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Home / Equine Research Bank / Equine Vet J / Implications of the neuroanatomy of the equine thoracolumbar...
Equine veterinary journal2021; 53(4); 649-655; doi: 10.1111/evj.13402

Implications of the neuroanatomy of the equine thoracolumbar vertebral column with regional anaesthesia and complications following desmotomy of the interspinous ligament.

Abstract: Impinging/overriding dorsal spinous processes (DSPs) of the thoracolumbar vertebrae are a common cause of poor performance in horses. In the last five decades, numerous surgical treatments have been reported on, from transverse transection of the affected DSPs, and endoscopic resection of the affected DSPs, to transection of the interspinous ligament. Until recently, cosmetic outcomes have been reported as good to excellent in studies. However, a previously unreported complication of neurogenic atrophy of the contralateral epaxial muscle following desmotomy of the interspinous ligament has been recently reported. The authors hypothesised that this was because of a more lateral approach than previously described, resulting in the scissors being too far across midline and transecting a nerve in the region. Considering this finding, we have reviewed the literature on the neuroanatomy of the thoracolumbar region in the horse. Literature on the neuroanatomy of the horse is lacking when compared with that of humans and companion animals, with most of the work extrapolated from companion animals. Based on the current literature, we hypothesise that transection of an intermediate branch of the dorsal spinal nerve supplying the m. longissimus is potentially the cause of the post-operative neurogenic atrophy. The lack of detailed knowledge of the neural anatomy of the equine back has resulted in the role of local anaesthesia in localising pain in the equine back being poorly understood. The wide variation in techniques used for localising back pain may explain why some horses suffering from poor performance or an abnormal gait because of back pain improve to local anaesthesia of the back while others do not. This review article highlights a lack of anatomical knowledge regarding the equine thoracolumbar region in the literature despite diagnostic local anaesthesia, medication, and surgery in this area being relatively common.
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Publication Date: 2021-02-15 PubMed ID: 33336365DOI: 10.1111/evj.13402Google 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.

The research article examines the impact of certain surgical treatments for horses with overlapped dorsal spinous processes, particularly focusing on a recent complication related to a specific surgical method, and the potential cause of this complication based on the present understanding of equine neuroanatomy.

Poor Performance in Horses

  • The study begins by identifying the impinging or overlapping of dorsal spinous processes (DSPs) of the thoracolumbar vertebrae as a frequent cause of poor performance in horses.
  • The authors run through several surgical treatments carried out over the past 50 years to address the issue, which range from transverse transection of the affected DSPs to transection of the interspinous ligament.

Complication Alert & Hypothesis

  • The report brings attention to a recently discovered complication following desmotomy of the interspinous ligament, known as neurogenic atrophy of the contralateral epaxial muscle. This was not previously reported.
  • The authors theorize that this may be due to the usage of a more lateral approach than formerly recommended, which leads to inadvertent transection of a nerve in the region.
  • The focus then turns to the equine neuroanatomy of the thoracolumbar region, as it is believed that a better understanding of it will help understand the cause of this complication.

Review of Equine Neuroanatomy & Hypothesis

  • The authors highlight that comprehensive literature on equine neuroanatomy is conspicuously lacking, especially when compared to that of humans and other domesticated animals.
  • They further hypothesize based on existing literature that the post-operative neurogenic atrophy may be a result of transection of an intermediate branch of the dorsal spinal nerve that supplies the m. longissimus muscle.

Anaesthetic Understanding and Diagnostic Local Anaesthesia

  • In the final discussion, the authors mention how insufficient knowledge of equine neural anatomy has left the effect of local anaesthesia in localizing pain in the equine back poorly understood.
  • They also note that the wide variety of techniques used for localising back pain might be why some horses with poor performance or abnormal gait due to back pain show improvement under local anaesthesia while others do not.
  • This review article emphasizes the need for more in-depth research on the thoracolumbar region of horses, given that local anaesthesia, medication, and surgery in this area are relatively common.

Cite This Article

APA
Derham AM, Schumacher J, O' Leary JM, Kelly G, Hahn CN. (2021). Implications of the neuroanatomy of the equine thoracolumbar vertebral column with regional anaesthesia and complications following desmotomy of the interspinous ligament. Equine Vet J, 53(4), 649-655. https://doi.org/10.1111/evj.13402

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 53
Issue: 4
Pages: 649-655

Researcher Affiliations

Derham, Ann M
  • University College Dublin, University Veterinary Hospital, UCD, Belfield, Dublin, Ireland.
Schumacher, Jim
  • University of Tennessee, Knoxville, TN, USA.
O' Leary, John M
  • University College Dublin, University Veterinary Hospital, UCD, Belfield, Dublin, Ireland.
Kelly, Ger
  • Fethard Equine Hospital, Tipperary, Ireland.
Hahn, Caroline N
  • Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, UK.

