- Candidates were expected to describe decreased T2 signal intensity in the L7-S1 disc; T1 and T2 hypointense tissue in the ventral L7-S1 canal, with loss of ventral epidural fat and circumferential disc bulging; T1 and T2 hypointense tissue in both L7-S1 foramina with loss of caudoventral epidural fat; and a transitional S1 vertebra.
- L7-S1 type II disc degeneration, protruding disc or bone spurs in L7-S1 canal, protruding disc or bone spurs in both L7-S1 foramina.
- Flexion/extension imaging (radiography, myelography) to assess instability.
- Correlation between imaging findings and clinical signs
- Imaging characteristics are consistent with degenerative/developmental lumbosacral disease and mild to moderate stenosis of the L7-S1 canal and foramina. Back pain could be due to physical compression of the cauda equina or local inflammation. Lameness could be due to entrapment of L7 nerve roots or intermittent venous congestion in the intervertebral foramina or lateral recesses. There is a poor correlation between severity of MRI compression and severity of clinical signs in working dogs.
- The dog had a decompressive laminectomy and discectomy at L7-S1. Protruding annulus and bone spurs were removed from the ventral canal and both lateral recesses. The dog improved post-operatively and was returned to active duty 6 months later.
- Most candidates performed adequately on this case. None noticed the transitional vertebra. Many did not notice the foraminal encroachment. Many under-interpreted the foraminal and canal encroachment and did not think they were clinically significant. A few over-interpreted partial volume artifacts and diagnosed spinal neoplasia.