Perineural Injection for Treatment of Root-Signature Signs Associated with Lateralized Disk Material in Five Dogs (2009-2013)

Abstract

Intervertebral disk disease (IVDD) is common in dogs; cervical IVDD accounts for 13-25% of all cases. Ventral slot decompression provides access to ventral and centrally extruded or protruded disk material. However, procedures to remove dorsally or laterally displaced material are more difficult. This case series describes the use of perineural injection as a potential treatment option for dogs experiencing root-signature signs associated with lateralized disk material in the cervical spine. Five dogs underwent fluoroscopically guided perineural injection of methylprednisolone ± bupivacaine. Most patients experienced improvement in root-signature signs and remained pain free without the assistance of oral pain medication. These findings suggest the perineural injection of methylprednisolone ± bupivacaine represents a viable option for dogs with cervical lateralized disk material causing root-signature signs.

Keywords: fluoroscopy; intervertebral disk disease; lateralized disk; perineural; root-signature.

Figure 1

Left lateral fluoroscopic projection of the cervical vertebral column (Case 1). A spinal needle is inserted dorsally at the level of the C3–C4 intervertebral foramen. Opacification of the C3-C4 intervertebral disk and foramen is also apparent (arrow).

Figure 2

Transverse CT image of the cervical spine at the level of C3–C4 (Case 1). Mineral-attenuating material is apparent in the left intervertebral foramen (arrow). There is also mineralization of the nucleus pulposus that remains in situ.

Figure 3

Transverse T1-weighted (A) and T2-weighted (B) MR images of the cervical spine at the level of C6–C7 (Case 5). Hypointense extruded disk material is noted within the left intervertebral foramen on both sequences (arrows).