Accuracy of ultrasound-guided injections of thoracolumbar articular process joints in horses: a cadaveric study.
Abstract: Arthrosis of the articular process joints (APJs) in the caudal thoracolumbar region of horses may cause back pain and subsequent reduced performance or lameness. Ultrasound-guided injections of the APJs of the equine back have been described only briefly in the literature. Objective: To evaluate factors affecting the accuracy of intra-articular injections of the APJs in the caudal thoracolumbar region. Methods: One-hundred-and-fifty-four injections with blue dye were performed on APJs including the T14-L6 region in 12 horses subjected to euthanasia for reasons unrelated to back problems. The backs were subsequently dissected to verify the location of the injectate in relation to the APJs. Results: Twenty-seven percent of the injections were found to be intra-articular and a total of 77% found to be within 2 mm of the joint capsule including the intra-articular deposits. Application of a medial approach and 18 gauge needle were significantly associated with an intra-articular injection or deposition close to the joint capsule. Operator, APJ (location) and back number (chronological) did not significantly affect the accuracy of injection. Conclusions: Injection of the vertebral APJ in the thoracolumbar region using ultrasound guidance is a reliable method, as most of the injections were either in or within 2 mm of the joint. Based on the findings of this cadaver study, the medial approach is expected to be the most accurate in live horses. Further investigations are required to evaluate the diagnostic and therapeutic potential of this method in clinical practice.
Publication Date: 2010-02-04 PubMed ID: 20121908DOI: 10.2746/042516409X454565Google Scholar: Lookup
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- Journal Article
Summary
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The study investigates the efficiency of ultrasound-guided injections in treating horse back pain caused by the degeneration of articular process joints (APJs) in the thoracolumbar region. The research found that a medial approach using 18 gauge needles yielded the most accurate injections, with most injections either entering the joint or landing within 2mm from it.
Research Purpose and Methodology
- The study aimed to examine the factors affecting the precision of applying ultrasound-guided intra-articular injections on a horse’s APJs, particularly in the thoracolumbar region.
- To achieve this, the research utilized 154 injections on APJs corresponding to the T14-L6 region in 12 horses who were euthanized for unrelated reasons.
- A blue dye was used in the injections to facilitate tracing the deposition points of the injections after dissection.
- The method included an assessment of the injection’s location in relation to the APJs, whether inside the joint or within a 2mm range around it.
Research Findings
- The results showed that 27% of all injections applied directly entered the articular joint.
- In general, 77% of the injections were closely successful, landing within a 2mm distance from the joint including the intra-articular deposits.
- Notably, the success rate was significantly higher when applying a medial approach and an 18-gauge needle.
- Interestingly, the study found that the operator’s expertise, the precise location of the APJ, and the chronological succession of the backs (back number) did not significantly impact the success rate of injections.
Conclusion and Recommendations
- In conclusion, the study found that ultrasound-guided injections of the joints in horses are a reliable technique as most injections landed in or just around the joint.
- The research strongly suggests the application of a medial approach in living horses since it was found to be the most accurate method in the cadaveric study conducted.
- The study further recommends more research to ascertain the diagnostic and therapeutic potentials of this method in clinical practice.
Cite This Article
APA
Fuglbjerg V, Nielsen JV, Thomsen PD, Berg LC.
(2010).
Accuracy of ultrasound-guided injections of thoracolumbar articular process joints in horses: a cadaveric study.
Equine Vet J, 42(1), 18-22.
https://doi.org/10.2746/042516409X454565 Publication
Researcher Affiliations
- Department of Basic Animal and Veterinary Sciences, Faculty of Life Sciences, University of Copenhagen, Groennegaardsvej 7, 1870 Frederiksberg C, Denmark.
MeSH Terms
- Animals
- Bromphenol Blue / administration & dosage
- Cadaver
- Coloring Agents / administration & dosage
- Horse Diseases / diagnosis
- Horse Diseases / diagnostic imaging
- Horses / anatomy & histology
- Injections, Intra-Articular / veterinary
- Joint Diseases / diagnosis
- Joint Diseases / diagnostic imaging
- Joint Diseases / veterinary
- Sensitivity and Specificity
- Spine / diagnostic imaging
- Ultrasonography
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