ISSN 2398-2969      

Spinal cord: acute non-compressive nucleus pulposus extrusion

icanis

Synonym(s): Traumatic disk extrusion, Hansen 'type III' disk herniation, high velocity/low volume disk herniation


Introduction

  • Cause: extrusion of non-degenerated nucleus pulposus during strenuous exercise or trauma.
  • Signs: peracute onset of non-progressive (after the first 24 hours) and often asymmetrical myelopathy.
  • Diagnosis: advanced imaging.
  • Treatment: nursing care, physiotherapy, hydrotherapy.
  • Prognosis: good if nociception remains unaffected.

Pathogenesis

Pathophysiology

  • Occurs when non-degenerate nucleus pulposus extrudes through a tear in the annulus fibrosus during strenuous exercise or trauma → spinal cord contusion Spinal cord: concussion and nuclear material dissipates within the epidural space causing minimal to no spinal cord compression.
  • The most commonly affected intervertebral disk spaces are T12-T13, T13-L1 and L1-L2.
  • The higher incidence of acute non-compressive nucleus pulposus extrusion at the junction between mobile lumbar segment of the vertebral column and the comparatively immobile thoracic segment of the vertebral column is likely attributable to the strong biomechanical forces that act at this junction, particularly during strenuous exercise or trauma.

Timecourse

  • Peracute or acute onset.
  • Non-progressive (after 24 hours).

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.
  • De Risio L, Adams V, Dennis R, McConnell F J (2009) Association of clinical and magnetic resonance imaging findings with outcome in dogs with presumptive acute noncompressive nucleus pulposus extrusion: 42 cases (2000-2007). J Am Vet Med Assoc 234 (4), 495-504 PubMed.
  • Chang Y, Dennis R, Platt S, Penderis J (2007) Magnetic resonance imaging features of traumatic intervertebral disc extrusion in dogs. Vet Rec 160 (23), 795-799 PubMed.

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