Web-Vet TM Neurology Specialists
Lumbosacral Disease
Lumbosacral disease, sometimes termed degenerative lumbosacral stenosis (DLSS), is a disease primarily observed in medium- and large-breed dogs. DLSS induces compression and damage to the cauda equina due to narrowing of the vertebral canal and intervertebral foramen caused by degenerative changes in the discs, vertebrae, joints, and soft tissues of the lumbosacral junction. It may cause various clinical signs related to the cauda equina, such as pain, lameness, paresis of the hind limbs and tail, urinary incontinence, and fecal incontinence
Diagnosis
This study aimed to validate the LSPain Scale, a novel 4-point ordinal instrument for assessing lumbosacral pain in dogs based on behavioural responses to palpation of the lumbosacral region. A prospective validation was performed using 50 anonymised clinical videos retrospectively collected from client-owned dogs evaluated for suspected lumbosacral pain. Dogs represented a broad clinical spectrum and were graded using the LSPain Scale, which ranges from 0 (no pain) to 3 (severe pain). Trained observers, including pain specialists and general practitioners, independently scored the videos while blinded to clinical data. Psychometric evaluation demonstrated strong convergent and discriminant validity, responsiveness to treatment, inter- and intra-rater reliability, and usability across experience levels.
Medical Treatment
This retrospective cohort study evaluated long-term outcomes (capped at 24 months) following a single procedure involving ultrasound- and fluoroscopy-guided foraminal and epidural corticosteroid and local anaesthetic injections, with (PRF; 9 dogs) or without PRF (No-PRF; 9 dogs) at the L7 DRG, in dogs with chronic lumbosacral pain. Outcome measures included clinician-based Lumbosacral Pain (LSPain) Scale scores and caregiver-reported Canine Brief Pain Inventory (CBPI) scores and quality of life (QoL). Clinically relevant improvement was defined as a two-grade reduction in LSPain Scale score and a CBPI decrease of ≥1 point in pain severity and ≥2 points in pain interference.
Pain severity and QoL improved significantly over time within both groups (p < 0.05). Dogs receiving PRF had significantly greater QoL improvement (p = 0.0247). Clinically relevant improvement was achieved in 9/9 of dogs in the PRF group and 5/9 in the No-PRF group. The median duration of clinically relevant improvement was longer in the PRF group [16.4 (2.2–24) months] than in the No-PRF group [8.9 (0 to 24) months], although this difference did not reach statistical significance in the sample size studied.
Surgery & Prognosis
The objective of this study was to retrospectively review the efficacy of combined surgery comprising dorsal laminectomy and dorsal fixation using screws and polymethylmethacrylate as treatment for dogs with degenerative lumbosacral stenosis (DLSS).
21 dogs with DLSS were evaluated; in all cases clinical signs were alleviated, proprioceptive deficits were improved from 3 months after surgery, and no recurrence of clinical signs was observed during the observation period. Minor complications were observed in 6 cases (28.6%), including implant failure in 2 (9.5%), delayed healing of surgical wounds in 2 (9.5%), seroma in 1 (4.8%), and swelling of the affected area in 1 (4.8%). There was no case with major complications.
The aim of this study was to compare transarticular screw fixation (TSF), pedicle screw-rod fixation (PSRF), and screws and polymethylmethacrylate (SPMMA) for stabilization of the canine lumbosacral junction (LSJ).
All stabilization methods resulted in an equal reduction in ROM in flexion/extension. Fatigue cyclic testing resulted in minor increases in ROM compared to baseline for all groups. Ramped cyclic testing resulted in failure of all groups, with no differences between groups for the bending moment necessary to reach 5.0°/7.5°/10.0° of ROM. The main failure mode for each method was progressive screw loosening.