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PubMedDate not supplied

MR imaging findings in a dog with lumbar ganglion cysts.

Intraspinal cysts of the L6-L7 and L7-S1 articular process joints in a six-year-old neutered female German Shepherd Dog were diagnosed using magnetic resonance (MR) imaging. Histopathology provided a diagnosis of ganglion cysts. Clinical, laboratory, radiographic and MR imaging findings are described. Briefly, radiographic findings revealed lumbarization of the first sacral vertebra, and fusion of the first caudal vertebra to the sacrum. In addition, spondylosis and articular process osteoarthrosis occurred at L6-L7 and L7-S1. MR imaging revealed multiple, well encapsulated structures ranging in size from 3-10 mm in diameter which were found to arise from the L6-L7 and L7-S1 articular process joints. These cysts had signal intensities that varied from hyperintense to the cerebrospinal fluid (CSF) on T1 weighted images to isointense to CSF on T2 weighted images. Decompressive surgery in conjunction with arthrodesis of these joints resulted in resolution of clinical signs. The dog remained pain-free 1 1/2 years following surgical therapy.

Animals↗
PubMedDate not supplied

Appearance and incidence of sacroiliac joint disease in ventrodorsal radiographs of the canine pelvis.

Ventrodorsal (VD) radiographs of cadaveric pelves of large and giant breeds (n = 40) and of the corresponding bone specimens were made. Gross changes seen in the specimens were marked with metal wire or radiopaque paint to relate radiographic changes to the postmortem appearance of degenerative sacroiliac (SI) joint lesions. Two positioning techniques were used, resulting in two radiographs for each specimen. The techniques used were: (1) pulling the pelvic limbs caudally, with gentle traction producing a view of the sacrum in almost parallel alignment between the sacrum and the X-ray film (we have termed this a "central SI view") and (2) pulling the pelvic limbs caudally with greater traction than above, resulting in maximal inclination of the sacrum with respect to the X-ray film (we have termed this an "angled SI view"). Lesions of the supportive soft connective tissue could be imaged on the central and angled SI views, whereas angled SI views allowed better identification of lesions of the synovial SI joint. The insights gained in the above study were then used in a retrospective examination of 145 routine ventrodorsal radiographs of the pelvis (i.e., 290 sacroiliac joints) to determine the incidence of degenerative changes of the SI joint in large dogs. The lesions most commonly observed were calcification of the supportive soft connective tissue (n = 184/290), whereas lesions of the synovial SI joint were less frequent (n = 86/290). The degree of central or angled projection obtained in standard ventrodorsal radiographs was noted to be significantly (P < 0.05) associated with age, body conformation, anesthetic status, and the presence of spondylosis deformans at the lumbosacral junction. In contrast, SI joint disease and the gender of the animal did not affect the SI view achieved in VD radiographs.

Animals↗
PubMedDate not supplied

Imaging features of discospondylitis in two horses.

Two horses with discospondylitis are described with emphasis on the imaging modalities used and their contribution to the final diagnosis and outcome. Radiographic findings were vertebral endplate lysis with sclerosis in both horses, with additional vertebral subluxation and ventral spondylosis in one horse. Ultrasonographic findings included vertebral malalignment and obliteration of the intervertebral disc by spondylotic bone in one horse and irregular endplates, a widened disc space, a hypoechoic paravertebral abscess and hypoechoic, atrophic adjacent musculature with loss of linear fiber pattern in the other horse. Bone scintigraphy excluded additional affected sites. A systematic approach is recommended when performing an ultrasound examination of the spine.

Animals↗
PubMed2007

X-linked spondylo-epiphyseal dysplasia tarda in the Danish-Swedish farm hound.

In two litters from the same parents, three out of four males had an abnormally short leg and body length. Affected dogs showed signs of pain when moving, which could be eliminated by analgesia. On radiography, these animals had widened, radiolucent, irregularly bordered intervertebral disc spaces. When examined at seven months of age, the epiphyses appeared widened and irregular in shape and outline. General bone opacity in the vertebral column was lower in the affected male dogs than in the normal littermate. The affected dogs developed spondylosis and arthrosis of the larger limb joints. All affected dogs were euthanased on humane grounds, the eldest at the age of two years nine months. Based on the clinical and radiographic evidence, the condition seen in the male dogs described here resembles X-linked spondylo-epiphyseal dysplasia tarda caused by a collagenopathy due to malformation of COL2A1 as seen in human beings.

