Myelography in calves: a comparative study between the contrast agents iopamidol and iohexol / Mielografia em bezerros: estudo comparativo entre os meios de contrastes iopamidol e ioexol

Due to the scarcity of myelogenous studies in cattle, the present study aimed to evaluate the efficacy and distribution of iopamidol and iohexol contrast agents in calves, in order to determine guidelines for obtaining diagnostic radiographs of spinal cord disorders in these animals. Ten healthy Holstein calves, seven days to two months of age, were divided into two groups, according to the contrast medium applied. Myelographic studies of the spine were performed with the calves in lateral recumbency, with radiographs repeated 20 times during a two-hour period. On the radiographs, the contrast medium was analyzed for opacity, detail of the image, distension of the medullary canal, and progression of the contrast line. After seven days, the myelographic studies were repeated, with the contrast media exchanged between the groups. There were no significant differences in the quality of the images and speed of the spinal column filling between the two contrast media. Furthermore, the best quality radiographic images were obtained six to eight minutes after injection of the contrast in the cervical spinal segment, 80 minutes in the thoracic, and 20 minutes in the lumbar, sacral, and cauda equina segments.(AU)

Devido à escassez de estudos mielográficos em bovinos e relatos de complicações no procedimento, o presente estudo teve por objetivo avaliar a eficácia e a distribuição dos meios de contraste iopamidol e ioexol em bezerros, a fim de nortear a melhor conduta para o diagnóstico de afecções vertebrais e medulares nesses animais. Foram utilizados 10 bezerros Holandeses, hígidos, com idade entre sete dias e dois meses, distribuídos em dois grupos, conforme o meio de contraste aplicado. O estudo mielográfico da coluna vertebral foi realizado na posição laterolateral, repetido em 20 momentos, durante o período de duas horas. Nas radiografias, analisou-se o meio de contraste quanto à opacidade, detalhes da imagem, distensão do canal medular e progressão da linha de contraste. Após sete dias, foi realizado o segundo período experimental, que compreendeu a troca do meio de contraste dentro de cada grupo. Não houve diferenças significativas em relação à qualidade da imagem e à velocidade do preenchimento da coluna medular entre os dois meios de contraste. A partir da administração dos meios de contraste, a obtenção de imagens radiográficas de melhor qualidade deu-se após seis a oito minutos no segmento medular cervical, 80 minutos no torácico e 20 minutos nos segmentos lombar, sacral e cauda equina.(AU)

Comparison of Magnetic Resonance Imaging and Computed Tomography-Myelography for Quantitative Evaluation of Lumbar Intracanalar Cross-Section

PURPOSE: A comparison of MRI and computed tomography-myelography (CTM) for lumbar intracanalar dimensions. To compare the capability and reproducibility of MRI and CTM in measuring the cross-sectional morphology of intracanalar lesions of the lumbar spine. MATERIALS AND METHODS: MRI and CTM of lumbar disc levels from 61 subjects with various lumbar spinal diseases were studied. Dural area, dural anteroposterior (AP) diameter, dural right-left diameter, and thickness of the ligamentum flavum were measured by two orthopedic surgeons. Each section was graded by degree of stenosis. Absolute value and intra- and inter-observer correlation coefficients (ICC) of these measurements and the associations between MRI and CTM values were determined. RESULTS: Except for MRI determination of ligament flavum thickness, CTM and MRI and intra- and ICC suggested sufficient reproducibility. When measurements of dural area, dural AP diameter, and RL diameter were compared, values in CTM were significantly (p = 0.01-0.004) larger than those in MRI (CTM/MRI ratios, 119%, 111%, and 105%, respectively). As spinal stenosis became more severe, discrepancies between CTM and MRI in measurements of the dural sac became larger. CONCLUSION: Both CTM and MRI provided reproducible measurements of lumbar intracanalar dimensions. However, flavum thickness may be more accurately measured by CTM. Because the differences in the measurements between CTM and MRI are very slight and there is very little data to suggest that the precise degree of stenosis is related to symptoms or treatment outcome, the usefulness of the CTM over MRI needs to be confirmed in future studies.

Doença do disco intervertebral cervical em cães: 28 casos (2003-2008) / Cervical intervertebral disk disease in dogs: 28 cases (2003-2008)

O objetivo deste estudo foi identificar cães com doença do disco intervertebral (DDIV) cervical atendidos no Hospital Veterinário Universitário (HVU) da Universidade Federal de Santa Maria (UFSM) entre janeiro de 2003 e outubro de 2008 e obter informações a respeito de raça, sexo, idade, sinais neurológicos, resposta ao tratamento cirúrgico, complicações, tempo de recuperação funcional após a cirurgia e ocorrência de recidiva. Hiperestesia cervical foi observada em todos os cães (n=28). Quanto ao grau de disfunção neurológica foram verificados: grau I (8/28[28,5 por cento]), grau II (3/28 [10,7 por cento]), grau III (5/28[17,8 por cento]) e grau V (12/2 [42,8 por cento]). A duração dos sinais neurológicos antes da cirurgia em sete cães (25 por cento) permaneceu por até 15 dias, em 14 cães (50 por cento) entre 15 e 30 dias e nos outros sete cães (25 por cento) por mais de 30 dias. A recuperação satisfatória e sem recidiva foi observada em todos os cães submetidos ao tratamento cirúrgico e que sobreviveram (n=21). Pode-se concluir que a DDIV cervical em nossa rotina acomete principalmente cães adultos, machos, de raças condrodistróficas e não condrodistróficas, incluindo as de grande porte; a hiperestesia cervical é a principal manifestação clínica; a técnica de fenda ventral promove recuperação funcional satisfatória e sem recidiva; as principais complicações trans-operatórias são a hemorragia do plexo venoso, a bradicardia e a hipotensão; e a duração dos sinais clínicos não interfere no tempo de recuperação pós-operatória dos cães.

