Spine – conditions not related to intervertebral disc disease

image of Spine – conditions not related to intervertebral disc disease
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Imaging for suspected spinal disease not related to intervertebral disc disease is appropriate in cases where: clinical signs are referable to the spine or there is a breed predisposition for congenital abnormalities; there is a history of severe trauma, e.g. road traffic accident; there is a suspicion of spinal disease from other imaging studies. This chapter explores indications; normal survey or contrast studies; abnormal imaging findings.

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21.1 (a) Close-up lateral view (myelogram) of the thoracic spine of an 8-year-old Labrador Retriever with osteosarcoma involving T6. Lysis of the dorsal spinous process of T6 is evident. Contrast medium can be seen within the subarachnoid space, which dorsally is narrowed and in places absent in this region. (b) Transverse CT image in a bone window from the same vertebra confirms the extensive lysis of the dorsal spinous process and further demonstrates marked bone lysis involving the lamina and vertebral body.
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21.2 Lateral views of the lumbar spine of a dog with a fracture of L6. (a) Initial radiograph showing a foreshortened vertebral body and fracture fragments with sharp edges, compatible with a recent traumatic fracture. (b) Similar view taken 9 weeks later still shows a shortened vertebral body. No visible fracture fragments are seen and a well organized callus is present on the ventral aspect of the vertebral body, indicating a healed fracture.
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21.3 Lateral view of the lumbar spine of a 5-month-old cat with a cranial physeal fracture of L5 and an articular process luxation after a traumatic incident.
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21.4 CT images in a bone window of a 5-year-old Border Collie with an L6 vertebral body fracture after having been hit by a car. (a) The sagittal reconstructed view mimics the appearance of a lateral view radiograph and gives the impression that the spinal canal is severely compromised. (b) The transverse view shows that the spinal canal has been spared.
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21.5 An 11-month-old dog that sustained injuries in a road traffic accident. (a) Lateral lumbar radiograph showing severe L1–2 subluxation. Fracture fragments are seen in the articular process region. The marked step in the spinal canal at this site and the acute nature of the injury suggest that significant spinal cord damage is likely. (b) The VD view demonstrates marked lateral displacement, again suggesting significant cord damage.
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21.6 (a) Close-up lateral view of the cervical spine of a skeletally mature dog with an incidental block vertebra: C3 and C4 are fused at the level of the vertebral bodies. The vertebral canal appears wide and no clinical signs were present. (b) CT sagittal reconstruction in a bone window from a French Bulldog. The body of T5 has a wedge or triangular shape. Its dorsal surface forms the base. There is no evidence of spinal canal compression at this site. Other misshapen thoracic vertebrae are present.
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21.7 Lateral view of the thoracic spine of a skeletally mature dog with hemivertebrae. The bodies of T7–9 are wedge shaped. There is an accompanying malformation of the articular processes and of the dorsal spinous processes, and also kyphosis. The vertebral canal appears to be of normal width.
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21.8 T2W MRI of a young English Bulldog with spina bifida and dermoid sinus. (a) Sagittal image of the thoracic spine. Crowding of the dorsal spinous processes, together with a dorsal elongation of the spinal cord and meninges, are seen. (b) Transverse image at the site of crowding, showing two discrete spinous processes. (c) Post-mortem segment of spinal cord showing the dermoid sinus extension from the spinal cord.
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21.9 Congenital atlantoaxial subluxation. (a–b) Close-up lateral views of C1–2 from two different dogs in different degrees of ventroflexion. The space between the neural arch of C1 and the dorsal spinous process of C2 is widened in each dog. (c) Sagittally reconstructed CT image in a bone window and (d) Sagittal T2W MRI of a skeletally mature Miniature Pinscher showing marked angulation and reduction in diameter of the vertebral canal at C1–C2. The MRI shows the degree of cord compression and angulation present. This dog went on to have successful atlantoaxial stabilization surgery.
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21.10 Close-up lateral cervical myelogram of a 3-year-old Dobermann showing an arachnoid cyst. Note the enlargement of the contrast-filled subarachnoid space dorsally at the level of C2 and C3, and the marked reduction in cord diameter that results. The cyst is orientated caudally to cranially, which is unusual; most cysts are orientated cranially to caudally. (Courtesy of Y Ruel)
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21.11 Sagittal T1W MRI from a 4-year-old male CKCS with neck pain, ear scratching and ataxia. Much of the diameter of the cervical spinal cord is fluid-filled (hypointense), indicating syringohydromyelia. This dog also had a Chiari-like malformation.
