C.) 2 Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy; [email protected] (M.R.); [email protected] (V.C.) 3 IRCCS Neuromed, 86077 Pozzilli, Italy; [email protected] 4 Department of Biomolecular Sciences, University of Urbino “Carlo Bo”, 61029 Urbino, Italy 5 Department of Biomedical Sciences, Catholic University Our Lady of Good Counsel, 1000 Tirana, Albania 6 Department of Clinical and Behavioral Neurology, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; [email protected] * Correspondence: [email protected] Abstract: Dementing disorders are a complex group of neurodegenerative diseases characterised by different, but often overlapping, pathological pathways. Genetics have been largely associated with the development or the risk to develop dementing diseases. Recent advances in molecular technologies permit analyzing of several genes in a small time, but the interpretation analysis is Citation: Zampatti, S.; Ragazzo, M.; complicated by several factors: the clinical complexity of neurodegenerative disorders, the frequency Peconi, C.; Luciano, S.; Gambardella, of co-morbidities, and the high phenotypic heterogeneity of genetic diseases.
    [Show full text]
  • Diffuse Idiopathic Skeletal Hyperostosis (DISH) and Spondylosis Deformans in Purebred Dogs: a Retrospective Radiographic Study Q ⇑ Hendrik-Jan C
    The Veterinary Journal 190 (2011) e84–e90 Contents lists available at ScienceDirect The Veterinary Journal journal homepage: www.elsevier.com/locate/tvjl Diffuse idiopathic skeletal hyperostosis (DISH) and spondylosis deformans in purebred dogs: A retrospective radiographic study q ⇑ Hendrik-Jan C. Kranenburg a, , George Voorhout b, Guy C.M. Grinwis c, Herman A.W. Hazewinkel a, Björn P. Meij a a Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands b Division of Diagnostic Imaging, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands c Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3584 CL Utrecht, The Netherlands article info abstract Article history: A retrospective radiographic study was performed to investigate the prevalence of diffuse idiopathic skel- Accepted 6 April 2011 etal hyperostosis (DISH) and spondylosis deformans (spondylosis) in 2041 purebred dogs and to deter- mine association with age, gender and breed. Four cases of DISH provided information on the appearance of canine DISH. Keywords: The prevalence of DISH and spondylosis was 3.8% (78/2041) and 18.0% (367/2041), respectively. Of Diffuse idiopathic skeletal hyperostosis dogs with DISH, 67.9% (53/78) also had spondylosis, whereas 14.0% (53/367) of dogs with spondylosis DISH also had DISH. Dogs with DISH and/or spondylosis were significantly older than those without spinal Spondylosis exostosis. The prevalence of DISH and spondylosis was 40.6% (28/69) and 55.1% (38/69), respectively, Dogs Radiography in Boxer dogs. Nineteen smaller breeds were not affected by DISH, but showed signs of spondylosis; only standard Poodles appeared not to be affected by either disorder.
    [Show full text]
  • Feline Degenerative Joint Disease
    Veterinary Surgery 39:2–13, 2010 INVITED REVIEW Feline Degenerative Joint Disease B. DUNCAN X. LASCELLES, BSc, BVSc, PhD, DSAS(ST), Diplomate ACVS & ECVS Objective: To critically review and collate published information on feline degenerative joint disease (DJD) and identify areas in which information is lacking. Study Design: Critical literature review. Methods: Literature search through Pub Med, Commonwealth Agricultural Bureau Abstracts published in the English Language, or translated into English (January 1940–August 2008). Results: Although there are no prospective studies, the prevalence of radiographic DJD appears to be high and can be associated with clinical signs of decreased mobility. There appears to be a mismatch between radiographic and clinical examination findings (pain response). There is little information on the cause of DJD in different joints. There are no fully validated subjective or objective assessment systems for the measurement of chronic DJD-associated pain in the cat. Development of a feline model of chronic DJD-associated pain may speed the development and evaluation of candidate pain-alleviating compounds and treatments. Conclusions: The high prevalence of feline DJD and lack of information about it, suggests further investigation is needed. Clinical Relevance: Feline DJD occurs with high frequency, and yet there is little to guide the clinician on prevention or treatment. r Copyright 2010 by The American College of Veterinary Surgeons INTRODUCTION the evidence for efficacy of postulated treatments for this pain. URPRISINGLY LITTLE is known about feline All mammals develop DJD, the progressive destruc- Sdegenerative joint disease (DJD) although there tion of one or more components of joints—cartilage, have been recent attempts to characterize feline joint dis- subchondral bone, ligaments, and joint capsule.