Animals↗
PubMed1975

Symposium on back problems in the horse. (2) The diagnosis of diseases of the horse's back.

A description of some of the clinical features of low back pain in the horse has been given and a number of methods for assisting diagnosis considered. As well as a complete clinical examination both at rest and during exercise, a useful diagnostic aid in some chronic cases was the injection of local anaesthetic into the interspinous spaces. A laboratory examination, including haematological and biochemical profiles, was undertaken in all cases. The serum enzymes GOT and CPK were particularly valuable as an aid to diagnosis in atypical tying-up. A technique for radiography of the vertebral column of the mid back in the standing position and of the pelvic and sacroiliac regions of the anaesthetised horse was described using a Siemens Triplex Optimatic 1023 machine. Some of the radiological features of the vertebral column were considered and a breakdown of the diagnosis of 110 referred back cases. The most important conditions included muscle strain, crowding and overriding of the dorsal spinous processes in the mid back, spondylosis, undue curvature of the spine and vertebral fractures.

Anesthesia, Local↗
PubMed1980

Disorders of the thoracolumbar spine of the horse--a survey of 443 cases.

The survey comprised 443 horses, referred to the clinical department of the Equine Research Station, with a history of a thoracolumbar (TL) complaint. A wide range of lesions were capable of producing back problems and more than one condition or site of injury was found in 75 animals (17 per cent). There were 103 horses (19.7 per cent) with no evidence of damage to the TL spine or its associated structures. In 66 of these cases, clinical signs were attributed to a variety of hindlimb lamenesses and, in 37, no specific diagnosis could be made. Soft tissue injury was diagnosed in 203 cases (38.8 per cent), the most frequent sites being the longissimus dorsi muscles and/or the supraspinous ligament in the caudal withers and cranial lumber regions. Chronic sacroiliac strain or mild sacroiliac instability was also a frequent cause of low back trouble in competitive horses. Other conditions included tying-up, subluxation of a lumbar vertebra and neuritis of the cauda equina. Fifteen cases (2.9 per cent) of vertebral malformations were found including scoliosis, lordosis and kyphosis. Vertebral lesions accounted for 202 (38.6 per cent) of the diagnoses. The most common condition was associated with crowding and overriding of the dorsal spinous processes in the caudal thoracic and cranial lumbar regions. This was most often diagnosed in competitive jumping horses (173 cases) and caused a loss of suppleness and spinal flexibility resulting in lowered performance and bouts of back pain. There was a comparatively low incidence of fractures (13 cases) and degenerative spondylosis (14 cases).

Animals↗
PubMed1997

The development of nao li shen and its clinical application.

The traditional Chinese medicine Nao Li Shen (containing ginseng, gastrodia tuber, chuanxiong rhizome and red sage root) is used in craniocerebral injury, cervical spondylosis and cerebrovascular diseases. The preparation, as an orally administered liquid, was tested in Mongolian gerbils and shown to increase tolerance to ischaemia and anoxia. Clinical use of the preparation resulted in improvement in 96% of 202 patients, as judged by right cerebral blood flow, TCD and CT examination. We conclude that Nao Li Shen has a positive curative effect upon craniocerebral injury and sequelae of cerebrovascular diseases.

Adult↗
PubMed2002

Acupuncture for carpal tunnel syndrome.

Acupuncture was used to treat a 51-year-old 'lollipop lady' (school crossing patrol officer), with severe carpal tunnel syndrome (CTS) affecting her dominant hand, and co-existing cervical spondylosis. I postulate that her symptoms were work related. She responded well to acupuncture, which provided good symptomatic treatment rather than cure and allowed her to continue working whilst she awaited surgical release.

Acupuncture Analgesia↗
PubMed2002

Superficial versus deep dry needling.

