CVI Wobble

INTRODUCTION

A special form of disk degeneration can occur in the neck (cervical spine), which results in instability of the vertebrae (neck bones). This is known as Cervical Vertebral Instability (CVI) or "Wobbler Syndrome". CVI occurs most commonly in middle-aged Doberman pinschers, although other breeds can be affected, as well.

The disk, made up of fibrocartilage, is positioned between each vertebra to act as a cushion and shock absorber. Degeneration results in collapse and bulging of the disks causing compression of the spinal cord.

When the disk degeneration occurs in the neck (cervical spine), the result is neck pain and nerve dysfunction behind the affected area. The nerve dysfunction may manifest itself as numbness, weakness, wobbliness and loss of control of bladder and bowel. If left untreated complete paralysis may occur. The signs may come on suddenly or gradually over many months to years.

DIAGNOSIS
Although we can be suspicious of the cause of the signs, a myelogram is required to be certain of the diagnosis. A myelogram is a special x-ray study, performed under anesthesia. A spinal tap is performed, cerebrospinal fluid removed and contrast injected in its place. The contrast agent outlines the spinal cord and highlights the tops of the disks. When the disks are degenerate, they will bulge up and cause compression on the spinal cord.

TREATMENT

The treatment may vary depending on the severity of the compressions and how many disks degenerate. Medication alone is usually ineffective in the long run and the condition only worsens. Surgery should be performed early, before permanent, irreversible spinal cord damage has occurred. A number of different types of surgical procedures are used depending on the nature of the compression. Essentially, surgery is directed at removing the degenerate disk or stretching and fusing the spine at the location or both. In either case, a bone graft may be taken from the shoulder to encourage the bones to fuse.

AFTER-CARE
After surgery, patients are rested for 8 weeks. If needed, they must be helped to stand and walk. Physical therapy consisting of slings, carts, exercises and swimming may be important for recovery of strength and coordination. If permanent spinal cord damage has not taken place, patients will begin to show improvement within six weeks, regardless of how long they had been affected. Continued improvement occurs for 6 months. Seventy to 75% of patients will not have future disk problems.

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