    [Show full text]
  • Lumbar Degenerative Disease Part 1
    International Journal of Molecular Sciences Article Lumbar Degenerative Disease Part 1: Anatomy and Pathophysiology of Intervertebral Discogenic Pain and Radiofrequency Ablation of Basivertebral and Sinuvertebral Nerve Treatment for Chronic Discogenic Back Pain: A Prospective Case Series and Review of Literature 1, , 1,2, 1 Hyeun Sung Kim y * , Pang Hung Wu y and Il-Tae Jang 1 Nanoori Gangnam Hospital, Seoul, Spine Surgery, Seoul 06048, Korea; [email protected] (P.H.W.); [email protected] (I.-T.J.) 2 National University Health Systems, Juronghealth Campus, Orthopaedic Surgery, Singapore 609606, Singapore * Correspondence: [email protected]; Tel.: +82-2-6003-9767; Fax.: +82-2-3445-9755 These authors contributed equally to this work. y Received: 31 January 2020; Accepted: 20 February 2020; Published: 21 February 2020 Abstract: Degenerative disc disease is a leading cause of chronic back pain in the aging population in the world. Sinuvertebral nerve and basivertebral nerve are postulated to be associated with the pain pathway as a result of neurotization. Our goal is to perform a prospective study using radiofrequency ablation on sinuvertebral nerve and basivertebral nerve; evaluating its short and long term effect on pain score, disability score and patients’ outcome. A review in literature is done on the pathoanatomy, pathophysiology and pain generation pathway in degenerative disc disease and chronic back pain. 30 patients with 38 levels of intervertebral disc presented with discogenic back pain with bulging degenerative intervertebral disc or spinal stenosis underwent Uniportal Full Endoscopic Radiofrequency Ablation application through either Transforaminal or Interlaminar Endoscopic Approaches. Their preoperative characteristics are recorded and prospective data was collected for Visualized Analogue Scale, Oswestry Disability Index and MacNab Criteria for pain were evaluated.
    [Show full text]
  • Evolutionary Medicine Evolutionary Medicine: Ancient Biological Samples to Study the Evolution of Disease
    Institute of Anatomy – Centre for Evolutionary Medicine Evolutionary Medicine: Ancient biological samples to study the evolution of disease Frank Rühli MD, PhD Institute of Anatomy – Centre for Evolutionary Medicine Outline Nature Medicine Evolutionary Medicine Swiss Mummy Project The field of aDNA Skeletal series bone microdamage of archaeological cortical bone (Tomils, 11th–15th AD ) fuchsin stained Future Papageorgopoulou et al., J Archeol Sci, 2009 Institute of Anatomy – Centre for Evolutionary Medicine Aim To present the research potential of clinically-oriented evolutionary medicine using unique, ancient samples (mummies, skeletons) The Neolithic Iceman, ca 5300 BP Institute of Anatomy – Centre for Evolutionary Medicine Evolutionary medicine Evolutionary medicine investigates human disease vulnerability and disease aetiologies (genetics, behaviour, environment, pathogens, etc.) from evolutionary perspective. It also addresses future developments in human health as a result of present-day medical and socio-economic practices. Humans still evolve, in terms of anatomical structures + disease patterns/prevalence. Institute of Anatomy – Centre for Evolutionary Medicine The Centre for Evolutionary Medicine (ZEM), University of Zurich As a transdisciplinary bridge between the past, the present and the future, researchers at the ZEM study the general evolutionary aspects of, e.g. disease aetiology and disease patterns (prevalence, socio-economic stratifications, etc.). Primarily, musculoskeletal and joint diseases as well as the molecular
    [Show full text]
  • Effect of a Core Conditioning Program on Lumbar Paraspinal Area, Asymmetry and Pain Score in Military Working Dogs with Lumbosacral Pain
    University of Tennessee, Knoxville TRACE: Tennessee Research and Creative Exchange Masters Theses Graduate School 12-2014 Effect of a Core Conditioning Program on Lumbar Paraspinal Area, Asymmetry and Pain Score in Military Working Dogs with Lumbosacral Pain Andrea Leigh Henderson University of Tennessee - Knoxville, [email protected] Follow this and additional works at: https://trace.tennessee.edu/utk_gradthes Part of the Small or Companion Animal Medicine Commons Recommended Citation Henderson, Andrea Leigh, "Effect of a Core Conditioning Program on Lumbar Paraspinal Area, Asymmetry and Pain Score in Military Working Dogs with Lumbosacral Pain. " Master's Thesis, University of Tennessee, 2014. https://trace.tennessee.edu/utk_gradthes/3155 This Thesis is brought to you for free and open access by the Graduate School at TRACE: Tennessee Research and Creative Exchange. It has been accepted for inclusion in Masters Theses by an authorized administrator of TRACE: Tennessee Research and Creative Exchange. For more information, please contact [email protected]. To the Graduate Council: I am submitting herewith a thesis written by Andrea Leigh Henderson entitled "Effect of a Core Conditioning Program on Lumbar Paraspinal Area, Asymmetry and Pain Score in Military Working Dogs with Lumbosacral Pain." I have examined the final electronic copy of this thesis for form and content and recommend that it be accepted in partial fulfillment of the requirements for the degree of Master of Science, with a major in Comparative and Experimental Medicine. Darryl L. Millis, Major Professor We have read this thesis and recommend its acceptance: Silke Hecht, Marti S. Drum Accepted for the Council: Carolyn R.
