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1.
No screening method is currently available to differentiate dogs with and without cervical spondylomyelopathy. Intravertebral and intervertebral ratios are used in horses and can predict cervical vertebral malformation. Intervertebral ratios could be a useful screening method for canine cervical spondylomyelopathy. Our purpose was to compare cervical intervertebral and intravertebral ratios in normal vs. affected Doberman pinschers. Forty dogs were studied, 27 affected and 13 normal. Cervical radiographs were obtained in all dogs. The minimum intra- and intervertebral sagittal diameter ratios were established for each cervical vertebrae and disc space from C(2) to C(7) . Comparisons were made between groups and specific vertebral body and disc levels. The effect of gender, age, and method of measurement (analog or digital radiographs) was also studied. There was no difference in either the intervertebral or intravertebral ratio between normal vs. affected dogs. The ratios decreased progressively along the cervical spine, being smallest at C(6) -C(7) and C(7) , respectively. Age, gender, and method of measurement had a significant influence on both inter- and intravertebral ratios, with smaller ratios seen as dogs aged and in male dogs. Based on our results, inter- or intravertebral ratios have no value to distinguish between clinically normal Doberman pinschers and Doberman pinschers with cervical spondylomyelopathy.  相似文献   

2.
Great Danes are predisposed to osseous‐associated cervical spondylomyelopathy (Wobbler syndrome). The first aim of this prospective study was to compare values measured using previously published intravertebral and intervertebral ratio methods and a novel ventrodorsal ratio method in radiographs of clinically normal and affected Great Danes. The second aim was to determine whether these ratios could be used as predictors of sites of spinal cord compression based on magnetic resonance imaging (MRI). Thirty dogs (15 normal, 15 affected) were prospectively enrolled. Lateral and ventrodorsal radiographs were obtained and six measurements were recorded from C3‐T1. For each vertebral location, intravertebral ratios and intervertebral ratios were calculated from lateral views, and the ratio of the distance between the articular process joints vs. vertebral body width (novel ventrodorsal ratio) was calculated from ventrodorsal views. Values for these three ratios were compared, by vertebral location and dog group. Intravertebral and intervertebral ratios did not differ between dog groups. The ventrodorsal ratio was significantly smaller in affected Great Danes at C5–6 (P = 0.005) and C6–7 (P < 0.001). The ventrodorsal ratio was significantly associated with MRI presence of spinal cord compression. For each 0.1 unit increase in this ratio value, there was a 65% decrease in the odds of spinal cord compression being present at that site, independent of vertebral location (P = 0.002). Findings from this study supported use of the novel ventrodorsal ratio as an initial radiographic screening method for Great Danes with suspected cervical spondylomyelopathy.  相似文献   

3.
The cervical spines of 6 horses with cervical stenotic myelopathy (CSM) were examined using myelography and contrast-enhanced computed tomography (CECT). Histopathology of the spinal cord of these horses identified 10 neurologically significant compressive lesions. Myelography and CECT were both able to demonstrate all 10 spinal cord compressive lesions, but myelography falsely identified 2 sites and CECT falsely identified 1 site as compressive lesions of the spinal cord which were not supported by histopathology. Additional qualitative information was obtained by CECT regarding the source, severity and location of spinal cord compression. Computed tomography identified stenosis of the vertebral canal with circumferential loss of contrast agent and documented lateral compressive lesions of the spinal cord due to malformed articular facets. Compression of the peripheral nerve roots by malformed articular facets encroaching on the intervertebral foramen was easily identified by CECT in the axial plane. No compressive lesions were identified in 3 unaffected horses by either method. Minimum sagittal diameter (MSD) values obtained from CECT images were strongly correlated with necropsy measurements, validating CECT as an accurate method of obtaining MSD values. The MSD values in the CSM-affected horses were significantly narrowed (P less than 0.05) from C3C6 regardless of the site of spinal cord compression, when compared with the unaffected controls. This finding supports previous reports suggesting that generalised stenosis of the vertebral canal is an important feature in the pathogenesis of cervical stenotic myelopathy.  相似文献   

