Arthroscopic removal of osteochondral fragments of the cervical articular process joints in three horses

Congenital variants of the ventral laminae of the sixth and seventh cervical vertebrae are not associated with clinical signs or other radiological abnormalities of the cervicothoracic region in Warmblood horses

BACKGROUND

There is controversy about the clinical relevance of congenital variants of the ventral laminae of the sixth (C6) and seventh (C7) cervical vertebrae and their relationship with other radiological abnormalities.

OBJECTIVES

To document the prevalence of congenital variants of C6 and C7 and that of other radiological abnormalities from C6 to the second thoracic vertebra (T2).

STUDY DESIGN

Cross-sectional.

METHODS

The study included Warmblood horses ≥3 years of age undergoing clinical assessment at two referral institutions: 127 control horses and 96 cases (neurologic, neck pain or stiffness, or neck-related forelimb lameness). All horses underwent a standardised orthopaedic and neurologic examination. Lateral-lateral and lateral 45°-55° ventral-lateral dorsal (left to right and right to left) radiographic views of C5 to T2 were acquired and assessed blinded to the horse's clinical category using a predetermined grading system.

RESULTS

The ventral profile of C7 was abnormal in 54 horses (24.2%). Cases were less likely to have congenital variants than control horses, p = 0.0002, relative risk (RR): 0.63 (95% confidence intervals [CIs]: 0.4, 1.0). There was no association between the presence of a congenital variant of C7 and the presence of modelling of the articular processes (APs) of C6-C7, C7-T1 or T1-T2. Cases were more likely to have severe modelling of the APs at C6-C7, p = 0.01, RR: 1.94, CI: 1.1, 3.5 and C7-T1, p = 0.04, RR: 1.97, CI: 1.2, 3.2 compared with control horses.

MAIN LIMITATIONS

Radiographs were read by one assessor independently at each institution.

CONCLUSIONS

There was no association between the presence of congenital variants of C7 and any other radiological findings. Congenital variants occurred less frequently in cases compared with control horses. There was no association between the presence or absence of a congenital variant and the type of case.

Percutaneous full endoscopic foraminotomy for treatment of cervical spinal nerve compression in horses using a uniportal approach: Feasibility study

BACKGROUND

Cervical spinal nerve insult can be a sequel of osteoarthropathy in horses due to enlargement of the articular processes (AP).

OBJECTIVES

To describe the percutaneous endoscopic cervical foraminotomy procedure in horses.

STUDY DESIGN

Ex vivo experimental study and clinical case report.

METHODS

The technique was performed in three equine cadavers and in two clinical cases with history of forelimb lameness located in the caudal cervical region. Briefly, the horse was positioned in lateral recumbency, with the affected AP joint uppermost. Under fluoroscopic guidance, the endoscopic instruments (Ø 6.9 mm, length 207 mm, 25° angle of vision) were positioned at the dorsal bony margin of the intervertebral foramen (IVF). The bone was freed from soft tissues and removed using diamond various burrs, hence widening the IVF. The bone drilling was continued until the medial cortical surface of the caudal AP was removed. Thereafter, the endoscope was removed and the skin portal was closed.

RESULTS

The average of operation time in clinical cases was 98 ± 24 min. The horses recovered smoothly from the operation. At 12-month follow-up, the clinical signs had resolved completely without recurrence.

MAIN LIMITATION

Small number of clinical cases and absence of post-mortem examination or histopathology performed in the cadaver study to assess possible iatrogenic injuries.

CONCLUSION

Cervical spinal nerve decompression via minimal invasive foraminotomy is feasible in horses. More research is required before this procedure can be recommended in clinical cases.