Feasibility and safety of lumbosacral epiduroscopy in the standing horse.

The research sought to test the feasibility and safety of using lumbosacral epiduroscopy, a minimally invasive diagnostic procedure, in standing, sedated horses. The findings showed that the procedure was safe with no complications observed two weeks post-procedure, potentially offering a useful method for diagnosing back or hindlimb pain of unknown origin in horses.

Objective and Methods

• The researchers aimed to assess the safety and viability of using lumbosacral epiduroscopy in diagnosing and possibly treating caudal (rear) back pain in horses. The study utilizes an experimental approach where the procedure is tested on seven adult horses.
• The horses, weighing between 504-578 kg, were sedated and restrained in preparation for the minor surgery.
• Vascular dilators of increasing size were inserted into the horses to facilitate a minimally invasive entrance into the epidural space of the spines, a procedure that allows visualization and potential treatment of the spinal space.
• A flexible video-endoscope was used to visualize this area. Vital data, including cortisol level samples, were collected pre-, during and post-operation, while neurological and lameness tests were conducted before and two weeks after the procedure.
• Additionally, post-mortem examinations were conducted on five of the seven horses.

Results

• All the horses tolerated the lumbosacral epiduroscopy while in a standing position.
• Surgical visualization allowed the anatomic structures in the epidural space, including the dura mater, spinal nerve roots, fat, and blood vessels, to be tracked as far as the thoracolumbar region.
• No complications were observed in the two-week monitoring period following the procedure. One horse had small, organized hematomas identified in the sacral epidural space during necropsy, but no abnormalities were observed in the other four horses.

Conclusion

• The study concluded that lumbosacral epiduroscopy could be performed safely on sedated, standing horses.
• This finding suggests that the procedure could be an important diagnostic tool for identifying the root causes of back or hindlimb pain of unknown origin in horses.