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21.12 Cervical myelogram from a Boxer, showing severe hydromyelia. Note the small gap between the outer margins of the contrast column within the central canal and the wall of the vertebral canal, indicating marked compression and atrophy of cord material. The contrast material was inadvertently placed in the central canal rather than the subarachnoid space during a cervical puncture. (Courtesy of P Mantis)
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21.13 Transverse T2W MRI of T5 from a 12-month-old Boerboel showing dorsolateral spinal cord compression by malformed articular process joints (*), resulting in a vertically oriented spinal cord. The dog had chronic pelvic limb paresis but recovered after surgical cord decompression.
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21.14 A 4-year-old female Vizsla with exercise intolerance caused by back pain, believed to be due to spondylarthrosis. (a) Lateral lumbar radiograph showing formation of small osteophytes at the articular processes (*). (b) Transverse CT images in a bone window of L5–6 and L6–7 show asymmetry of the articular process joints, with sclerosis and osteophyte formation (arrowed).
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21.15 Synovial cyst in a 6-year-old Dobermann. (a) Transverse and (b) dorsal T2W MRI from the cervical spine showing an extradural cyst compressing the spinal cord at C5–6 on the right. The dog had progressive ataxia, which resolved after surgical removal of the cyst.
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21.16 Lateral caudal thoracic radiograph from a 5-year-old Boxer, showing spondylosis. New bone formation extends beyond the vertebral edges and in places bridges the intervertebral disc space ventrally.
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21.17 Lateral cervical radiograph of a 12-year-old Flat Coated Retriever. A fine mineralized linear marking (arrowed) is seen running parallel and dorsal to the floor of the vertebral canal. This appearance is typical of dural ossification.
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21.18 (a) Close-up lateral thoracolumbar radiograph of an adult dog with advanced discospondylitis. There is a mixed proliferative and lytic process involving the T11–12 endplates. There is loss of intervertebral disc material, resulting in collapse of the disc space. (b) Lateral lumbar radiograph from a 9-week-old Labrador Retriever that had parvovirus infection 3 weeks previously and presented with back pain. Note the collapsed disc spaces at L2–3 and L4–5. (c) Same view from the same dog as in (b), 3 weeks later. Note the vertebral subluxations at both locations and the mild (L2–3) and marked (L4–5) vertebral endplate lysis. (b, c, Courtesy of R Kirberger, Onderstepoort Veterinary Academic Hospital)
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21.19 CT images in a bone window from a 7.5-year-old male Jack Russell Terrier with lower lumbar pain due to discospondylitis. (a) Sagittal reconstruction and (b) transverse images at presentation. The L6–7 intervertebral disc space is narrowed. There is sclerosis and focal bone lysis in the caudal endplate of L6 and the cranial endplate of L7. (c–d) Images from similar areas 5 weeks later. The radiographic signs at the second CT were worse, but the dog started to respond to antibiotics at this stage and improved.
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21.20 Transverse L1–2 CT myelogram in a soft tissue window of an 8-year-old Nova Scotia Duck Tolling Retriever with acute pelvic limb paralysis. Hyperattenuating epidural fat is seen compressing the spinal cord (*) from the right. Necrotic fat containing neutrophils, indicative of empyema, was found surgically.
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21.21 Transverse short tau inversion recovery MRI of the C6–7 region in a 3-year-old male East Siberian Laika with right thoracic limb lameness. Right-sided nerve root thickening is seen as a hyperintense signal indicative of neuritis. The clinical signs were successfully treated with steroids.
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21.22 Lateral view of the lumbar spine of a dog with spondylitis. There is new bone formation at the ventral aspect of L2 and L3. Bone sclerosis is evident within the affected vertebral bodies. The spondylitis is likely to be secondary to a migrating foreign body.
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21.23 Close-up lateral view of the caudal thoracic spine showing spondylitis secondary to infection. Note the lack of ventral concavity of the middle vertebral bodies due to a solid periosteal reaction. (Courtesy of R Kirberger, Onderstepoort Veterinary Academic Hospital)
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21.24 Vertebral body tumour in L6 in a 10-year-old male Belgian Tervuren. (a) Lateral lumbar radiograph with no obvious L6 lesion visible. (b) Sagittal T2W MRI (obtained 1 day after the radiograph) of the lumbar spine. There is a hyperintense signal within the body of L6 extending into the ventral vertebral canal and elevating the spinal cord. There is an additional disc protrusion at L7–S1. (c) Sagittal CT reconstruction in a bone window of the lumbar spine showing extensive bone lysis in the body of L6.