4.
REASONS FOR PERFORMING STUDY: Different criteria have been described based on height reduction of the total myelographic contrast column and components of it as tests for compression of the spinal cord due to cervical stenotic myelopathy (CSM). Fifty percent height reduction of the dorsal myelographic column (DMC), <2 mm empiric height of the DMC and a 40% reduction of the ratio of stenosis calculated based on the height reduction of the entire dural diameter (DD) have been described as decision criteria for considering the test result positive. The reasons for selecting these decision criteria or their accuracies have rarely been reported. OBJECTIVES: To evaluate the accuracy of diagnostic criteria based on reduced height of the total myelographic column and components of it for diagnosing extradural spinal cord compression using different decision criteria, and make recommendations for consistent myelographic interpretation in horses suspected of having CSM. METHODS: Four measurements were obtained by 2 readers in a retrospective sample population of 38 horses in which both cervical myelography and histopathological examination of the cervical spinal cord were performed. The prevalence of CSM in the sample was 50%. At intervertebral sites, the minimum heights of the DD and DMC were measured. At intravertebral sites, the maximum heights of the entire DD and DMC were obtained. Percent height reductions of the DMC and DD were determined as the ratio of minimum intervertebral height to maximum intravertebral height within the next cranial vertebra. Histological examination was used as the gold standard for determining the actual site of spinal cord compression. Sensitivity and specificity for the diagnostic criteria were estimated at each site in neutral and flexed neck positions using several different decision criteria. CONCLUSIONS: At C6-C7, in neutral or flexed neck position and using 20% reduction of DD, the test was highly sensitive and specific for CSM. At other sites, reduced height of the myelographic column generally was not accurate for diagnosing extradural spinal cord compression. Using 20% reduction of DD in neutral position at the mid-cervical sites, the test had only low sensitivity and high specificity. Flexion of the neck appeared to increase detection of spinal cord compression in the mid-cervical region, but also substantially increased the frequency of false-positive diagnoses. POTENTIAL RELEVANCE: By using the reported sensitivity and specificity estimates, readers may decide on a decision criterion for diagnosis of extradural spinal cord compression due to CSM. However, in planning a surgical correction, it is difficult to define a decision criterion that combines acceptable sensitivity and specificity, especially at the mid-cervical sites.  相似文献   

5.
The Cloward technique for intervertebral fusion was utilized on 12 horses ranging from 3 months to 2 years of age. Of the 12 horses, 9 had been diagnosed as having equine cervical vertebral malformation (CVM) or "wobbles," and 3 were normal controls. A large hole was drilled from the ventral border of the vertebral bodies spanning the intervertebral disc and the vertebral end plates of the 2 articulating vertebrae. Frozen homologous bone dowels of slightly larger diameter from equine cadaver ilia were inserted in the holes. No adverse postoperative complication arose. Clinical improvement was seen in all horses with CVM. Three months postoperatively, partial or complete fusion was evident radiographically in 11 of the 12 horses. Necropsies were performed 3–6 months postoperatively to evaluate the quality of the fusion. Cadaver manipulation demonstrated reduced intervertebral movement at the operative site in all cases. The articulations of the equine cervical spine can be operatively fused by the Cloward technique, and surgically induced trauma is minimal. This technique can be used for stabilizing subluxations and may be applicable for treating fractures and osteolytic processes that have weakened vertebrae.  相似文献   

6.
Reason for performing study: Different examiners or the same examiner were observed at different times producing slightly different results when obtaining cervical‐vertebral ratios. If the difference is substantial, then measurement variability would have an important impact of radiographic interpretation. Objective: To quantify agreement and repeatability of these measurements. Methods: An observer agreement study was performed using 75 horses. Measurements were made at C3–4 and C6–7 by a board‐certified radiologist and an imaging resident. Intra‐ and interobserver agreement was quantified using Bland‐Altman plots. Repeatability was assessed as the percentage of differences between duplicate measurements by the radiologist that were within ± 2 s.d. of the differences. Results: At C3–4, the limits of agreement for the intra‐vertebral ratio were between ‐5 and 4% for the intra‐ and ‐5 and 6% for interobserver comparison. For the intervertebral ratio, they were between ‐9 and 8% for the intra‐ and ‐10 and 10% for interobserver comparison. At C6–7, the limits of agreement for the intra‐vertebral ratio were between ‐6 and 5% for the intra‐ and ‐6 and 8% for interobserver comparison. For the intervertebral ratio, they were between ‐7 and 7% for the intra‐ and ‐6 and 13% for interobserver comparison. At C3–4, all measurements were 95% repeatable (differences typically ≤4% and always ≤8%) for the intra‐vertebral ratio and 96% repeatable (differences typically ≤8% and always ≤11%) for the intervertebral ratio. At C6–7, all measurements were 98% repeatable (differences typically ≤6% and always ≤7%) for the intravertebral ratio and 92% repeatable (differences typically ≤6% and always ≤10%) for the intervertebral ratio. Conclusions: Cervical‐vertebral ratios typically varied by 5–10% within and between examiners. Potential relevance: When using cervical‐vertebral ratios in practice, the impact of measurement agreement should be factored into the interpretation of the test result because measurement variability may lead to misdiagnosis and limit the clinical usefulness of these tests.  相似文献   

