Clinical, magnetic resonance imaging, surgical features and comparison of surgically treated intervertebral disc extrusion in French bulldogs

Guillaume Marc Albertini, Fabio Stabile, Oliver Marsh and Ane Uriarte

Background

Intervertebral disc extrusion (IVDE) is the most common neurological condition in French Bulldogs (FBD), a chondrodystrophic breed prone to spinal disorders. This study aimed to retrospectively analyze the clinical presentations, MRI characteristics, surgical findings, and short-term recovery outcomes of FBDs with cervical (C-IVDE) and thoracolumbar IVDE (TL-IVDE). The study focused on differences in neurological dysfunction and surgical intervention between these two IVDE locations.

Methods

The study included 39 surgically treated FBDs with MRI-confirmed IVDE between January 2020 and March 2022. Cases were evaluated based on neurological grading at admission, MRI findings, and surgical outcomes. Variables such as lesion location, spinal cord compression, extent of extruded disc material (EIVDM), and time to neurological improvement were analyzed. Statistical tests, including Fisher’s Exact and Kruskal-Wallis tests, were used to identify significant differences (p < 0.05).

Results

-Neurological Grade: C-IVDE cases were less severe (grades 1–2) compared to TL-IVDE (grades 2–5) (p < 0.001).

-Lesion Localization: The most common site for C-IVDE was C3-C4, while L3-L4 was the most affected site for TL-IVDE.

-MRI Features: EIVDM was hypointense on T1/T2-weighted images in all C-IVDE cases but was hyperintense in 93% of TL-IVDE cases (p < 0.001). T2-weighted intramedullary spinal cord hyperintensity, indicating spinal injury, was found in 86% of TL-IVDE cases but absent in C-IVDE cases (p < 0.001).

Surgical Findings: TL-IVDE required more extensive surgery, often spanning multiple intervertebral spaces (68% of cases), whereas most C-IVDE surgeries were localized to a single disc space.

-Recovery: Mean time to improvement was shorter for C-IVDE (1.1 days) compared to TL-IVDE (2.1 days). Successful recovery at 4 weeks was achieved in 87% of cases, with all C-IVDE cases showing improvement.

Limitations

-Retrospective design limited control over variables.

-Lack of advanced MRI sequences to confirm hemorrhagic components.

-Histological confirmation of EIVDM composition was not performed.

Follow-up was restricted to 4 weeks, which may not capture long-term recovery.

Conclusions

TL-IVDE in FBDs causes more severe neurological deficits and requires extensive surgical intervention compared to C-IVDE. Despite these challenges, the majority of cases recover successfully post-surgery. The study highlights the importance of MRI in diagnosing and planning treatment for IVDE and suggests that rapid postoperative improvement is a positive prognostic indicator, particularly for TL-IVDE.

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