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Equine veterinary journal2025; doi: 10.1111/evj.14498

Experimental comparison of caudal wedge ostectomy to cranial wedge ostectomy for surgical treatment of overriding/impinging spinous processes in horses.

Abstract: Caudal wedge ostectomy has not been investigated for overriding or impinging spinous processes (SPs). Objective: To establish the feasibility of caudal wedge ostectomy and compare measures of surgical trauma and error between hypothetical caudal and cranial wedge ostectomies on SPs of different inclinations. Methods: Experimental, method comparison study. Methods: Computed tomography and caudal wedge ostectomy surgery were performed on four cadavers. Observations, technical difficulties, and surgical errors were recorded. Radiographs from 67 horses with overriding/impinging SPs were reviewed. Hypothetical 'ideal' caudal and cranial wedge ostectomies, and 'error' ostectomies 12° from ideal, were drawn at sites of impingement. Ostectomy area/SP width, ostectomy length/SP width, absolute difference of exit angles (angle ostectomy exits the SP) from 90°, and number of error ostectomies failing to exit the SP (never-ending-cuts [NEC]) were calculated. Continuous variables were compared between techniques in caudally and cranially inclined SP groups using Wilcoxon signed-rank tests. Proportions of NEC were compared using McNemar's tests. Results: No surgical errors were recorded with caudal wedge ostectomy. Median ostectomy area/SP width was lower for caudal versus cranial wedge ostectomy in caudally (14.32, interquartile-range [IQR] 9.72-20.34 vs. 25.57, IQR 17.74-33.06; p < 0.001) and cranially inclined SP groups (11.78, IQR 7.98-17.19 vs. 19.62, IQR 13.65-28.68; p < 0.001). Median difference in exit angles from 90° was smaller for caudal versus cranial wedge ostectomies in caudally (34.77°, IQR 26.85°-45.91° vs. 67.54°, IQR 58.13°-74.55°; p < 0.001) and cranially inclined SP groups (49.14°, IQR 35.61°-59.33° vs. 62.84°, IQR 55.34°-70.61°; p < 0.001). The proportion of NEC was lower for caudal versus cranial wedge ostectomy in caudally (37.6%, 95% confidence interval [CI] 29.4%-45.8%; n = 50/133 vs. 96.2%, 95% CI 93.0%-99.5%; n = 128/133; p < 0.001), but not in cranially inclined SP groups (76.8%, 95% CI 70.9%-82.7%; n = 152/198 vs. 84.3%, 95% CI 79.3%-89.4%, n = 167/198; p = 0.06). Conclusions: Potential bias drawing 'ideal' ostectomy. Conclusions: Experimentally, caudal wedge ostectomy was feasible, removed less bone, and resulted in fewer NEC in caudally inclined SPs. Further investigation of the technique is warranted.
© 2025 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2025-03-20 PubMed ID: 40110991DOI: 10.1111/evj.14498Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This study set out to assess the feasibility of caudal wedge ostectomy, a surgical technique for treating conditions related to the impingement of spinous processes in horses. The research concluded that caudal wedge ostectomy was feasible, resulted in less bone removal, and had fewer surgical errors, particularly in caudally inclined spinous processes, as compared to the cranial wedge ostectomy.

Objective and Methods used

  • The study was aimed at assessing the feasibility and efficiency of caudal wedge ostectomy relative to cranial wedge ostectomy when dealing with issues linked to the impingement of spinous processes.
  • The researchers carried out their experiments on four horse cadavers by means of computed tomography (CT) and surgical procedures. During the surgical operations, they paid attention to and recorded any surgical errors or technical difficulties encountered.

Method Comparison Study

  • The researchers carried out an analysis of radiographs obtained from 67 horses that had issues with impinging/overriding spinous processes.
  • Following this, they illustrated hypothetical instances of perfect caudal and cranial wedge ostectomies, as well as flawed ostectomies deviating from the ideal by 12°, at the sites of impingement.
  • Performing these comparisons allowed the researchers to deduce quantitative measures related to surgical trauma and error between the cranial and caudal wedge ostectomies.
  • Determined measures included; ostectomy area, SP width, ostectomy length, absolute difference of exit angles and the number of failed ostectomies.

Results of the Research

  • According to the findings, none of the caudal wedge ostectomies resulted in any surgical errors.
  • Both in caudally and cranially inclined SP groups, the median ostectomy region in relation to SP width was found to be lower in caudal wedge ostectomy than in cranial wedge ostectomy.
  • The median difference in exit angles from 90° was seen to be smaller for caudal as against cranial wedge ostectomies in both caudally and cranially inclined spinous process groups.
  • The proportion of ostectomies that failed to exit the spinous process (termed never-ending-cuts) was lower in caudal wedge ostectomy than in cranial wedge ostectomy in caudally inclined SP groups, but was found to be not significantly different in cranially inclined SP groups.

Conclusions

  • The study concluded that caudal wedge ostectomy is viable for addressing issues related to impingement of spinous processes in horses. Furthermore, during experiments, it was discovered that this surgical approach resulted in less bone removal compared to cranial wedge ostectomy.
  • Additionally, the number of ‘never-ending-cuts’, a measure of surgical errors, was also found to be lower in caudal wedge ostectomy, particularly in the case of caudally inclined spinous processes.
  • Despite acknowledging potential bias towards caudal ostectomy, the research suggests that further investigation of this technique is justified.

Cite This Article

APA
Connaughton MT, MacDonald EJ, Ireland JL, Rocchigiani G, Stack JD. (2025). Experimental comparison of caudal wedge ostectomy to cranial wedge ostectomy for surgical treatment of overriding/impinging spinous processes in horses. Equine Vet J. https://doi.org/10.1111/evj.14498

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Connaughton, Maurice Thomas
  • Department of Equine Clinical Science, University of Liverpool, Neston, UK.
MacDonald, Eilidh Janet
  • Department of Equine Clinical Science, University of Liverpool, Neston, UK.
Ireland, Jo L
  • Department of Equine Clinical Science, University of Liverpool, Neston, UK.
Rocchigiani, Guido
  • Department of Veterinary Anatomy, Physiology and Pathology, University of Liverpool, Neston, UK.
Stack, John David
  • Department of Equine Clinical Science, University of Liverpool, Neston, UK.

Grant Funding

  • Gerald Leigh Charitable Trust and Beaufort Cottage Educational Trust

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