7.
We compared the frequency and severity of osteochondrosis lesions in young Thoroughbred horses with cervical stenotic myelopathy (CSM) vs that in clinically normal Thoroughbreds of the same age. All lesions of the cervical vertebrae and appendicular skeleton were classified histologically as osteochondrosis or nonosteochondrosis and were measured for severity. Minimal sagittal diameter was significantly smaller in horses with CSM from C2 through C6; no difference was detected at C7. Severity of cervical vertebral osteochondrosis was greater in the horses with CSM, however frequency was not different. Frequency and severity of nonosteochondrosis lesions were not different in cervical vertebrae or appendicular skeleton. Frequency and severity of appendicular skeleton osteochondrosis lesions were both greater in horses with CSM. Osteochondrosis and nonosteochondrosis lesions were more severe on facets at sites of compression than on facets at noncompressed sites in horses with CSM. However, compression was also observed at sites with no articular facet lesions. The association of widespread osteochondrosis and spinal canal narrowing with CSM suggests CSM may represent a systemic failure in the development or maturation of cartilage and bone.  相似文献   

8.
The sixth cervical vertebra (C6) has unique morphology due to a ventral extension from the transverse process known as the ventral lamina. Little information was found regarding the prevalence and clinical relevance of morphologic variations. Aims of this observational, retrospective study were to characterize C6 morphologic variations in a large sample of horses. Cervical radiographic studies of 100 horses were retrieved. Data recorded were signalment, clinical history, morphology of the C6 ventral lamina, presence of articular process osteoarthritis, and presence of static vertebral canal stenosis. Morphologic variations were found in C6 vertebrae for 24/100 horses, with symmetric absence of the ventral lamina in nine horses and asymmetric absence in 15. Anomalous C6 vertebrae were more common in Warmbloods, with 19/55 Warmbloods in the population being affected (P = 0.006). No association was found with sex. There was no significant difference in the mean of the intravertebral sagittal ratios between horses with normal or anomalous C6 vertebrae; however there was a significantly greater proportion of horses with anomalous C6 vertebrae that had an intravertebral sagittal ratio of less than 0.5 at C6 (P = 0.047). There was no association between the morphology of C6 and articular process osteoarthritis. Anomalous C6 vertebrae in our population were associated with a higher likelihood of cervical pain (P = 0.013). Authors propose that morphologic variations in the C6 ventral laminae could be linked to other developmental abnormalities such as vertebral canal stenosis, might affect regional biomechanics and should therefore be considered clinically relevant in horses. Future, controlled prospective studies are needed to test this theory.  相似文献   

