A herniated disc is the most common cause of paralysis in dogs, but it can also occur in cats. Not every herniated disc requires surgery. The key factor is whether and how much the herniation compresses the spinal cord (which can be determined with MRI or CT). Additionally, pain symptoms caused by herniated discs that cannot be adequately resolved with conservative methods (such as medications and physical therapy) may also indicate the need for surgery.

Depending on the location of the herniated disc, the choice of surgical technique is made. In principle, during a disc surgery, the spinal canal is opened, the herniated material is removed, and thus the spinal cord or nerve root is relieved. Extreme caution is necessary to avoid damaging neural structures.

It is not always the herniated disc that compresses the spinal cord and causes symptoms such as paralysis, gait abnormalities, and/or pain. Other causes, such as spinal instabilities, bony narrowing of the spinal canal, and spinal deformities, can contribute to a similar clinical picture. Once the cause of the symptoms has been diagnosed, an appropriate treatment plan will be developed. This may include, similar to herniated disc cases, decompression surgical techniques, but in some instances, the placement of implants or stabilization may also be indicated.

Tumors can occur in the brain and spinal cord, as well as in nerve roots. For tumors of the brain and spinal cord, surgical intervention is primarily beneficial when the tumor is located outside of or within the brain and spinal cord meninges. Tumors of the brain meninges and spinal cord meninges in cats (meningiomas) particularly have a good prognosis with surgical treatment (see image). If a tumor cannot be completely removed, radiation therapy is usually recommended afterward.

For “deeper” located tumors, a biopsy may be considered depending on the location, with the results potentially guiding further treatment decisions. The appropriateness of this approach must be carefully evaluated on a case-by-case basis.

For nerve root tumors, complete removal is often difficult, so radiation therapy should also be considered.

Especially in young animals that show neurological symptoms, the possibility of a malformation should be considered. This includes conditions such as “water on the brain” (hydrocephalus), which is usually diagnosed using MRI (magnetic resonance imaging). If the pressure in the brain is increased due to hydrocephalus, it is possible to address this by using a ventricular-peritoneal shunt. In this procedure, the cerebrospinal fluid (CSF) is drained into the abdominal cavity through one or two small tubes controlled by a valve.