Ex Vivo Assessment of an Ultrasound-Guided Injection Technique of the Lumbosacral Disc in the Horse.

The research article focuses on assessing the accuracy and potential complications of an ultrasound-guided injection technique of the lumbosacral disc in horses. The findings indicate the method holds potential risk, as it reaches the intended area only less than 60% of the time, alongside a possibility of sciatic nerve damage.

Objective of the Study

• The primary purpose of the research was to examine an ultrasound-guided injection technique aimed at the lumbosacral disc in horses.
• The technique was carried out through the cranial vertebral notch of the horse’s sacrum, with the study primarily looking at accuracy and potential complications.

Methodology

• The researchers carried out 24 injections in the lumbosacral area on 12 horse cadavers post-euthanasia.
• The technique was conducted under ultrasound guidance, with two different dyes used to differentiate each side.
• The lumbosacral area of each horse was then dissected to evaluate the accuracy of the technique, determine potential complications, and detect the dyes and the structures they coloured.

Results

• The findings showed limited accuracy, as the lumbosacral area was correctly reached in only 11 out of the 24 injections carried out.
• Moreover, only 7 out of the 12 horses allowed for a lumbosacral peridiscal injection, indicating further limitations of the technique.
• The main challenge was reaching the ventral opening of the L6-S1 intervertebral foramen, which is usually partially covered by the iliac wing in ultrasound scans.
• The possibility of puncturing the vertebral canal was observed in almost half the cases (11/24), indicating a significant risk factor.
• The L6 spinal nerve roots that emerge through the intervertebral foramen posed a potential harm zone during needle insertion.

Conclusions

• The overall results showed that the ultrasound-guided technique allowed for a peridiscal injection in the lumbosacral space in less than 60% of cases, which is a fairly low success rate.
• The technique was also at a substantial risk of damaging the sciatic nerve.
• Based on the findings, further investigation and refinement of the method is crucial before its application in clinical practice for treating horses with lumbosacral lesions.