    [Show full text]
  • Ankylosing Spondylitis: Yesterday and Today
    Medical History, 1980, 24: 60-69. ANKYLOSING SPONDYLITIS: YESTERDAY AND TODAY by DAVID G. SPENCER, ROGER D. STURROCK AND W. WATSON BUCHANAN* ANKYLOSING SPONDYLITIS is one of the diseases at the forefront of medical interest at the present time. This renewed interest is largely due to the exciting discovery that approximately ninety-five per cent ofindividuals with ankylosing spondylitis possess a human leucocyte associated antigen (HLA antigen) shown as HLA-B27.1,2 We considered that a critical evaluation of the literature of spinal lesions both in prehistoric and modern animals together with the palaeopathological evidence for the existence ofspondylitis in ancient man would be ofinterest to the modern-day study of the disease. The existence of disease of the spine causing ankylosis has been described in two crocodiles, one from Egypt and the other from Cuba, dating from the Miocene and Pliocene periods respectively.3'4 Ruffer3 stated that "the changes due to spondylitis in human dorsal vertebrae show a great resemblance between the lesions ofthis disease in man and those seen in our crocodile." From examining the illustrations of the crocodile's vertebrae in Ruffer's paper3 it is clearly evident that there is spinal fusion, but unfortunately only a few vertebrae are illustrated and no radiographs are provided. Numerous other prehistoric animals have been described with spinal lesions similar to human ankylosing spondylitis.4'5,6 These animals consisted ofmany different species, which are now extinct such as the dinosaurs4'5'6 Diplodocus and Polacanthusfoxi, the cave bear Ursus spelaeus,3 and the sabre-toothed tiger Smilodon californicus.4 However, whether these lesions are developmental or pathological, and ifpathological * From The Centre for Rheumatic Diseases, University Department of Medicine, Royal Infirmary, Glasgow, and Department ofRheumatology, Westminster Hospital, London.
    [Show full text]
  • Commented Glossary for Rheumatic Spinal Diseases, Based on Pathologyf
    Annals ofthe Rheumatic Diseases 1995; 54: 615-625 615 NOW AND THEN Ann Rheum Dis: first published as 10.1136/ard.54.8.615 on 1 August 1995. Downloaded from Commented glossary for rheumatic spinal diseases, based on pathologyf Robert J Franqois, Frits Eulderink, Eric G L Bywaters Abstract or the posterior facet joints' and in another3 as Objectives-To redefine and comment on 'dissolution of a vertebra' or as 'a condition terms on a pathological basis, in order to marked by platyspondylia, aplasia of the avoid the confusion due to the use ofterms posterior arch, and separation of the pars with different meanings, to standardise interarticularis'. Thus the simplest and most usage among clinicians, radiologists and common meaning, 'separation of the pars pathologists, and to facilitate literature interarticularis', is not given by either of these searches. two authoritative dictionaries. Methods-Within the Committee of The idea of standardising nomenclature in Pathology ofthe European League against this field arose in 1967, at the VIth European Rheumatism, a study group was set up to Congress of Rheumatology in Lisbon.4 It was analyse the medical literature and taken up again by the Committee on Pathology common practice concerning the nomen- of the European League against Rheumatism clature of rheumatic spinal diseases. The (EULAR): a subgroup was appointed to define group tried to amalgamate the main concepts, list synonyms, and recommend trends in the field, to reconcile etymology, preferred terms. After agreement was reached historical background, morphology, and on a number of items pertaining to the normal common practice. anatomy of the spine,5 a list of terms Results-The group warns against use of concerning pathological changes and diseases the terms 'acquired hyperostosis syn- is now proposed.