9.
OBJECTIVE: To investigate the biomechanics of cervical vertebral motion units (VMUs) before and after a ventral slot procedure and after subsequent pin-poly-methylmethacrylate (pin-PMMA) fixation and to assess the use of smooth and positive-profile threaded (PPT) pins in pin-PMMA fixation and intravertebral pin placement. SAMPLE POPULATION: Cervical portions (C3 through C6 vertebrae) of 14 cadaveric canine vertebral columns. PROCEDURE: Flexion and extension bending moments were applied to specimens before and after creation of a ventral slot across the C4-C5 intervertebral space and after subsequent smooth or PPT pin-PMMA fixation at that site. Data for the C3-C4, C4-C5, and C5-C6 VMUs were compared among treatments and between pin types, and pin protrusion was compared between pin types. RESULTS: Compared with values in intact specimens, ventral slot treatment increased neutral zone range of motion (NZ-ROM) by 98% at the treated VMUs and appeared to decrease overall ROM at adjacent VMUs; pin-PMMA fixation decreased NZ-ROM by 92% at the treated VMUs and increased overall NZ-ROM by 19% to 24% at adjacentVMUs. Specimens fixed with PPT pins were 82% (flexion) and 80% (extension) stiffer than smooth-pin-fixed specimens. Overall, 41% of pins protruded into foramina; PPT pins were more likely to protrude into transverse foramina. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that fixation of a cervical VMU alters the biomechanics of adjacent VMUs and may contribute to intervertebral degeneration of adjacent intervertebral disks. Use of threaded pins may lower the incidence of pin loosening and implant failure but enhances the likelihood of transverse foramina penetration.  相似文献   

10.
Cervical spinal cord abnormalities are often unapparent on myelographic studies, because no normal values for cervical spinal cord diameter are currently available. The purpose of this study was to establish, myelographically, the normal sagittal diameter of the cervical spinal cord in large and small breed dogs and its relationship to the sagittal diameter of the vertebral canal and sagittal height/length of the corresponding vertebral bodies. Forty-one adult dogs underwent cervical radiography and myelography. Spinal cord and vertebral canal sagittal diameter, vertebral body height at C2 to 5, body length at C3 to 5, and dorsal spine length of C2 were measured on lateral views. Ratios of spinal cord:vertebral canal diameter, spinal cord:body height, and spinal cord:body length/spine were calculated, and a normal range was determined for small and large breed dogs. The spinal cord:vertebral canal ratios showed that small breeds have a higher cervical cord-to-canal ratio than large breeds. The mean values and ranges of 14 ratios are reported. The ratios of spinal cord:body length at C2 to 4 in small breeds and spinal cord:body height at C3 to 5 in large breeds were found to be the most accurate for assessing spinal cord sagittal diameter. These normal ranges would allow quantitative and objective evaluation of the cervical spinal cord by myelography and early identification of dogs with altered spinal cord diameter, which could be further evaluated by means of alternative imaging techniques.  相似文献   

11.
Two adult horses with progressive neurologic signs were examined clinically and at necropsy. Both horses had signs of progressive ataxia and weakness, clinically diagnosed as spinal cord in origin. Differential diagnoses for cervical spinal ataxia in horses included cervical vertebral malformation, equine degenerative myeloencephalopathy, equine herpes-virus-I myeloencephalopathy, and equine protozoal myeloencephalopathy. Necropsy findings in both horses were similar and consisted of a large hematoma in the fourth ventricle, with upward compression of the cerebellum and downward compression of the pons and rostral portion of the medulla.  相似文献   

12.
OBJECTIVE: To compare morphologic and morphometric features of the cervical vertebral column and spinal cord of Doberman Pinschers with and without clinical signs of cervical spondylomyelopathy (CSM; wobbler syndrome) detected via magnetic resonance imaging (MRI). ANIMALS: 16 clinically normal and 16 CSM-affected Doberman Pinschers. PROCEDURES: For each dog, MRI of the cervical vertebral column (in neutral and traction positions) was performed. Morphologically, MRI abnormalities were classified according to a spinal cord compression scale. Foraminal stenosis and intervertebral disk degeneration and protrusion were also recorded. Morphometric measurements of the vertebral canal and spinal cord were obtained in sagittal and transverse MRI planes. RESULTS: 4 of 16 clinically normal and 15 of 16 CSM-affected dogs had spinal cord compression. Twelve clinically normal and all CSM-affected dogs had disk degeneration. Foraminal stenosis was detected in 11 clinically normal and 14 CSM-affected dogs. Vertebral canal and spinal cord areas were consistently smaller in CSM-affected dogs, compared with clinically normal dogs. In neutral and traction positions, the intervertebral disks of CSM-affected dogs were wider than those of clinically normal dogs but the amount of disk distraction was similar between groups. CONCLUSIONS AND CLINICAL RELEVANCE: The incidence of intervertebral disk degeneration and foraminal stenosis in clinically normal Doberman Pinschers was high; cervical spinal cord compression may be present without concurrent clinical signs. A combination of static factors (ie, a relatively stenotic vertebral canal and wider intervertebral disks) distinguished CSM-affected dogs from clinically normal dogs and appears to be a key feature in the pathogenesis of CSM.  相似文献   

