ISSN 2398-2969      

Diskospondylitis

icanis

Introduction

  • Causes: bacterial or fungal intervertebral disk infection with extension to the vertebral end plates and vertebrae may be blood borne or localized foreign body.
  • Mainly in adult dogs of larger breeds.
  • Signs: referable to disks involved, most commonly C6/C7, T5/T6, T13/L1, L7/S1; often systemically ill, unlike degenerative disk disease.
  • Diagnosis: radiography, advanced imaging, urine and blood culture.
  • Treatment: antibiotics, rest, analgesia.
  • Prognosis: good with appropriate treatment.

Pathogenesis

Etiology

  • Foreign body migration.
  • Associated with adjacent tissue infection.
  • Iatrogenic trauma (spinal surgery, disk fenestration or epidural injection).
  • Immumnosuppression may play a role in infection.
  • Hematogenous spread of infection from elsewhere in the body, egS. intermedius.
  • Most common cause is bacterial infection with coagulase positive Staphylococci (S. aureus Staphylococcus aureus orS. intermedius Staphylococcus intermedius ) being the most frequent isolate.
  • Other frequently identified bacteria includeStreptococcus Streptococcus spp ,Escherichia coli Escherichia coli andBrucella canis.
  • Fungal infections have also been reported, withAspergillus,Paecilomyces,Pencillium, andFusariumspecies, andCoccidioides immitisbeing cultured.

Predisposing factors

General

Pathophysiology

  • Most commonly arises from hematogenous spread of organisms to the intervertebral disk space.
  • Primary source can be urogenital tract, skin or dental disease, and valvular endocarditis.
  • Infection, egS. intermediusfrom elsewhere (commonly urinary tract) → infection of disk and end plate → intervertebral body → involves local meninges → inflammation → soft tissue swelling → vertebral instability → pressure on canal → pain → clinical signs.
  • Diskospondylitis rarely produces secondary meningitis.
  • Grass awn penetrates skin → alimentary penetration → migration from the cranial to the mid-lumbar region via the mesentary. Tends to affect L2-L4 disk spaces.
  • Extradural spinal cord compression can occur as a result of proliferation of inflammatory tissue, epidural empyema or secondary disk protrusion.
  • Extensive inflammation can also lead to meningitis Meningitis and meningomyelitis.

Timecourse

  • Usually chronic and progressive.
  • Occasional acute deterioration with secondary pathological vertebral fracture or disk protrusion.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Schwartz M, Boettcher I C, Kramer S et al (2009) Two dogs with iatrogenic discospondylitis caused by methicillin-resistant Staphylococcus aureus. JSAP 50, 201-205 PubMed.
  • Burkert B A, Kerwin S C, Hosgood G L (2005) Signalment and clinical features of diskospondylitis in dogs: 513 cases (1980-2001). JAVMA 227 (2), 268-275 PubMed.
  • Kinzel S, Koch J, Buecker A et al (2005) Treatment of 10 dogs with discospondylitis by fluoroscopy-guided percutaneous discectomy. Vet Rec 156 (3), 78-81 PubMed.
  • Adamo P F, Cherubini G B (2001) Discospondylitis associated with three unreported bacteria in the dog. JSAP 42, 352-355 PubMed.
  • Auger J, Dupuis J, Quesnel A et al (2000) Surgical treatment of lumbrosacral instability caused by discospondylitis in four dogs. Vet Surg 29, 70-80 PubMed.
  • Davis M J et al (2000) Contrast radiographic findings in canine bacterial diskospondylitis - a multicenter retrospective study of 27 cases. JAAHA 36 (1), 81-5 PubMed.
  • Gonzelo-Orden J M, Altonaga J R, Orden M A & Gonzalo J M (2000) Magnetic resonance, computed tomographic and radiologic findings in a dog with discospondylitis. Vet Rad Ultra 41 (2), 142-144 PubMed.
  • Thomas W B (2000) Discospondylitis and other vertebral infections. Vet Clin North Am Small Anim Pract 30, 169-182 PubMed.
  • Siems J A, Jakovlijevic S, Adams L G, Munjar T A & DeNicola D B (1999) Discospondylitis in association with an intra-abdominal abscess in a dog. JSAP 40 (3), 123-126 PubMed.
  • Kraft S L et al (1998) Magnetic resonance imaging of presumptive lumbosacral diskospondylitis in a dog. Vet Radiol Ultrasound 39 (1), 9-13 PubMed.
  • Jaffe M H (1997) Canine diskospondylitis. Comp Cont Educ 19 (5), 551-555 VetMedResource.
  • Remedios A M et al (1996) Epidural abscess and diskospondylitis in a dog after administration of a lumbosacral epidural analgesic. Can Vet J 37 (2), 106-107 PubMed.
  • Seim H B III (1996) Conditions of the thoracolumbar spine. Semin Vet Med Surg (Small Anim)​ 11 (4), 235-253 PubMed.
  • Butterworth S J et al (1995) Multiple discospondylitis associated with Aspergillus species infection in a dog. Vet Rec 136 (2), 38-41 PubMed.
  • Kerwin S C (1992) Diskospondylitis associated with Brucella canis infection in the dog - 14 cases (1980-1991). JAVMA 201 (8), 1253-1257 PubMed.
  • Moore M P (1992) Diskospondylitis. Vet Clin North Am Small Anim Pract 22 (4) 1027-1034 SciDirect.
  • Bennett D et al (1981) Discospondylitis in the dog. JSAP 22 (8) 539-547 PubMed.
  • van Bree H et al (1981) Successful conservative treatment of cervical discospondylitis in a dog. JSAP 22 (2) 59-65 PubMed.
  • Johnston D E (1971) Osteomyelitis of the lumbar vertebrae in dogs caused by grass seed bodies. Aus Vet J 47 (7), 289-294 PubMed.

Other sources of information

  • Oliver & LorenzHandbook of Veterinary Neurologic Diagnosis. Philadelphia: W B Saunders, pp 171.
  • Merck Veterinary Annual. (1998)8, pp 923-924.
  • Thomas W B (1997)Diskospondylitis.The 5 Minute Veterinary Consult - Canine and Feline.pp 524-525.
  • Oliver, Lorenz & Kornegay (1997)Handbook of Veterinary Neurology. 3rd edn. pp 155-156.

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