Lumbosacral Disease/Lumbosacral Malarticulation/Cauda Equina Syndrome
Various spinal diseases can involve the lumbosacral region of the spine. Many of these conditions exist under the lumbosacral disease or cauda equina syndrome labels. Degenerative lumbosacral (LS) disease is often the cumulative result of malarticulation, malformation, or, most commonly, intervertebral disk degeneration and protrusion at the lumbosacral joint space. In some instances, this abnormality is associated with occult osteochondritis dissecans (OCD) lesions of the L7 vertebrae or sacrum. Similar to what was described with some aspects of wobbler’s syndrome, damage and degeneration of supporting elements of the lumbosacral vertebral structures may result in intervertebral disk damage, annulus protrusion, tearing of the annulus, or nucleus extrusion. Conversely, the primary disease of the IVD may be the inciting pathologic feature of this disease process. Hypertrophy of supporting ligamentous elements and joint capsule may also occur concurrently. In some instances, primary vertebral abnormalities of either the L7 vertebrae or the sacrum may be present. These pathologic processes may predispose this area to instability.
Hypertrophy of ligamentous tissue and synovial elements, as well as intervertebral disk protrusion/extrusion, may result in spinal cord or nerve compression. The associated spinal nerve compression usually affects the L7 peripheral nerve and nerve roots as well as the sacral and caudal nerve roots as these nerves traverse through the lumbosacral area. Nervous tissue compression can result from a dorsal direction from the interarcuate ligament and joint capsule, or ventrally from the bulging or tearing of the annulus fibrosus or, occasionally, from extrusion of the nucleus pulposus. The L7 nerve roots are often also compressed from a ventral and lateral direction as they exit the vertebral canal at the intervertebral foramen either from collapse of the foraminal area or from osteophyte proliferation.
Degenerative lumbosacral disease and compression occurs most often in larger breeds of dogs such as German shepherds. Many of these dogs are also working breeds whose performance activity may place added strains on the lumbosacral articulation and associated IVD elements. In some breeds, a congenital stenosis of this region may also contribute to spinal and nerve root compression and is the primary pathological feature of the disease.
Hypertrophy of ligamentous tissue and synovial elements, as well as intervertebral disk protrusion/extrusion, may result in spinal cord or nerve compression. The associated spinal nerve compression usually affects the L7 peripheral nerve and nerve roots as well as the sacral and caudal nerve roots as these nerves traverse through the lumbosacral area. Nervous tissue compression can result from a dorsal direction from the interarcuate ligament and joint capsule, or ventrally from the bulging or tearing of the annulus fibrosus or, occasionally, from extrusion of the nucleus pulposus. The L7 nerve roots are often also compressed from a ventral and lateral direction as they exit the vertebral canal at the intervertebral foramen either from collapse of the foraminal area or from osteophyte proliferation.
Degenerative lumbosacral disease and compression occurs most often in larger breeds of dogs such as German shepherds. Many of these dogs are also working breeds whose performance activity may place added strains on the lumbosacral articulation and associated IVD elements. In some breeds, a congenital stenosis of this region may also contribute to spinal and nerve root compression and is the primary pathological feature of the disease.
Age of Onset: Greater than 5 years of age
Sex Predisposition: Any sex of animal can be affected
Clinical Course:
Clinical signs often worsen over time
Clinical signs often worsen over time
Clinical Signs:
Posture and Appearance
Tail often held in a downward direction
Movement
Reluctance to walk
Pelvic limb tremor
“Stiff” or “stilted” pelvic limbs when walking
Proprioception
With severe disease, mild paraparesis
Cranial Nerves
Spinal Reflexes
Reduced withdrawal reflex
Exaggerated patellar reflex (Due to loss of antagonistic muscle action)
Special Functions (e.g. respiration; urination)
Fecal incontinence
Urinary incontinence
Painful Reactions
Pain on palpation of the lumbosacral vertebral column
Muscle Atrophy
Cranial tibial muscle atrophy
Posture and Appearance
Tail often held in a downward direction
Movement
Reluctance to walk
Pelvic limb tremor
“Stiff” or “stilted” pelvic limbs when walking
Proprioception
With severe disease, mild paraparesis
Cranial Nerves
Spinal Reflexes
Reduced withdrawal reflex
Exaggerated patellar reflex (Due to loss of antagonistic muscle action)
Special Functions (e.g. respiration; urination)
Fecal incontinence
Urinary incontinence
Painful Reactions
Pain on palpation of the lumbosacral vertebral column
Muscle Atrophy
Cranial tibial muscle atrophy
Lumbosacral spinal cord
Unknown
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