Plus-Hex CLINICAL
Introduction
Canine intervertebral disc ( IVD ) herniation is a relatively common emergency admission to both primary care practices and referral hospitals . From the time the patient is admitted , throughout surgery , recovery and discharge , veterinary nurses ( VNs ) can have a huge impact on the care and progress of these patients . It is important that , as VNs , we understand the postoperative complications that can arise and the impact these can have on the patient ' s recovery , including life-limiting compromises of ventilation [ 1 ] .
This article will provide an overview of cervical IVD herniation and the associated surgical intervention . It will also highlight the multidisciplinary team approaches to nursing , which can be used to guide the practical measures that can be taken to enhance patient recovery .
The article will also cover the identification of any deterioration or changes in the patient , and will outline the appropriate , proactive steps to be taken to avoid worsening of the patient ' s condition [ 2 ] .
Spinal cord
Nerve root
Spinal cord
Extruded disc
Extruded disc material
Although these cases can be time-consuming and daunting to nurse , the recovery and progression of the patients can be very rewarding for the nursing team .
Learning outcomes
• To understand and identify postoperative complications in the cervical IVD herniation patient
• To be able to monitor these patients for progression and deterioration
• To be able to implement a holistic nursing care plan for the recumbent ventral slot patient
• To fully support these patients ' needs throughout their hospital stay and recovery .
Aetiology
IVDs act as shock absorbers between spinal vertebrae . Each IVD comprises the annulus fibrosus ( outer fibrous ring ) and the nucleus pulposus ( gelatinous centre ).
IVD herniation is a general term referring to the displacement of a portion of disc material into the vertebral canal . The displaced disc material herniates into the spinal canal , causing damage to or inflammation of the spinal cord where the herniation occurs ( Figure 1 ) [ 3 ] .
Causes of IVD herniation include trauma , neoplasia , discospondylitis , cervical spondylomyelopathy , atlantoaxial instability and secondary degenerative disc disease [ 3 ] .
Annulus fibrosus
Presentation of IVD herniation
The presenting signs of IVD herniation vary but they include :
• Cervical spine pain
• Diffuse spinal pain
• Stiffness
• Reduced cervical spine movement
• Muscle spasms
• Thoracic limb lameness
• Ataxia
• Conscious proprioceptive deficits
• Weakness
• Tetraparesis [ 4 ] .
Nucleus pulposus
Figure 1 . Disc extrusion . Adapted from Thomas et al [ 3 ] .
Volume 39 ( 1 ) • February 2024
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