De Decker Steven, Watts Vicky, Neilson David M
Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, United Kingdom.
Front Vet Sci. 2017 Aug 18;4:134. doi: 10.3389/fvets.2017.00134. eCollection 2017.
A 1-year and 11-month- old English Cocker Spaniel was evaluated for clinical signs of progressive right pelvic limb lameness and urinary incontinence. Neurological examination was suggestive of a lesion localized to the L4-S3 spinal cord segments. No abnormalities were seen on magnetic resonance imaging (MRI) performed in the dog in dorsal recumbency and the hips in a neutral position and the conus medullaris ended halfway the vertebral body of L7. An MRI of the hips in extended and flexed positions demonstrated minimal displacement of the conus medullaris in the cranial and caudal directions, respectively. Similar to the images in neutral position, the conus medullaris ended halfway the vertebral body of L7 in both the extended and flexed positions. In comparison, an MRI of the hips in neutral, extended, and flexed positions performed in another English Cocker Spaniel revealed obvious cranial displacement of the conus medullaris with the hips in extension and caudal displacement with hips in flexion. A standard dorsal lumbosacral laminectomy was performed. Visual inspection of the vertebral canal revealed excessive caudal traction on the conus medullaris. After sectioning the distal aspect of the filum terminale, the conus medullaris regained a more cranial position. A neurological examination 4 weeks after surgery revealed clinical improvement. Neurological examinations at 2, 4, 7, and 12 months after surgery did not reveal any abnormalities, and the dog was considered to be clinically normal. Tethered cord syndrome with a tight filum terminale is a very rare congenital anomaly and is characterized by an abnormally short and inelastic filum terminale. Therefore, this disorder is associated with abnormal caudal traction on the spinal cord and decreased physiological craniocaudal movements of the neural structures within the vertebral canal. Although further studies are necessary to evaluate and quantify physiological craniocaudal movement of the spinal cord and conus medullaris in neurologically normal dogs, the results of this report suggest further exploration of dynamic MRI to demonstrate decreased craniocaudal displacement of the conus medullaris in dogs with tethered cord syndrome with a tight filum terminale.
一只1岁11个月大的英国可卡犬因右后肢进行性跛行和尿失禁的临床症状接受评估。神经学检查提示病变定位于L4 - S3脊髓节段。该犬在仰卧位且髋关节处于中立位时进行的磁共振成像(MRI)未发现异常,脊髓圆锥终止于L7椎体的中部。髋关节处于伸展和屈曲位时的MRI显示,脊髓圆锥分别在头侧和尾侧有最小程度的移位。与中立位图像相似,在伸展和屈曲位时脊髓圆锥均终止于L7椎体的中部。相比之下,另一只英国可卡犬在中立、伸展和屈曲位时进行的髋关节MRI显示,髋关节伸展时脊髓圆锥明显向头侧移位,髋关节屈曲时则向尾侧移位。进行了标准的腰骶部椎板切除术。对椎管进行目视检查发现脊髓圆锥受到过度的尾侧牵拉。切断终丝远端后,脊髓圆锥恢复到更靠近头侧的位置。术后4周的神经学检查显示临床症状有所改善。术后2个月、4个月、7个月和12个月的神经学检查均未发现任何异常,该犬被认为临床正常。终丝紧张所致的脊髓拴系综合征是一种非常罕见的先天性异常,其特征是终丝异常短且无弹性。因此,这种疾病与脊髓的异常尾侧牵拉以及椎管内神经结构的生理性头尾向移动减少有关。尽管需要进一步研究来评估和量化神经学正常犬脊髓和脊髓圆锥的生理性头尾向移动,但本报告结果提示进一步探索动态MRI以显示终丝紧张所致脊髓拴系综合征犬脊髓圆锥头尾向移位减少的情况。