Ninety percent of my patients with myofascial trigger point (MTrP) pain have this alone and are treated with superficial dry needling. Approximately 10% have concomitant MTrP pain and nerve root compression pain. These are treated with deep dry needling. SUPERFICIAL DRY NEEDLING (SDN): The activated and sensitised nociceptors of a MTrP cause it to be so exquisitely tender that firm pressure applied to it gives rise to a flexion withdrawal reflex (jump sign) and in some cases the utterance of an expletive (shout sign). The optimum strength of SDN at a MTrP site is the minimum necessary to abolish these two reactions. With respect to this patients are divided into strong, average and weak responders. The responsiveness of each individual is determined by trial and error. It is my practice to insert a needle (0.3mm x 30mm) into the tissues immediately overlying the MTrP to a depth of 5-10 mm and to leave it in situ long enough for the two reactions to be abolished. For an average reactor this is about 30secs. For a weak reactor it is several minutes. And for a strong reactor the insertion of the needle and its immediate withdrawal is all that is required. Following treatment muscle stretching exercises should be carried out, and any steps taken to eliminate factors that might lead to the reactivation of the MTrPs. DEEP DRY NEEDLING (DDN): This in my practice is only used either when primary MTrP activity causes shortening of muscle sufficient enough to bring about compression of nerve roots. Or when there is nerve compression pain usually from spondylosis or disc prolapse and the secondary development of MTrP activity. Unlike SDN, DDN is a painful procedure and one which gives rise to much post-treatment soreness.

Acupuncture Analgesia↗
PubMed1989

Injections and physiotherapy for the painful stiff shoulder.

Cost effective treatment is needed for common self limiting rheumatological conditions. Periarthritis of the shoulder is an example. There is no consensus for one type of treatment, though local steroids or physiotherapy are conventionally used. Their cost and efficacy were compared in a prospective randomised observer-blind trial--in essence a medical audit of the treatment of a common rheumatological problem. Sixty two consecutive patients presenting with a painful stiff shoulder were studied. Patients with coexistent diseases like cervical spondylosis or a stroke were excluded. They were randomly allocated to receive local steroids, six weeks' physiotherapy, or both. The three groups were of similar age, sex, and disease severity. Assessments of pain and shoulder movement were made initially, at six weeks, and at six months by a 'blinded' observer. Physiotherapy was given by one therapist and injections by one physician. All three groups showed significant improvements by six weeks, with further improvement at six months. Improvements were identical in all three groups. No treatment gave complications. The costs of treatment varied: an injection of triamcinolone cost 2.10 pounds; a six week course of physiotherapy cost 48.50 pounds; combination treatment cost 50.60 pounds. Patients expect treatment for a painful stiff shoulder. The results show that local steroid injections are as effective as physiotherapy alone or a combination. They provide rapid treatment and are less expensive. In the uncomplicated case a local steroid injection is the most cost effective treatment.

Costs and Cost Analysis↗
PubMed1995

Commented glossary for rheumatic spinal diseases, based on pathology.

OBJECTIVES: To redefine and comment on terms on a pathological basis, in order to avoid the confusion due to the use of terms with different meanings, to standardise usage among clinicians, radiologists and pathologists, and to facilitate literature searches. METHODS: Within the Committee of Pathology of the European League against Rheumatism, a study group was set up to analyse the medical literature and common practice concerning the nomenclature of rheumatic spinal diseases. The group tried to amalgamate the main trends in the field, to reconcile etymology, historical background, morphology, and common practice. RESULTS: The group warns against use of the terms 'acquired hyperostosis syndrome', '(von) Bechterew's disease', 'Kümmel's disease', 'pseudospondylolisthesis', 'rheumatoid spondylitis', 'spondylarthropathy' in the sense of spondarthritis, and 'spondylosis'. It recommends intercorporal or interapophyseal rather than intervertebral (osteo) chondrosis, zygapophyseal diverticulum rather than cyst, disc hernia rather than prolapse, spondyloarthritis rather than spondyloarthropathy, marginal rather than anterior spondylitis, and discarthrosis. It proposes 'zygarthrosis' to designate zygapophyseal osteoarthrosis. CONCLUSIONS: Knowledge of the pathological basis of diseases and an understanding of the original definitions given by those who coined new terms make it possible to avoid most of the confusion arising from improper use of spinal terms.

Humans↗
PubMed1979

A study of changes in the spine in weight lifters and other athletes.

