Thoracolumbar intervertebral disc disease: anaesthetic considerations during MRI and hemilaminectomy

Intervertebral disc disease (IVDD) can result in spinal cord injury. In veterinary patients, this is seen most commonly in the thoracolumbar (TL) region of the spine. Certain dog breeds are genetically predisposed, including dachshunds, corgis, beagles and French bulldogs; the latter is the subject of this case study. TL IVDD can cause a variety of clinical signs depending on the severity of spinal cord injury. These range from pelvic limb weakness and instability (paraparesis) to complete pelvic limb paralysis (paraplegia). In the veterinary profession, the modified Frankel system can be used to grade the severity of the disease. Magnetic resonance imaging (MRI) is used to identify IVDD, and can localise the affected disc space(s). IVDD can be managed either medically or surgically. The treatment choice is directed by factors such as the patient's clinical presentation, its overall fitness, any comorbidities and its overall amenability, as well as the economic feasibility of surgery. Surgical treatment is favoured in a patient that presents with a more severe spinal cord injury and, overall, demonstrates a greater likelihood of swift and full neurological restoration. The most common surgical technique performed for TL IVDD is a hemilaminectomy. This article describes the perioperative anaesthesia nursing care of an aggressive French bulldog that presented with grade 2 TL IVDD and was treated with a hemilaminectomy procedure. The patient underwent MRI of the spine and a hemilaminectomy procedure was subsequently performed. The challenges of the patient assessment, investigation, anaesthetic and analgesia management are discussed.