Lumbosacral Disease

What is Lumbosacral Disease?

Lumbosacral disease is the term used for a group of diseases that result in the dysfunction of the lumbosacral intervertebral joint and the compression of surrounding nerve tissue.

Located at the very base of the spinal column, the lumbosacral disc sits between the lumbar vertebrae and the sacrum, the triangular-shaped bone which supports the pelvis.

The high mobility of the lumbosacral joint means that it is prone to degeneration and compression, due to the large amount of stress placed on it. Ageing can contribute to dehydration and degeneration of the disc, causing it to bulge (protrude) and compress (trap) the nerves. The resultant narrowing of the vertebral (spinal) canal, or the vertebral foramen (exit holes between the bones), is called stenosis.

How is Lumbosacral disease diagnosed?

If left untreated, compression of the nerves can cause permanent damage, so if you suspect that your pet is suffering from lumbosacral disease you should visit a veterinary professional as soon as possible.

A detailed exam from one of our expert veterinary neurologists is needed to accurately diagnose the condition, and so a full evaluation of your dog will be completed first. This will include a full medical history along with a physical examination and tests to determine if any red flags or additional conditions are present. This is because the clinical signs of lumbosacral disease are often similar to other similar conditions such as hip dysplasia or degenerative myelopathy.

Advanced imaging will be used to quickly and accurately diagnose the problem and to give your pet the best chance of recovery. An MRI scan will be performed under general anaesthetic to gain a clearer picture of the spine.

How is it treated?

Treatment for lumbosacral disease in dogs depends entirely on the severity of the nerves compressed, and how long your pet has been suffering from the condition. The Vets at Swift will advise on the correct course of treatment for your dog’s individual case.

Non-surgical treatment

Non-surgical conservative management can go a long way towards helping to improve some of the symptoms in patients with lumbosacral disease. These include:

• Medication: For many dogs suffering from lumbosacral disease, the use of medication can go a long way towards helping them to lead a pain-free life, similar to people with a “slipped disc” in their lower back. Dogs are commonly prescribed non-steroidal anti-inflammatory drugs (NSAIDs), additional pain killers directed at nerve (neuropathic) pain, along with muscle relaxants to manage the symptoms of the condition and provide some relief. Lumbosacral stenosis can also be managed by long acting steroid injections (cortisone), injected via lumbar puncture around the compressed spinal nerves. These are performed under general anaesthesia and may require repeat injections.
• Physiotherapy: Physiotherapy is very often the treatment of choice and is effective in halting the progression of spinal compression symptoms. During therapy, your pet will receive help with their balance, strength and nerve compression, while hydrotherapy sessions may also be used to improve mobility.
• Weight and exercise monitoring: If your dog is overweight, weight reduction will play a huge part in your pet’s recovery. This may involve a calorie restricted diet or a reduction in portion size, along with exercise modification. It may be necessary to modify your dog’s exercise routine, for example avoiding strenuous activities including jumping, climbing and ball chasing, which involves twisting and turning. Initially dogs should have lead exercise only, little and often. Exercise can then be gradually increased over several weeks if the patient is coping well.

Surgical treatment

In more serious conditions, or if your pet is not responding to alternative treatments, surgery may be required to decrease the pressure on the compressed nerves, to stabilise the lumbosacral spine or to relieve pain, improve hindlimb lameness and help with incontinence.

• Dorsal laminectomy (decompression surgery): during this procedure, the bony layer that sits over the spinal cord is removed, allowing bulging disc material to be removed, releasing the pressure on the compressed nerves.
• Foraminotomy: surgery that enlarges the exit holes between the bones (vertebral foramen).
• Stabilisation surgery: a screw or pin secured with a metal bar is inserted to stabilise the damaged bone surrounding the lumbosacral disc. 3D printed guides can be made specifically for the individual patient in order to do this.

What is the prognosis?

For dogs with lumbosacral disease, once the pressure on the nerves is relieved, normal hindlimb function should resume. However, it’s important to note that permanent damage to the spinal cord cannot be cured, and surgical treatments will not cure any muscle or nerve inflammation. With continued medication pain and lack of mobility will be reduced or eliminated, which may take a few months.

Our team of veterinary experts have over 40 years’ combined experience across our fields of expertise and are always happy to help. If you’re a veterinarian looking to make a referral, visit our veterinary professionals’ page now for expert advice and guidance.