Lecture 8

Question 1

What are the indications for nonsurgical treatment of disc disease?

Answer 1

-pain
-mild neurologic deficits
-surgery is contraindicated or declined by owner

Question 2

What are the components of nonsurgical treatment for disc disease?

Answer 2

-strict cage rest; at least 2 weeks of cage rest + 2 weeks of leash walks only
-analgesics as needed
-must see patients ASAP if worsening on this protocol

Question 3

What are the indications for surgical treatment of disc disease?

Answer 3

-substantial neurologic deficits
-no response to nonsurgical therapy
-recurring attacks
-compression on imaging (if no compression, no benefit of surgery)

Question 4

In regards to disc disease clinical signs, where is the “line” drawn between trying nonsurgical management vs needing surgery?

Answer 4

-patients with pain, ataxia, or ambulatory paraparesis can attempt non-surgical treatment
-patients with non-ambulatory paraparesis, paraplegia, or paraplegia with absent deep pain need surgery

Question 5

What are the characteristics of hemilaminectomy?

Answer 5

-top portion of bony vertebral canal is removed
-only done on one side
-want to remove bone on the side that has more extruded material
-muscle overlying spine will protect the side without bone

Question 6

What are the characteristics of fenestration?

Answer 6

-done at the same time as hemilaminectomy
-involves going into disc and removing remaining calcified material to prevent further extrusion
-can be done to adjacent discs to prevent them from ever extruding
-typically does not cause arthritis or other adverse effects

Question 7

What are the characteristics of ventral slot approach?

Answer 7

-done for cervical vertebrae/in the neck
-incision made from below larynx to sternum
-less muscle to go through; most direct approach
-slot is drilled down through disc and into vertebral canal
-slot must be small to maintain stability and avoid vasculature

Question 8

What is the prognosis for intervertebral disc disease?

Answer 8

-worse prognosis with increased severity of clinical signs
-better prognosis with surgery vs. conservative management