Canis ISSN: 2398-2942

Intervertebral disk: type 2 herniation

Synonym(s): Hansen type 2 disk disease, Disk protrusion, Ruptured disk, Slipped disk

Contributor(s): Rodney Bagley, Laurent Garosi

Introduction

  • Intervertebral disk disease (IVD) can occur in any area of the spinal cord caudal to C1-2 (Hoerlein 1979).
  • Myelopathy usually seen in older animals of large non-chondrodystrophic breeds.
  • Cause: fibroid degeneration and weakening of dorsal annulus → bulging of the nucleaus pulposus within the weakened annulus fibrosus → protrusion of the disk into the vertebral canal.
  • Signs: depend on area of the cord affected - paresis progressing to paralysis.
  • Diagnosis: presence or absence of pain, response to a short course of analgesics/anti-inflammatory drugs (especially glucocorticoids) → helps differentiate degenerative from compressive spinal pathology.
  • Treatment: rest, analgesia and/or surgery.
  • Prognosis: guarded.
    Print off the owner factsheet Intervertebral disk herniation or "slipped disk" Intervertebral disk herniation or "slipped disk" to give to your client.
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Pathogenesis

Etiology

  • Aging related fibroid degeneration of annulus fibrosus.

Pathophysiology

  • Two basic types of intervertebral disk disease are seen.
  • A type I (Hansen's) intervertebral disk abnormality Intervertebral disk: type 1 herniation is seen in chondrodystrophic breeds of dogs which have chondroid metaplasia of their disks beginning early in life (Hansen 1951).
  • These disks usually extrude rather that protrude.
  • The type II IVD is seen most commonly in older, larger non-chondrodystrophoid dogs with fibroid metaplasia of the disk.
  • These disks usually protrude (bulge) rather that extrude.
  • Fibrous metaplasis is an age-related degenerative process characterized by bulging of the nucleus pulposus within the weakened annulus fibrosus and ultimately dorsal disk protrusion.
  • Fibrous metaplasia affects only a small number of disks and mineralisation is infrequent.
  • Protrusions are usually smooth, firm, and round and are rarely adhered to the dura mater.
  • Disk = cushion between vertebrae absorbing and dissipating shock.
  • With age fibroid degeneration of the annulus → less elastic and relatively inefficient at distributing load → hypertrophy of the annulus → protrusion into the spinal canal occurs, compression of the spinal cord → clinical signs progress with protrusion.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Salger F, Ziegler L, Bottcher I C et al (2014) Neurologic outcome after thoracolumbar partial lateral corpectomy for intervertrbal disc disease in 72 dogs. Vet Surg 43 (5), 581-8 PubMed.
  • Flegel T, Boettcher I C, Ludegwig E et al (2011) Partial lateral corpectomy of the thoracolumbar spine in 51 dogs: assessment of slot morphometry and spinal cord decompression. Vet Surg 40 (1), 14-21 PubMed.
  • Levine J M, Levine G J, Johnson S I, Kerwin S C, Hettlich B F, Fosgate G T (2007) Evaluation of the success of medical management for presumptive cervical intervertebral disk herniation in dogs. Vet Surg 36 (5), 492-499 PubMed.
  • Levine J M, Levine G J, Johnson S I, Kerwin S C, Hettlich B F, Fosgate G T (2007) Evaluation of the success of medical management for presumptive thoracolumbar intervertebral disk herniation in dogs. Vet Surg 36 (5), 482-491 PubMed.
  • Lamb C R, Nicholls A, Targett M, Mannion P (2002) Accuracy of survey radiographic diagnosis of intervertebral disc protrusion in dogs. Vet Rad Ultrasound 43 (3), 222-228 PubMed.
  • Jensen V F (2001) Asymptomatic radiographic disappearance of calcified intervertebral disc material in the Dachshund. Vet Rad Ultra 42 (2), 141-148 PubMed.
  • Hay C W & Muir P (2000) Tearing of the dura mater in three dogs. Vet Rec 146 (10), 279-282 PubMed.
  • McKee M (2000) Intervertebral disk disease in the dog: 2. management options. In Practice 22 (8), 458-471 VetMedResource.
  • Otani K et al (1997) Experimental disk herniation - evaluation of the natural course. Spine 22 (24), 2894-2899 PubMed.
  • Takahiashi T et al (1997) Treatment of canine intervertebral disk displacement with chondroitinase ABC. Spine 22 (13), 1446-1447 PubMed.
  • Seim H B III (1996) Conditions of the thoracolumbar spine. Semin Vet Med Surg (Small Anim) 11 (4), 235-253 PubMed.
  • Bracken M B, Shepard M J, Collins W F et al (1990) A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal cord injury. New Engl J Med 322 (20), 1405-11 PubMed.
  • Hoerlein B F (1979) Comparative disk disease - Man and dog. JAAHA 15 (5), 535-45 VetMedResource.
  • Hansen H J (1951) A pathologic anatomical interpretation of disk degeneration in dogs. Acta Orthop Scand 20 (4), 280-93 PubMed.

Other sources of information

  • Oliver, Lorenz & Kornegay (1997)Handbook of Veterinary Neurology.3rd edn. Philaelphia: W B Saunders. pp 132-139.
  • Bartels J E (1994)Intervertebral disk disease.In:Textbook of Veterinary Diagnostic Radiology.2nd edn. Ed: Thrall D E. Philadelphia: W B Saunders. pp 59.


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