13.
Client-owned, clinically normal Doberman Pinschers (n=20), English Foxhounds (n=17), and Doberman Pinschers with clinical signs of disk-associated cervical spondylomyelopathy (DA-CSM) (n=17) were prospectively studied. All dogs underwent magnetic resonance imaging (MRI) of the cervical vertebral column. To evaluate vertebral canal stenosis, the canal occupying ratios of the spinal cord and cerebrospinal fluid (CSF)-column were calculated from C5 to C7. To evaluate the degree of spinal cord compression and the amount of canal compromise, the compression ratio, remaining spinal cord and CSF-column area, and vertebral canal and dorsoventral vertebral canal compromise ratios were calculated at the site of most severe compression. For each canal occupying ratio, there was a significant higher value (implicating less space available for the spinal cord in the vertebral canal) at the level of C7 for clinically affected Doberman Pinschers compared with clinically normal English Foxhounds. The remaining spinal cord area was significantly smaller in dogs with clinically relevant spinal cord compression compared to dogs with clinically irrelevant spinal cord compression. Relative stenosis of the caudal cervical vertebral canal occurred more often in Doberman Pinschers with DA-CSM compared to English Foxhounds and a critical degree of spinal cord compression should be reached to result in clinical signs.  相似文献   

14.
Reason for performing study: Localisation of spinal cord compression in horses with cervical vertebral stenotic myelopathy is inexact. Vertebral canal endoscopy has been used in man to localise spinal cord lesions and has the potential to become a useful diagnostic technique in horses. Objective: To establish a surgical approach via the atlanto‐occipital space to the cervical vertebral canal in equine cadavers and describe the endoscopic anatomy of the cervical epidural and subarachnoid spaces. Methods: The cadavers of 25 mature horses were used to assess 3 surgical methods to approach the cervical vertebral canal, including 2 minimally invasive and one open technique. Once the approach had been made, a flexible videoendoscope was inserted into the epidural space (epiduroscopy) or the subarachnoid space (myeloscopy) and advanced caudally until the intervertebral space between C7 and T1 was reached. Results: The epidural and subarachnoid spaces could not be accessed reliably using the minimally invasive techniques. Furthermore, damage to the nervous tissues was a frequent complication with these procedures. The open approach allowed successful insertion of the videoendoscope into the epidural and subarachnoid spaces in all horses and no inadvertent damage was observed. Anatomical structures that could be seen in the epidural space included the dura mater, nerve roots, fat and the ventral internal vertebral venous plexus. In the subarachnoid space, the spinal cord, nerve roots, blood vessels, denticulate ligaments and external branch of the accessory nerve were seen. Conclusions: Using the open approach, epiduroscopy and myeloscopy over the entire length of the cervical vertebral canal are possible in the mature horse. Potential relevance: Cervical vertebral canal endoscopy may become a valuable tool to localise the site of spinal cord injury in horses with cervical vertebral stenotic myelopathy and could aid in the diagnosis of other diseases of the cervical spinal cord.  相似文献   

15.
Subtotal dorsal cervical laminectomy was used to relieve spinal cord compression due to cervical vertebral malformation in 16 horses. The majority were Thoroughbred or Quarter Horse males, 1 to 4 years old. The caudal cervical vertebrae were involved in all but two instances. A Funkquist type B laminectomy was performed and the defect filled with a free autogenous nuchal fat graft. All horses recovered from surgery without complication or deterioration in neurological status. Neurological improvement occurred in 12 cases, including six that became sound. Three horses fractured a vertebral articular process and were euthanized. A modification to the shape of the laminectomy was adopted to reduce this complication.  相似文献   

16.
Cervical vertebral fusion was noted radiographically in four dogs presented for signs of cervical spinal cord compression. Ventral extradural spinal cord compression was seen on myelography at intervertebral disc spaces adjacent to the fused vertebrae in two dogs and at a site removed in two dogs. At surgery, no intervertebral disc space was found in the area of fusion. No other instances of cervical vertebral fusion were identified in reviewing radiographs of 1225 other dogs with cervical intervertebral disc extrusion evaluated at our hospital. Clinical signs resolved in all dogs after surgical removal of extruded intervertebral disc material. Information from these four dogs suggest vertebral fusion may predispose adjacent discs to herniation.  相似文献   

