Tethered Cord Syndrome Associated with a Thickened Filum Terminale in a Dog

Decker, Steven De; Gregori, Tommaso; Kenny, Patrick; Hoy, Carol; Erles, Kerstin; Volk, Holger A.

doi:10.1111/jvim.12522

Cited by 13 publications

(15 citation statements)

References 18 publications

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“…Clinical signs of cauda equina disease include pelvic limb lameness, pain and disorders of continence and tail movement. Cauda equina syndrome can be caused by neoplasia, discospondylitis, epidural empyema, tethered cord syndrome, epidural lipomatosis, and epidural/para synovial cysts in addition to DLSS 49–53. These differentials must be ruled in or out by diagnostic investigations 48,54…”

Section: Principles Of Diagnosis Of Dlssmentioning

confidence: 99%

<p>Canine Degenerative Lumbosacral Stenosis: Prevalence, Impact And Management Strategies</p>

Worth¹,

Meij²,

Jeffery³

2019

VMRR

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Canine degenerative lumbosacral stenosis (DLSS) is a syndrome of low back pain with or without neurologic dysfunction associated with compression of the cauda equina. Most commonly occurring in medium- to large-breed dogs of middle to older age, German shepherd and working dogs are predisposed. Diagnosis is based on a combination of clinical signs, advanced imaging and ruling out other differential diagnoses. The volume of the intervertebral foramina at the lumbosacral junction is naturally reduced on extension but degenerative changes lead to a more marked reduction that can impinge the L7 nerve roots. Evidence is lacking on which to base decision-making for treatment of dogs with DLSS. However, surgical intervention may be indicated in dogs that do not respond to conservative management, or for dogs in which there is a requirement to work that prevents lifestyle adjustments. Improvements in electrodiagnosis and novel intra-discal treatments may improve the management of DLSS in the future.

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Section: Principles Of Diagnosis Of Dlssmentioning

confidence: 99%

<p>Canine Degenerative Lumbosacral Stenosis: Prevalence, Impact And Management Strategies</p>

Worth¹,

Meij²,

Jeffery³

2019

VMRR

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“…6 7 9 11 More recently tethered cord syndrome has been identiied as a sole inding in a canine patient causing progressive pelvic limb lameness. 8 Currently, diagnosis in dogs remains challenging considering the lack of data of normal anatomical position of the CM, therefore being able to estimate the expected position of the CM would further aid diagnosis of this condition.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally it would help with the identiication of pathological variations in the position of the CM such as tethered cord syndrome: a congenital disorder described in both human beings and dogs characterised by an abnormal caudal traction of the CM. [6][7][8][9][10][11] The aim of the study is to determine the position of the CM and DS termination in a population of dogs of various sizes and evaluate whether these termination points depend on the size of the dog. The authors' hypotheses were that the CM position depends on the size of the dog while the end point of the DS is a species constant.…”

Section: Introductionmentioning

confidence: 99%

Variation in the position of the conus medullaris and dural sac in adult dogs

et al. 2019

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Although it has long been stated that the level of spinal cord termination varies depending on the size of the dog, the evidence for this remains limited. The aim of this study is to investigate the position of the conus medullaris (CM) and dural sac (DS) in a population of dogs of varying size. MRIs of the thoracolumbosacral spine of 101 dogs were included. The location of CM and DS was determined on sagittal T2-weighted images and T1-weighted images, respectively, by three independent observers. The bodyweight and the back length were used as markers of size. Regression analysis showed that the termination point of the CM had a statistically significant relationship with bodyweight (R2=0.23, P<0.05). Although not statistically significant (P=0.058), a similar relationship was found between CM and back length (R2=0.21). No statistically significant relationship was found between the termination point of the DS and bodyweight (P=0.24) or back length (P=0.19). The study confirms the terminal position of the CM is dependent on size, with a more cranial position with increasing size; however, the termination point of DS remains constant irrespective of dog size.

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“…Obtaining a diagnosis of tethered cord syndrome with a tight filum terminale is challenging in dogs for several reasons ( 5 ). The anatomical variation in conus medullaris termination and the theoretical possibility of occult tethered cord syndrome make it difficult to consider an abnormal caudal position of the conus medullaris as a reliable diagnostic criterion in dogs ( 5 ). Therefore, this case report explored the possibility of dynamic MRI with the hips in neutral, extended, and flexed positions to facilitate diagnosing this rare congenital anomaly.…”

Section: Discussionmentioning

confidence: 99%

“…However, in the majority of human patients, tethered cord syndrome is associated with an abnormal short, thickened, and inelastic filum terminale without other spinal malformations ( 3 ). This is also referred to as tethered cord syndrome with a tight filum terminale ( 1 , 4 ) and has been reported only once previously in the veterinary literature ( 5 ). As a consequence of excessive caudal traction, tethered cord syndrome is classically associated with an abnormal caudodorsal position of the conus medullaris ( 1 – 4 ).…”

Section: Introductionmentioning

confidence: 96%

Dynamic Lumbosacral Magnetic Resonance Imaging in a Dog with Tethered Cord Syndrome with a Tight Filum Terminale

2017

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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.Keywords: spinal dysraphism, spinal malformation, magnetic resonance imaging, cauda equina, conus medullaris Case pReseNtatIoNA 1-year and 11-months-old, female neutered English Cocker Spaniel was evaluated for clinical signs of progressive right pelvic limb lameness of 16 months duration and intermittent urinary incontinence of 2 weeks duration. Orthopedic and neurological examinations; radiographs of the hips, pelvis, and right stifle; and spinal magnetic resonance imaging (MRI) performed at 10 months before Sagittal and transverse plane T1-weighted (T1W TSE) (TR/TE, 400/8) images were acquired before and after IV injection with gadolinium contrast (0.1 ml/kg gadoterate meglumine, Dotarem, Guerbet, Milton Keynes, England). No abnormalities were seen on MRI, and the conus medullaris ended halfway the...

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Tethered Cord Syndrome Associated with a Thickened Filum Terminale in a Dog

Cited by 13 publications

References 18 publications

<p>Canine Degenerative Lumbosacral Stenosis: Prevalence, Impact And Management Strategies</p>

<p>Canine Degenerative Lumbosacral Stenosis: Prevalence, Impact And Management Strategies</p>

Variation in the position of the conus medullaris and dural sac in adult dogs

Dynamic Lumbosacral Magnetic Resonance Imaging in a Dog with Tethered Cord Syndrome with a Tight Filum Terminale

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