Cooper Lauryn, Kent Marc
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
JFMS Open Rep. 2025 Sep 4;11(2):20551169251352386. doi: 10.1177/20551169251352386. eCollection 2025 Jul-Dec.
A 10-year-old female spayed domestic shorthair cat was evaluated for a 6-week history of abnormal tail carriage and constipation. Examination revealed tail paresis and pain over the lumbosacral and sacrocaudal articulations and on tail manipulation. MRI revealed a contrast-enhancing mass within the vertebral canal over the lumbosacral disc space, compressing the cauda equina. The mass filled the epidural space, resulting in complete attenuation of the cerebrospinal fluid signal. Laminectomy and durotomy were performed over L7-S1, revealing white, firm material within the subarachnoid space. Microscopically, the material was consistent with degenerative intervertebral disc material. Postoperatively, the clinical signs resolved completely.
Intervertebral disc herniation (IVDH) is uncommon in cats, with most cases involving extradural compression of nervous tissue. Reports describing intramedullary intervertebral disc extrusions in cats are rare. To the authors' knowledge, the present case is the first reported intradural-extramedullary intervertebral disc extrusion in a cat. Although MRI can often delineate extradural lesions, it can be insensitive in differentiating intradural-extramedullary from intramedullary lesions. In the present case, the location of the lesion within the vertebral canal at the lumbosacral disc space made the determination of the lesion's location with respect to the meninges challenging. Moreover, the strong contrast enhancement of the lesion raised an index of suspicion for neoplasia. Surgical intervention and histopathology confirmed an intradural-extramedullary IVDH. The present case adds to a growing body of literature regarding IVDH in cats and details the imaging findings of intradural-extramedullary IVDH in a cat.
一只10岁已绝育的雌性家养短毛猫因异常的尾巴姿势和便秘6周病史接受评估。检查发现尾巴轻瘫，腰骶关节和骶尾关节处及尾巴触诊时有疼痛。磁共振成像（MRI）显示在腰骶椎间盘间隙水平的椎管内有一个强化肿块，压迫马尾神经。肿块充满硬膜外间隙，导致脑脊液信号完全衰减。在L7-S1节段进行了椎板切除术和硬脊膜切开术，发现蛛网膜下腔内有白色、质地硬的物质。显微镜检查显示，该物质与退变的椎间盘物质一致。术后，临床症状完全消失。
椎间盘突出症（IVDH）在猫中并不常见，大多数病例涉及神经组织的硬膜外压迫。描述猫髓内椎间盘突出的报告很少。据作者所知，本病例是首例报道的猫硬脊膜内-硬膜外椎间盘突出。尽管MRI通常可以清晰显示硬膜外病变，但在区分硬脊膜内-硬膜外病变与髓内病变时可能不敏感。在本病例中，病变位于腰骶椎间盘间隙水平的椎管内，使得确定病变相对于脑膜的位置具有挑战性。此外，病变的强烈强化增加了对肿瘤的怀疑指数。手术干预和组织病理学证实为硬脊膜内-硬膜外IVDH。本病例增加了关于猫IVDH的越来越多的文献，并详细描述了猫硬脊膜内-硬膜外IVDH的影像学表现。
