Differential diagnoses of spinal cord diseases are often correlated with neuroanatomic location of the disease. A thorough, proper neurologic examination should always be performed and a list of differential diagnoses generated.
Different diseases tend to affect different spinal cord regions: C1-C5, C6-T2, T3-L3, L4-S3, and L6-L7. Distinctive neurologic signs are associated with disease of various spinal cord segments. For example, a C1-C5 myelopathy often presents with spinal pain. Disease in the L6-L7 region often can present similarly to musculoskeletal disorders, with lameness the only clinical sign. Appropriate differentials also depend greatly on patient age and breed. For example, a puppy 6 months of age with chronic paraparesis is unlikely to have intervertebral disk disease and more likely to have a congenital or inflammatory condition. Diagnostic testing for spinal disease should start with spinal radiography and progress to MRI, CT, myelography, or CSF analysis as warranted.—da Costa RC