The present study was undertaken in sportsmen of those groups of sports activities where weight training exercises constitute a major part of the training. Two groups consisting of 25 weight-lifters and 25 track and field athletes were studied to find out the effect of sports activities and lifting weights on the spine. 84% weight-lifters and 72% track and field athletes suffered from varying abnormalities. Incidence of backache in 25 weight-lifters was 40% and in 25 track and field athletes 48%. Radiological changes were more common in weight-lifters (84%) than in athletes (72%). Reduction in lumbar lordosis was found in three cases (12%) in both the groups. Obtuse angle deformity of vertebral margins was found in 11 cases (44%) amongst weight-lifters and six cases (24%) amongst athletes. Osteophytic formation was found in six cases (24%) in weight-lifters and four cases (16%) in athletes. Schmorl's node were noticed in five cases (20%) amongst weight-lifters and seven cases (28%) amongst athletes. The incidences of spondylosis and Schmorl's node were found only in those cases who had been doing weight training exercises for more than four years.

Adolescent↗
PubMed1981

Injuries in professional footballers.

The incidence of injuries in footballers is described. Nearly half of footballer's injuries involve the knee, with vertical tearing of the meniscus being common; surgical intervention may be required. Approximately one third of injuries involve the ankle, and will often require immobilisation. Other injuries include muscle damage, spondylosis of L4 or L5, concussion, and dislocations. The importance of prompt and correct treatment of injuries is emphasised.

Ankle Injuries↗
PubMed1976

Space phobia: syndrome or agoraphobic variant?

Four elderly women had intense fears of falling when there was no visible support at hand or on seeing space cues while driving. Two patients had cervical spondylosis. The mean age at onset of the fear was 54--thirty years later than that for agoraphobia. Fear of public places and of heights was not prominent, nor was depersonalisation or depression. These "space phobias" might be a hitherto unrecognised syndrome or an unusual variant of agoraphobia. The visuospatial reflexes involved might illuminate the pathogenesis of certain fears.

Adult↗
PubMed1996

Evaluation of investigations to diagnose the cause of dizziness in elderly people: a community based controlled study.

OBJECTIVE: To compare the findings in dizzy elderly people with those in controls of a similar age to identify which investigations differentiate dizzy from non-dizzy patients and to design an investigational algorithm. DESIGN: Community based study of clinical and laboratory findings in dizzy and control elderly people. SETTING: Research outpatient clinic at a teaching hospital. SUBJECTS: 149 dizzy and 97 control subjects aged over 65 years recruited from a community survey and articles in the local press. MAIN OUTCOME MEASURES: Findings on physical examination, blood testing, electrocardiography (at rest and over 24 hours), electronystagmography, posturography, and magnetic resonance imaging of head and neck (125 (84%) dizzy subjects and 86 (89%) controls); hospital anxiety and depression score; responses to hyperventilation, carotid sinus massage, and the Hallpike manoeuvre. RESULTS: Blood profile, electrocardiography, electronystagmography, and magnetic resonance imaging failed to distinguish dizzy from control subjects because of the frequency of asymptomatic abnormalities in controls. Posturography and clinical assessment (physical examination, dizziness provocation, and psychological assessment) showed significant differences between the groups. A cause of the dizziness was identified from clinical diagnostic criteria based on accepted definitions in 143 subjects, with 126 having more than one cause. The most common diagnoses were central vascular disease (105) and cervical spondylosis (98), often accompanied by poor vision and anxiety. CONCLUSION: Expensive investigations are rarely helpful in dizzy elderly people. The cause of the dizziness can be diagnosed in most cases on the basis of a thorough clinical examination without recourse to hospital referral.

Aged↗
PubMed1975

Congenital narrowing of the cervical spinal canal.

The clinical and laboratory findings in six patients with congenital narrowing of the cervical spinal canal and neurological symptoms are described. A variable age of onset and an entirely male occurrence were found. Signs and symptoms of spinal cord dysfunction predominated in all but one patient. Symptoms were produced in five patients by increased physical activity alone. Congenital narrowing of the cervical spinal canal may result in cord compression without a history of injury and occasionally without evidence of significant bony degenerative changes. The clinical features may be distinguishable from those found in cervical spondylosis without congenital narrowing. Intermittent claudication of the cervical spinal cord appears to be an important feature of this syndrome. Surgery improved four out of five people.

Adolescent↗
PubMed1976

The shoulder girdle disc.

Weakness and wasting of shoulder girdle muscles occurred in 40 cases of cervical spondylosis at the level C 3/4 intervertebral space with spinal cord, and lower with nerve root compression. Often there was no sensory loss. Prompt recovery followed Cloward's operation in more than half the cases. The pathogenesis and the need for early diagnosis and radical treatment of the condition are considered.

Cervical Vertebrae↗