    [Show full text]
  • Degenerative Spinal Disease (DSD), Which Is One of the Most Common Disorders in Humans
    editoriaL Adv Clin Exp Med 2012, 21, 2, 133–142 © Copyright by Wroclaw Medical University ISSN 1899–5276 Marek J. Sąsiadek, Joanna Bladowska Imaging of Degenerative Spine Disease – the State of the Art Obrazowanie w chorobie zwyrodnieniowej kręgosłupa – obecny stan wiedzy Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland Abstract The authors review the current state of imaging of degenerative spinal disease (DSD), which is one of the most common disorders in humans. The most important definitions as well as short descriptions of the etiopathology and clinical presentation of DSD are provided first, followed by an overview of conventional and advanced imag- ing methods that are used in DSD. The authors then discuss in detail the imaging patterns of particular types of degenerative changes. Finally, the current imaging algorithm in DSD is presented. The imaging method of choice is magnetic resonance, including advanced techniques – especially diffusion tensor imaging. Other imaging methods (plain radiography, computed tomography, vascular studies, scintigraphy, positron emission tomography, discog- raphy) play a supplementary role (Adv Clin Exp Med 2012, 21, 2, 133–142). Key words: spine degeneration, intervertebral disc degeneration, magnetic resonance imaging. Streszczenie Autorzy przedstawiają obecne poglądy na temat obrazowania choroby zwyrodnieniowej kręgosłupa (ch.zw.kr.), która jest jedną z najczęstszych schorzeń u ludzi. W pierwszej części pracy omówiono najważniejsze definicje oraz opisano krótko etiopatogenezę i objawy kliniczne ch.zw.kr., po czym przedstawiono standardowe i zaawansow- ane metody diagnostyczne stosowane w ch.zw.kr. Następnie omówiono szczegółowo zmiany obrazowe w posz- czególnych typach zmian zwyrodnieniowych kręgosłupa, wreszcie przedstawiono bieżący algorytm obrazowania w ch.zw.kr.
    [Show full text]
  • Whole Genome Sequencing for Mutation Discovery in a Single Case of Lysosomal Storage Disease (MPS Type 1) in the Dog
    Veterinary Clinical Sciences Publications Veterinary Clinical Sciences 4-16-2020 Whole genome sequencing for mutation discovery in a single case of lysosomal storage disease (MPS type 1) in the dog Tamer A. Mansour University of California, Davis and Mansoura University Kevin D. Woolard University of California, Davis Karen L. Vernau University of California, Davis Devin M. Ancona VCA West Coast Specialty and Emergency Animal Hospital Sara M. Thomasy University of California, Davis See next page for additional authors Follow this and additional works at: https://lib.dr.iastate.edu/vcs_pubs Part of the Animal Diseases Commons, Congenital, Hereditary, and Neonatal Diseases and Abnormalities Commons, Genomics Commons, Small or Companion Animal Medicine Commons, and the Veterinary Pathology and Pathobiology Commons The complete bibliographic information for this item can be found at https://lib.dr.iastate.edu/ vcs_pubs/43. For information on how to cite this item, please visit http://lib.dr.iastate.edu/ howtocite.html. This Article is brought to you for free and open access by the Veterinary Clinical Sciences at Iowa State University Digital Repository. It has been accepted for inclusion in Veterinary Clinical Sciences Publications by an authorized administrator of Iowa State University Digital Repository. For more information, please contact [email protected]. Whole genome sequencing for mutation discovery in a single case of lysosomal storage disease (MPS type 1) in the dog Abstract Mucopolysaccharidosis (MPS) is a metabolic storage disorder caused by the deficiency of any lysosomal enzyme required for the breakdown of glycosaminoglycans. A 15-month-old Boston Terrier presented with clinical signs consistent with lysosomal storage disease including corneal opacities, multifocal central nervous system disease and progressively worsening clinical course.
    [Show full text]