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CT Disc Extrusion with Mild Myelocompression and Spinal Cord Swelling and Epidural Mass Effect

Case Study

CT Disc Extrusion with Mild Myelocompression and Spinal Cord Swelling and Epidural Mass Effect

Presented with possible back pain and inactivity. Tense abdomen. Hepatic congestion with multiple hyper-echoic nodules seen on ultrasound. 

Presented with possible back pain and inactivity. Tense abdomen. Hepatic congestion with multiple hyper-echoic nodules seen on ultrasound. 

DX

disc extrusion with mild myelocompression and spinal cord swelling level with L1/2. The epidural mass effect occupies 25 % of the vertebral canal diameter and is mildly lateralized to the left.

Image Interpretation

CT of the spine, plain, with myelogram – There were 14 vertebrae with symmetrical rib pairs. The 9th thoracic vertebra (counting from cranial to caudal) was a short vertebra with short and thin ribs. The 14th thoracic vertebra had bilaterally symmetric free ribs. There were 7 lumbar vertebrae.
The myelogram showed disc associated extradural mass effects with pronounced compression of the ventral subarachnoid space level with T13/14, T14/L1 and L1/2.
The most significant myelocompressive effect was noted L1/2 where 25% of the vertebral canal diameter was occupied. The epidural mass effect extended cranially along the caudal half of L1 and was slightly deviated to the left. A mineral opaque focus was associated with the epidural mass effect level with L1. Moreover, there was circumferential thinning of the subarachnoid space suggestive of spinal cord swelling and the disc L1/2 showed a central vacuum phenomenon.
Level with T13/14 a left-sided ventral and T14/L1 a ventral mild epidural mass effect restricted to the intervertebral disc space was noted.
Mild protrusions were noted level with C2/3, L6/7 and L7/S1 without significant myelo-/neurocompressive effects.
Multifocal disc mineralizations were seen.
Multiple small cystoliths were present.
The liver presented mild contour irregularity.
There was anesthesia related splenomegaly.

Outcome

Mild chronic disc protrusions with minor myelo-/neurocompressive effects were present level with C2/3, T13/14, T14/L1, L6/7 and L7/S1.
There was generalized chondroid disc degeneration.
There was cystolithiasis.
There were non specific signs of hepatopathy. Further definition would require an intravenous contrast study or sampling yet.

Comments

Please note the congenital vertebral malformations with hemi- and transitional vertebrae and supranormal number of thoracic vertebrae (see above)!! 

Patient Information

Patient Name : Brandy O'Neal , Aloha Pet and bird hospital
Type of Imaging : Ultrasound
Status : Complete

Clinical Signs

  • Lethargy

Exam Finding

  • Tense Abdomen

Images

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Clinical Signs

  • Lethargy