Diskospondylitis spondylitis and vertebral osteomyleitis
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Diskospondylitis ( spondylitis and vertebral osteomyleitis ). 7/27/09 Trisha J. Oura. Review of Definitions. Physitis Skeletally immature Possible collapse of vertebral body, spinal abnormalities Spondylitis Vertebral bone Direct innoculation Diskitis Intervertebral disk only

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Diskospondylitis spondylitis and vertebral osteomyleitis

Diskospondylitis(spondylitis and vertebral osteomyleitis)

7/27/09

Trisha J. Oura


Review of definitions

Review of Definitions

  • Physitis

    • Skeletally immature

    • Possible collapse of vertebral body, spinal abnormalities

  • Spondylitis

    • Vertebral bone

    • Direct innoculation

  • Diskitis

    • Intervertebral disk only

  • Diskospondylitis

    • Primary infection/inflammation of endplates

    • Secondary IVD involvement

* usually no differentiation between diskitis and diskospondylitis in vet med


Pathophysiology

Pathophysiology

  • Hematogenous/iatrogenic/trauma/FB

  • Source

    ** Urogenital

    • Respiratory, oral, endocarditis, abscess

  • Bacterial > Fungal

    • S. aureus, S. intermedius

    • B. canis (ZOONOTIC)

    • Aspergillus sp.

    • Spirocerca lupi

  • Most common sites

    • Thoracolumbar, lumbosacral

    • Mobility  focal ischemia?

  • Neurologic effects

The ubiquitous plant awn!

www.bouldervet.com


Signalment presentation

Signalment/Presentation

  • Signalment

    • Males

    • Giant/large breed

    • Older

  • Clinical signs

    • Non-specific  signs of sepsis

    • Neurologic deficits, pain

  • Recommendations for diagnostics:

    • MDB: leukocytosis, cystitis/bacteruria

    • Cultures: urine, blood, TTW, etc

    • BRUCELLA TESTING

    • Imaging!

Burkert BA, SC Kerwin, GL Hosgood, et al. Signalment and clinical features of diskospondytlitis in dogs: 513 cases (1980-2001). J Am Vet Med Assoc 2005;227:268-275.

www.my-pet-medicine.com


Imaging

Imaging

  • Radiographic

    • Survey spinal radiographs

  • Nuc-med

  • CT/MR

Stern L, R McCarthy, R King, et al. Imaging diagnosis—discospondylitis and septic arthritis in a dog. Vet Radiol Ultrasound 2007;48:335-337.

Shamir MH, N tavor, T Aizenberg. Radiographic findings during recovery from discospondylitis. Vet Radiol Ultasound 2001;42:496-503.


Radiography

Radiography

  • Early/active

    • Narrowing of IVD space

    • Loss of endplate margins

    • Rarefaction of bone

    • Bone lysis and/or proliferation

    • Sclerosis

  • Progression/resolution

    • Lack of lytic focus

    • Loss of sclerotic margins

    • Smoothing of lytic margins

    • Bridging

**Radiographic findings DO NOT correlated well with clinical disease**


Diskospondylitis spondylitis and vertebral osteomyleitis

12 yo M bull terrier: Hx chronic back pain, ataxia of few days duration


Diskospondylitis spondylitis and vertebral osteomyleitis

6 yo FS Cocker Sp: lethargy, poorly localized pain

8 yo FS mix: previous acute lymphoplasmacytic hepatitis , now difficult rising, lethargic


Diskospondylitis spondylitis and vertebral osteomyleitis

5 m MN PitX: hind limb lame x 3 weeks after HBC & IM fixation of L femur fracture 3 mos prior

At presentation

3 months later


Now what

Now what?

  • Good prognosis

  • Sequelae

    • Collapse of vertebrae, malformation, residual CNS deficits

  • Treatment

    • Long course antibiotics

      (>6 weeks)

    • Based on culture results (e.g. B-lactam +/- fluorquinolone/ aminoglycoside


References

References

  • Bahr A. The vertebrae. In: Thrall DE, ed. Textbook of veterinary diagnostic radiology. 5th ed. St. Louis: Sauders Elsevier, 2007;179-193.

  • Textbook of veterinary internal medicine Website. Discospondylitis (spondylitis, vertebral osteomyelitis) . Available at: http://www.vetmedtext.com/content/default.cfm. Accessed Jul 26, 2009.

  • Burkert BA, SC Kerwin, GL Hosgood, et al. Signalment and clinical features of diskospondytlitis in dogs: 513 cases (1980-2001). J Am Vet Med Assoc 2005;227:268-275.

  • Stern L, R McCarthy, R King, et al. Imaging diagnosis—discospondylitis and septic arthritis in a dog. Vet Radiol Ultrasound 2007;48:335-337.

  • Shamir MH, N tavor, T Aizenberg. Radiographic findings during recovery from discospondylitis. Vet RadiolUltasound 2001;42:496-503.


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