Spinal Disc Disease
Spinal Disc Disease
Spinal surgery in dogs and cats
Intervertebral disc disease (or slipped disc) is the most common surgical spinal neurological problem seen in small animal veterinary practice and varies in its presentation from back or neck pain through limb weakness, ataxia, recumbancy to complete paralysis of one or more limbs.
Myelographs of the lumbar spine showing extrusion of an ossified disc
Spinal disc lesions
Whilst pain and mild neurological symptoms can be treated with rest and non steroidals more advanced spinal lesions require urgent investigation and surgery if the outcome is to be successful. Intervertebral disc disease / slipped disc cases with deep pain sensation have at least a 90% success rate in our clinic for return to function, however early referral cannot be over emphasised.
This condition occurs frequently in Spaniels, Terriers, Dachshunds, Bassets, Labradors, Golden Retrievers, Rottweilers and GSDs. If deep pain sensation is absent success rates are much lower. In disc disease deep pain sensation is always present when a dog is ataxic or can move a limb voluntarily.
Myelogram of a dog’s lumbar back region showing an narrowed disc space, with a disc which has herniated causing spinal cord compression, and then the inability to walk on his hindlegs. Removal of the herniated disc allowed this dog to return to full mobility again after several weeks.
Myleography in our hands permits us to localise the site of spinal cord compression in over 95% of cases of disc disease without having to resort to alternative methods of imaging such as MRI or CT in every case. The major advantage of myelography is it can be performed immediately and is considerably less expensive than other methods, permitting many of our owners to have considered disc surgery for their pets and have excellent outcomes, when otherwise the additional costs of MRI scanning may have prevented them proceeding to surgery at all and resulted in euthanasia.
MRI and CT scanning is arranged in more complex cases, or in specific cases where more detailed imaging is required.
In order to locate the site of spinal cord compression we perform a specialist x-ray technique called myelography which is carried out under general anaesthesia– this involves carefully injecting a clear sterile solution into the space along side the spinal cord. This solution runs by gravity along the spinal cord and stops or deviates at the site of the problem, allowing us to know where exactly to surgically relieve the compression on the spinal cord.
Following location of the disc lesion (slipped disc) by myelography a hemi-laminectomy is carried out for thoraco-lumbar disc lesions in the back, whilst a ventral slot is performed for cervical disc lesions in the neck with fenestration of adjacent discs if necessary.
Prior to treatment and surgery most dogs present with weakness or paralysis of either all 4 legs or both hind legs, and are unable to walk.
Tommy is another patient that was referred to Ewing from his own vet practice in Sligo, just one year ago. When Tommy came to us, he had complete hind leg paralysis and was unable to stand at all for any amount of time on either of his hind legs, even when he was supported. After undergoing spinal surgery with our orthopaedic surgeon, followed by a strict rest and recovery period, it was not long until Tommy was back on his feet. Yesterday his owners sent us this amazing video of Tommy which we would like to share with you all. We are so proud of Tommy and it is great to see the progress he has made within one year of his surgery
5 year old Labrador Monty was referred to Ewing Walker orthopaedic surgeon a number of weeks ago suffering from spinal problems affecting his neck and had great difficulty walking on any of his legs. Monty has undergone major spinal surgery with Ewing to fuse 3 of his vertebrae in this neck with the placement of an orthopaedic plates to span the region. He has truly amazed us all with his great recovery so far! Monty is staying with us a few more days and as he is so well behaved and so very handsome, we have asked him if he would do the honours of posing along side some of our nurses tomorrow for our practice photo of the Assisi Gift Appeal collection!
Thankfully he was chuffed at the thought and has agreed to be our model!
We haven't told him yet, but as a special thank you, we have a Christmas present for him! We can't tell you what it is as it must be a surprise, but we'll give you a clue.....It's super soft and super squeaky!!!
4 weeks after surgery and making excellent progress
Post op radiographs showing his collapsed spinal neck vertebrae now distracted and stabilised from C3-C4-C5
Sitting up 24hrs after surgery
Post op check at 2 weeks
Follow up check at 3 months
Cervical disc disease in dogs- Spinal Surgery to remove herniated disc by Ventral slot
Myelogram of a dog’s cervical neck region showing spinal cord compression by a herniated disc lesion at C4-C5. Ventral slot spinal surgery on this dog permitted removal of the herniated disc and a full recovery with full use of all 4 legs returned over the following weeks post surgery.
Roxy the Boxer dog a few days after ventral slot spinal surgery for disc prolapse and collapse in his neck at C4-C5
Caudal cervical spondylomyelopathy CCSM
Caudal cervical spondylomyelopathy CCSM or Wobbler syndrome usually affects the C6-C7 region of the neck and is due to vertebral instability, hyperplasia of the soft tissue spinal structures, disc herniation and in some cases vertebral malformation. These lead to spinal cord compression causing hind leg ataxia and later foreleg involvement. CCSM occurs in older large breeds such as Dalmations, Dobermans, Rottweillers & Retreivers. Also young Great Danes. The surgery performed is either a standard ventral slot or in some cases fusion of the vertebrae in a distracted position by "screw & washer" placement, screws and bone cement or plating techniques.
Rotweiller after ventral slot for wobbler syndrome CCSM
Thankfully the vast majority of cases >90% recover function of their legs following surgery and are able to walk again.
Here are just a few of patients at various stages following successful surgery.