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21.25 Lateral cervical radiograph of a skeletally mature dog with multiple myeloma. Multiple focal lucencies with sharp margins are seen throughout the cervical spine. There is no evidence of new bone formation in response to the lesions. (Courtesy Y Ruel)
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21.26 MRI of an 8-year-old male Standard Poodle with severe thoracic limb lameness and muscle atrophy secondary to a chondrosarcoma at the level of C6–7. (a) Dorsal T2W and (b) sagittal T1W image showing a right-sided mass (*) causing marked extradural compression of the spinal cord (#).
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21.27 Cranial cervical CT in a soft tissue window from a 1-year-old male Great Dane with progressive ataxia. (a) Sagittal reconstruction and (b) transverse images showing a stippled mineralized mass causing dorsal cord compression (*) at C1–2. A histological diagnosis was not available but this could be calcinosis circumscripta or an atypical solitary cartilaginous exostosis.
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21.28 Close-up lateral view of the lumbar spine of an 8-year-old German Shepherd Dog. (a) There is a sublumbar mass arising from the medial iliac lymph nodes. This has resulted in a mass effect displacing the descending colon ventrally. The mass has a non-uniform opacity containing numerous linear mineral markings. The mineral component of the mass somewhat obscures the ventral surfaces of the underlying vertebrae. (b) Post-mortem examination confirmed the mineralized nature of the mass with local extension into L7 and S1. The histological diagnosis was fibrosarcoma.
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21.29 T1W MR images from an 11-year-old Bearded Collie: (a) sagittal and (b) transverse images at the level of C5. There is an intramedullary hyperintense zone (*) at the level of C5 which occupies over 80% of the cross-sectional area of the cord, but causes little cord swelling. Such lesions may go undetected on plain radiographs and on myelography. The final diagnosis was neoplasia.
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21.30 Lateral caudal thoracic post-myelogram radiograph after lumbar puncture in a middle-aged dog with an intramedullary neoplasm. There is diffuse cord swelling within the thoracic region. The long transition zone between swollen and normal cord can be seen on this image at the level of T11 and T12. Note the narrow contrast medium columns positioned at the outer limits of the spinal canal, indicating a uniform cord swelling; these were also evident on the VD view. These features are common to cord swelling of any origin. (Courtesy Y Ruel)
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21.31 Lateral thoracolumbar post-myelogram radiograph from a dog with a meningioma. This intradural extramedullary neoplasm has caused a filling defect in the contrast extending the length of L1. The cord is compressed by the mass so that the myelographic appearance at the cranial aspect of the lesion is one of cord swelling (outward displacement of the contrast columns). Caudally and dorsally, however, the contrast–lesion interface is highly suggestive of an intradural mass (i.e. the contrast medium column stops abruptly and is widened with an irregular cranial border). This irregular interface represents the caudal limits of the intradural mass.
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21.32 Lateral cervical radiograph from a 9-year-old cat with hypervitaminosis A. Proliferative well mineralized new bone formation is seen at the ventral aspects of C1–3.
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21.33 Mucopolysaccharidosis. Lateral radiographs of segments of the (a) cervical and (b) lumbar spine of a 7-year-old cat. Note the incompletely ossified vertebral endplates, which have a ‘folded’ appearance, the shortening of the vertebral bodies and the irregular and widened intervertebral disc spaces.
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21.34 VD cervical radiograph of a 13-month-old German Shepherd Dog. A roughly spherical zone of unstructured stippled calcification, typical of calcinosis circumscripta, is present within the soft tissues of the neck adjacent to the vertebral column.
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21.35 T2W MR images from a 6-year-old female English Springer Spaniel with an acute onset of tetraplegia. (a) Sagittal and (b) transverse images show a hyperintense zone (*) within the spinal cord at C6–7. The final diagnosis was a fibrocartilaginous embolus. This dog recovered with rest and intense rehabilitation.
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21.36 Lateral lumbar post-myelogram radiograph of a 5-year-old Dachshund. There is marked accumulation of contrast medium within the spinal cord, indicative of myelomalacia. (Reproduced from , with permission from )
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