Early recurrence of thoracolumbar intervertebral disc extrusion after surgical decompression: a report of three cases

Øyvind Stigen,Karin H Jäderlund,Nina Ottesen

doi:10.1186/1751-0147-52-10

Øyvind Stigen, Karin H Jäderlund + Show 1 more

Open Access

https://doi.org/10.1186/1751-0147-52-10

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Abstract

Thoracolumbar disc extrusions were diagnosed in three chondrodystrophic dogs with paraparesis of up to three days duration. All cases were managed by hemilaminectomy and removal of extruded disc material. In one dog, fenestration of the herniated disc space was also performed. Initially neurological function improved or was unchanged, but from two to ten days postoperatively clinical signs of deterioration became apparent. In all the dogs, recurrence of disc extrusion at the same location as the initial extrusion was diagnosed by computer tomography and at a second surgery abundant disc material was found at the hemilaminectomy site between the dura and an implanted graft of autogenous fat.

Highlights

Dogs with thoracolumbar intervertebral disc disease causing severe neurological deficits are commonly treated by surgical decompression of the spinal cord
In a prospective MRI study that included 19 chondrodystrophic dogs with a first episode of thoracolumbar disc disease, Forterre et al [3] found that fenestration of the affected disc space did prevent
The deterioration was caused by recurrence of disc extrusion at the initial herniation site and shows that disc extrusions in chondrodystrophic dogs may progress over several days and with a stepwise accumulation of disc material in the spinal canal

Summary

Background

Dogs with thoracolumbar intervertebral disc disease causing severe neurological deficits are commonly treated by surgical decompression of the spinal cord. In the above-mentioned study by Forterre et al [3], early (within six weeks) recurrence of disc extrusion was reported in six out of ten dogs with thoracolumbar disc disease that had hemilaminectomy without fenestration Out of these six, three remained without clinical signs, two developed signs of temporary back pain and one had a deterioration of neurologic status three days after surgery. CT revealed a disc extrusion lateralised to the right, causing severe spinal cord compression at L3-4 (Figure 5) and moderate compression at L4-5. CT was repeated and revealed calcified disc material ventrally and to the right of a compressed spinal cord at L3-4 (Figure 6). No more postoperative complications appeared and at examination three weeks following the second surgery the dog was ambulatory with very mild pelvic limb ataxia

Discussion

Conclusion