The aim of this study was to evaluate the medical records of dogs with cervical intervertebral disk disease (IDD), submitted to surgical treatment at the Hospital Veterinário Universitário of Universidade Federal de Santa Maria (HVU-UFSM), between January 2003 and October 2008. The animal data included breed, sex, age, neurological signs and their durations, response to surgical treatment, complications, time for functional recovery after surgery, and recurrence. All dogs showed cervical hyperaesthesia confirmed by the neck movement test. Regarding the degree of neurological dysfunction, the following were verified: degree I (eight dogs, 28.5 percent), degree II (three dogs, 10.7 percent), degree III (five dogs, 17.8 percent), and degree V (twelve dogs, 42.8 percent). In relation to the duration of neurological signs prior to surgery, seven dogs (25 percent) showed neurological deficits for up to 15 days, fourteen dogs (50 percent) for 15 to 30 days and the other seven dogs (25 percent) showed signs of neurological deficiencies for more than 30 days. All dogs (n=21) showed satisfactory recovery and no recurrence. It can be concluded that most affected dogs are middle aged, males and condrodystrophic and noncondrodystrophic breeds including large-breed dogs and the main neurological sign is cervical hyperaesthesia. The surgical treatment promotes satisfactory functional recovery and no recurrence, the main complications intraoperative are venous plexus hemorrhage, bradycardia and hypotension and the duration of clinical signs prior to surgery do not interfere with the recovery time of the dogs.

A musculatura epaxial e a fibrose epidural na compressão medular em cães submetidos à laminectomia dorsal modificada / Epaxial musculature and epidural fibrosis in the spinal compression in dogs submitted modified dorsal laminectomy

O objetivo deste experimento foi isolar a musculatura epaxial da medula espinhal de cães submetidos à laminectomia dorsal modificada (LDM) e averiguar se os músculos influenciaram na formação da fibrose epidural, na compressão medular e no aparecimento dos sinais neurológicos. Para isso, dez cães hígidos foram submetidos à LDM entre as vértebras T13 e L1 e distribuídos aleatoriamente em dois grupos denominados controle (I) onde a medula espinhal permaneceu exposta sem a presença de implante, e tratado (II)onde foi colocado um im-plante a base de alumínio entre a musculatura epaxial adjacente e a medula espinhal exposta pela LDM. As avaliações constaram de exames neurológicos diários até 180 dias de pós-operatório (PO); mielografia, decorridos 15, 30 e 60 dias de PO; e avaliação macroscópica mediante a reintervenção cirúrgica. Não houve diferença durante as avaliações neurológicas. Aos 15 dias de PO, foi verificado na mielografia, que o grau de compressão da linha de contraste foi maior no grupo tratado (P<0,05) quando comparado ao grupo controle, não havendo diferença dos demais tempos estudados. Na avaliação macroscópica, pode-se observar que no Grupo II, a musculatura epaxial adjacente à medula espinhal não estava em contato com a fibrose epidural, diferentemente do grupo controle. O implante pôde ser removido facilmente e apresentava discreto grau de deformidade crânio-dorsal. Pode-se concluir que a musculatura epaxial adjacente é isolada da medula espinhal pelo implante à base de alumínio em cães submetidos à LDM, e esta não influencia na formação da fibrose epidural, compressão medular e no aparecimento dos sinais neurológicos.

The purpose of this study was to isolate the adjacent epaxial musculature from exposed spinal cord by modified dorsal laminectomy in dogs with aluminum implant and to verify whether the muscles contribute to form epidural fibrosis, spinal cord compression, and development of neurological signs. Ten dogs were submitted to modified dorsal laminectomy between T13 and L1 and then distributed along two groups. Dogs in the group 1 remained with the spinal cord exposed without the implant; dogs in the group 2 had an aluminum implant inserted between the epaxial muscles and the exposed spinal cord. Neurological examination was daily performed until 180 days post surgery. Additionally, myelography at 15, 30, and 60 days post surgery and macroscopic evaluation of the implant at six months post surgery were done. There was no difference between groups in the neurological examination. A statistical difference in the degree of spinal compression was observed at day 15 post surgery in the group 2. In this group, the epaxial musculature adjacent to the spinal cord was not in contact with the epidural fibrosis, differently to what was observed in the control group. The implant was removed easily with some degree of deformity. The results showed that the adjacent musculature of the spinal cord submitted to a modified dorsal laminectomy in dogs can be isolated by aluminum implant, without any contact with epidural fibrosis or influence in the development of neurological signs.

