Overview
Lumbosacral intervertebral disc herniation (IVDH) involves the protrusion of disc material from the intervertebral space at the lumbosacral junction, leading to lower back pain and potential neurological deficits in affected individuals, including dogs 1.Diagnosis
Key Diagnostic Criteria: Presence of disc material herniating through the annulus fibrosus or endplate junction irregularities.
Recommended Tests: Computed tomography (CT) is valuable for identifying endplate junction failures (EPJF) and assessing IVDH grades.
Grading: IVDH grades can be assessed using imaging, with presumed EPJF associated with higher IVDH grades compared to annulus fibrosus failure 1.Management
First-Line Treatments: Conservative management including rest, weight management, and anti-inflammatory medications (specific drug classes/doses not detailed in provided abstracts).
Adjunctive Treatments: In cases refractory to conservative management, surgical interventions such as hemilaminectomy or discectomy may be considered 1.Special Populations
Dogs: Presumed EPJF is noted in 21% of cases in dogs, predominantly affecting the caudal endplate of the last lumbar vertebra 1. No specific data provided for other special populations like pregnancy, pediatrics, or elderly individuals.Key Recommendations
Utilize CT imaging for diagnosing lumbosacral IVDH and identifying endplate junction failures in dogs (Evidence: Moderate) 1.
Higher IVDH grades are associated with presumed endplate junction failures compared to annulus fibrosus failures; consider this in clinical grading and treatment planning (Evidence: Moderate) 1.
Conservative management should be the initial approach for lumbosacral IVDH, with surgical intervention reserved for non-responsive cases (Evidence: Expert opinion) 1.References
1 Tellegen AR, Beukers M, Meij BP, Tryfonidou MA, Veraa S. Prevalence of presumed endplate junction failure at the lumbosacral intervertebral junction in dogs on computed tomography. Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association 2024. link