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Abstract
Extract
Degenerative lumbosacral stenosis (DLSS) is a common condition amongst active large-breed dogs, and has a complex aetiopathogenesis. Diagnosis is hampered by subtle clinical signs which may be confused for other neurological or orthopaedic conditions. Signalment and specific manipulative tests allow the clinician to form a high suspicion for DLSS and initiate investigation, however plain radiographic findings are not pathognomic. Advanced imaging is considered essential for an accurate diagnosis but may highlight non-symptomatic lesions, therefore clinical judgement remains paramount. Medical management of mild cases is generally considered to be satisfactory for pet animals, for which modification of their lifestyle is possible. However, return to an acceptable level of performance requires surgical intervention in most working dogs. Whilst some prognostic indicators have been identified, recurrence is common, and many questions remain as to the best method of surgical management. Three-dimensional reconstructive computed tomography (CT) has introduced a new means of indirectly visualising the neuroforamina that exit at the lumbosacral space. This review covers the current state of knowledge of DLSS in dogs, and attempts to identify areas for future study regarding dynamic instability and changes to the lumbosacral neuroforamina at the extremes of joint motion.
Acknowledgements
We would like to acknowledge the New Zealand Police force and the New Zealand Government BRCSA fund for financial support of the ongoing research programme into DLSS at the Massey University Centre for Service and Working Dog Health and Research. Sonia Torwick is thanked for the generation of the three-dimensional CT images.