Spinal subdural extramedullary masses: myelography, CT myelography and MRI diagnosis

13 conventional myelographic examinations were performed, 7 myelographic CT studies and 4 MRE examinations on 16 cases of subdural extramedullary mass lesions. The lesions were 6 meningioma, 7 neurinoma, 2 lipomas and 1 subdural deposit. The diagnostic criteria of subdural extramedullary mass in myelography, CT myelography and in MRI as well as the differential diagnosis of the different pathological subdural mass lesions were discussed. Subdural extramedullary mass lesions can be easily diagnosed by myelography and CT myelography as well as by MRI. However, MRI has proven to be the procedure of choice in the diagnosis of such lesions

Myelography, CT myelography and MRI of spinal cord lesions: modality evaluation and comparative study

We performed 12 conventional myelographic examinations, 8 secondary CT myelographic studies and 9 MRI examinations on 19 cases having intramedullary lesions. The lesions were 8 ependymoma, 3 astrocytoma, 3 hypdrosyringomyelia, 1 cord contusion, 2 cord arteriovenous malformation and 2 undiagnosed intramedullary lesions. In spite of diagnosis of cord lesion could be reached by myelograhic findings in conjunction with patients clinical picture, MRI has proven to be procedure of choice in the evaluation of suspected cord lesions

Paraplejia flacida dolorosa por calcificación de discos intervertebrales: presentación de un caso en un adolescente con recuperación completa / Flaccid painful paraplegia by calcfication of the intervertebral disc

La calcificación del disco intervertebral en la infancia y adolescencia ha sido reconocida desde la descripción original de Baron en 1924 como una entidad clínica bien definida, de etiología desconocida, caracterizada por la calcificación del núcleo pulposo del disco, el cual da origen a una enfermedad aguda caracterizada por un severo síndrome doloroso, de resolución espontánea, autolimitada por la desaparición de la calcificación y con respuesta favorable al manejo conservador sin secuelas, a diferencia de la espondiloartritis de la edad madura. Los autores presentan la Historia Clínica de un paciente masculino, de 13 años, agricultor, que ingresa por intenso dolor en ambas regiones lumbares irradiado a miembros inferiores, exacervado con el ejercicio, de un mes de evolución, acompañado de hormigueo y sensación urente en ambos pies, con disminución progresiva de la fuerza muscular en extremidades inferiores hasta la parálisis completa con incontinencia urinaria y fecal. En su examen físico destaca: paraplejía flácida con maniobra de Lassegue francamente dolorosa bilateral, acentuada hipotonía de miembros inferiores con pie péndulo, arreflexia aquiliana y patelar bilateral; ausencia de reflejo cremasteriano, anestesia de periné, región glútea, cara posterior de muslos, piernas y región arquiliana. En los complementarios se observo eosinofilia marcada (12%) en ausencia de parasitosis alergias, ligera hiperproteinorraquia (55 mg/dl), maniobra de Queckenstedt positiva para bloqueo incompleto. El estudio radiológico simple y toográfico de columna lumbosacra mostró imágenes densas en los espacios D12-L1 y L1-L2 correspondiendo a calcificación de los discos intervertebrales, la mielografía reveló zona de bloque parcial D12-L1 y en la electromiografía se apreció cambios en la actividad motora y signos de denervación por afección de neurona motriz inferior. El resto de las exploraciones para descartar otras etiologías fueron negativas. Con el diagnóstico de Síndrome de la cola de caballo debida a la calcificación de discos intervertebrales se le sometió a un programa de rehabilitación observandose mejoría progresiva del cuadro neurológico, hasta su recuperación completa en 3 meses, sin haber requerido ningún otro régimen terapéutico salvo la analgesia

Cervical intramedullary neurofibroma

Intramedullary spinal neurofibroma is extremely rare. A case of cervical intramedullary neurofibroma is presented in a 21-year-old man. Only 20 case have been previously reported in the literature. The site of origin is discussed with various hypotheses.

Surgical treatment of spondylosis, allesthesias in adult-short term follow-up

During the period extending from 1982-1986, in King Fahad Hospital. Jeddah. We performed 10 operations of posterior fusion for ten patients of different ages group 30-45 years old with mean age 34 years. four were females and six males. Spondylosis in two patients and olisthesis in seven cases, a combined lesions of spondylolysis of L4 and L5 spondylolisthesis.One case dysplastic type of Olisthesis in Two, patients with sloping angles of 20

Mielografia cervical com iohexol: punçäo ântero-lateral C1-C2 / Cervical mielography with iohexol: antero-lateral C1-C2 puncture

A Mielografia cervical com Iohexol, na concentraçäo de 240 mg 1/ml, foi realizada em pacientes portadores de Mielopatia cervical, através de punçäo ântero-lateral C1-C2. Foi analisada a eficiência dessa via de acesso, efeitos colaterais do contraste utilizado e a qualidade da imagem