N03 - Clinical and Imaging Findings in Fourteen Dogs with Surgically Treated Tethered Cord Syndrome

Abstract:

Background: Tethered cord syndrome (TCS) results from tissue attachments that limit the movement of the conus medullaris or dural sac. This can lead to pain, bladder or bowel dysfunction, and lower limb sensorimotor problems in humans. TCS remains an under-recognized condition in dogs, with no consensus on diagnosis and treatment. Hypothesis/

Objective: To detail the clinical signs, advanced imaging, surgical procedures, and outcomes of dogs diagnosed with suspected TCS. Animals: Fourteen client-owned dogs.

Methods: Medical records were reviewed retrospectively for dogs that underwent imaging and surgery for suspected TCS. Dogs were diagnosed based on a combination of clinical signs and dynamic MRI or CT.

Results: Median age of onset of initial signs was 21 months and median age at presentation was 51 months. The most commonly reported clinical signs for all dogs were lumbar pain and exercise intolerance. Each dog underwent either dynamic MRI or CT, which revealed minimal craniocaudal movement of the dural sac, conus medullaris, or both between flexion and extension. In all dogs, a taught external or internal filum terminale, extradural adhesions, or a combination of these structures were found and transected during surgery. All dogs showed subsequent improvement in discomfort and exercise intolerance. Conclusion/Clinical Importance: Dogs with unexplained lumbar pain and exercise intolerance should be evaluated using dynamic imaging. Surgery to remove the tethering structure(s) is indicated when imaging shows minimal movement of the dural sac and conus medullaris.