17.
OBJECTIVE: To determine the effect that ventral intervertebral disk fenestration has on the sagittal range of motion about the C5-C6 intervertebral space. STUDY DESIGN: A repeated measures in vitro mechanical study of spinal range of motion under controlled loading conditions before and after fenestration. SAMPLE POPULATION: A total of 10 canine cervical vertebral specimens (C4-C7) collected from clinically normal animals within 12 hours of euthanasia. METHODS: Specimens were loaded as cantilever beams fixed at C7. Weights (1 to 5 kg) were progressively applied to C4 to produce flexion or extension in the sagittal plane. Radiographs were taken at each load, 3 times before and 3 times after fenestration of the C5-C6 disk. The positions of radiodense markers embedded in the vertebrae were used to calculate flexion and extension angles and range of motion. RESULTS: Range of motion (difference between flexion and extension) and flexion and extension angles (individually) significantly increased after fenestration (P < .0001). CONCLUSION: Ventral fenestration produces sagittal instability of the C5-C6 disk space. CLINICAL RELEVANCE: In surgical fusion of caudal cervical intervertebral spaces in dogs, radiographically normal disks adjacent to the affected space are often fenestrated to facilitate distraction before surgical stabilization. This study shows that ventral fenestration produces instability of a caudal cervical intervertebral space in the model used. Such instability may contribute to the development of the secondary instability ("domino lesions") seen in some surgically treated dogs.  相似文献   

18.
A retrospective study of 19 ataxic horses admitted to the College of Veterinary Medicine of the University of Montreal during the period of January 1985 to December 1988 is presented. There were 11 cases of cervical vertebral malformation, four of equine degenerative myeloencephalopathy, two of equine protozoal myeloencephalitis, one each of vertebral osteomyelitis and intervertebral disc protrusion. The clinical diagnosis of ataxia in horses requires neurological, radiographic, myelographic, and laboratory examinations.  相似文献   

19.
Canine cervical vertebral instability is a complex syndrome involving cervical spinal cord compressive lesions. Doberman pinschers and Great Danes are the most commonly affected breeds. Measurements of vertebral canal diameter (VCD), vertebral body height (H), and vertebral body length (L) were made from C3-C7 in 24 Doberman pinschers and 8 Great Danes by using digital and analog techniques. Significant differences between affected and unaffected sites were noted for Doberman pinschers at C6 (P = 0.039) and C7 (P = 0.027) using analog measurements of VCD/H, and Great Danes at C6 using analog (P = 0.041) and digital (P = 0.004) measurements of VCD/L. Cervical vertebral ratios have potential as a breed-specific screening tool for cervical vertebral instability and warrant longitudinal studies.  相似文献   

20.
Cervical spondylomyelopathy or Wobbler syndrome commonly affects the cervical vertebral column of Great Dane dogs. Degenerative changes affecting the articular process joints are a frequent finding in these patients; however, the correlation between these changes and other features of cervical spondylomyelopathy are uncertain. We described and graded the degenerative changes evident in the cervical articular process joints from 13 Great Danes dogs with cervical spondylomyelopathy using MR imaging, and evaluated the relationship between individual features of cervical articular process joint degeneration and the presence of spinal cord compression, vertebral foraminal stenosis, intramedullary spinal cord changes, and intervertebral disc degenerative changes. Degenerative changes affecting the articular process joints were common, with only 13 of 94 (14%) having no degenerative changes. The most severe changes were evident between C4-C5 and C7-T1 intervertebral spaces. Reduction or loss of the hyperintense synovial fluid signal on T2-weighted MR images was the most frequent feature associated with articular process joint degenerative changes. Degenerative changes of the articular process joints affecting the synovial fluid or articular surface, or causing lateral hypertrophic tissue, were positively correlated with lateral spinal cord compression and vertebral foraminal stenosis. Dorsal hypertrophic tissue was positively correlated with dorsal spinal cord compression. Disc-associated spinal cord compression was recognized less frequently.  相似文献   

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