MeSH Terms

  • Anesthesia, Conduction / veterinary
  • Animals
  • Back Pain / veterinary
  • Horse Diseases / etiology
  • Horse Diseases / surgery
  • Horses
  • Ligaments, Articular
  • Lumbar Vertebrae / surgery
  • Neuroanatomy
  • Thoracic Vertebrae / surgery

References

This article includes 63 references
  1. Derham AM, O’Leary JM, Connolly SEE, Schumacher J, Kelly G. Performance comparison of 159 Thoroughbred racehorses and matched cohorts before and after desmotomy of the interspinous ligament.. Vet J 2019;249:16-23.
    doi: 10.1016/j.tvjl.2019.05.004google scholar: lookup
  2. Cousty M, Retureau C, Tricaud C, Geffroy O, Caure S. Location of radiological lesions of the thoracolumbar column in French trotters with and without signs of back pain.. Vet Rec 2010;166(2):41-5.
    doi: 10.1136/vr.c70google scholar: lookup
  3. Girodroux M, Dyson S, Murray R. Osteoarthritis of the thoracolumbar synovial intervertebral articulations: Clinical and radiographic features in 77 horses with poor performance and back pain.. Equine Vet J 2009;41(2):130-8.
    doi: 10.2746/042516408x345099google scholar: lookup
  4. Jeffcott LB. Disorders of the thoracolumbar spine of the horse - a survey of 443 cases.. Equine Vet J 1980;12(4):197-210.
    doi: 10.1111/j.2042-3306.1980.tb03427.xgoogle scholar: lookup
  5. Jeffcott LB, Hickman J. The treatment of horses with chronic back pain by resecting the summits of the impinging dorsal spinous processes.. Equine Vet J 1975;7(3):115-9.
    doi: 10.1111/j.2042-3306.1975.tb03245.xgoogle scholar: lookup
  6. Meehan L, Dyson S, Murray R. Radiographic and scintigraphic evaluation of spondylosis in the equine thoracolumbar spine: A retrospective study.. Equine Vet J 2009;41(8):800-7.
    doi: 10.2746/042516409x436592google scholar: lookup
  7. Roberts EJ. Resection of thoracic or lumbar spinous processes for the relief of pain responsible for lameness and some other locomotor disorders of horses.. Proceedings American Association Equine Practitioners 1968;14:13-30.
  8. Pettersson H, Strömberg B, Myrin I. Das thorkolumbale, interspinale Syndrom (TLI) des Reitpferdes-Retriospektiver Vergleich konservativ und chirurgisch behandelter Fälle.. Pferdeheilkunde 1987;3:313-9.
  9. Steckel RR, Kraus-Hansen AE, Fackelman GE, Mitchell SM. Scintigraphic diagnosis of thoracolumbar spinal disease in horses: A review of 50 cases.. Proc Am Assoc Equine Pract 1991;36:583-9.
  10. Lauk HD, Kreling I. Behandlung des Kissing spines-Syndroms beim pferd -50 Falle Teil 2: Ergebnisse.. Pferdeheilkunde 1998;14(2):123-30.
    doi: 10.21836/pem19980203google scholar: lookup
  11. Brink P. Subtotal ostectomy of impinging dorsal spinous processes in 23 standing horses.. Vet Surg 2014;43(1):95-8.
    doi: 10.1111/j.1532-950x.2013.12078.xgoogle scholar: lookup
  12. Jacklin BD, Minshall GJ, Wright IM. A new technique for subtotal (cranial wedge) ostectomy in the treatment of impinging/overriding spinous processes: Description of technique and outcome of 25 cases.. Equine Vet J 2014;46:339-44.
    doi: 10.1111/evj.12215google scholar: lookup
  13. Desbrosse FG, Perrin R, Launois T, Vandeweerd JME, Clegg PD. Endoscopic resection of dorsal spinous processes and interspinous ligament in ten horses.. Vet Surg 2007;36(2):149-55.
    doi: 10.1111/j.1532-950x.2007.00247.xgoogle scholar: lookup
  14. Prisk AJ, García-López JM. Long-term prognosis for return to athletic function after interspinous ligament desmotomy for treatment of impinging and overriding dorsal spinous processes in horses: 71 cases (2012-2017).. Vet Surg 2019;48(7):1278-86.
    doi: 10.1111/vsu.13298google scholar: lookup
  15. Coomer RPC, McKane SA, Smith N, Vandeweerd JME. A controlled study evaluating a novel surgical treatment for kissing spines in standing sedated horses.. Vet Surg 2012;41(7):890-7.
    doi: 10.1111/j.1532-950x.2012.01013.xgoogle scholar: lookup
  16. Walmsley JP, Pettersson H, Winberg F, McEvoy F. Impingement of the dorsal spinous processes in two hundred and fifteen horses: case selection, surgical technique and results.. Equine Vet J 2002;34(1):23-8.
    doi: 10.2746/042516402776181259google scholar: lookup
  17. Fintl C. The normal anatomy of the nervous system.. In: Henson FMD, editor. Equine Back Pathology: Diagnosis and Treatment. Oxford, UK: Wiley-Blackwell; 2009. p. 32-8.
  18. Dellmann HD, McClure RC. Equine Nervous System.. In: Getty R, editor. Sisson and Grossman’s The Anatomy of Domestic Animals, 5th edn. Philadelphia: W. B. Saunders; 1975. p. 634-5.
  19. Masty J. Overview of Neuroanatomy.. In: Furr M, Reed S, editors. Equine Neurology, 1st edn. Ames: Blackwell Publishing Ltd; 2007. p. 3-32.
  20. Blythe LL, Engel HN. Neuroanatomy and neurological examination.. Vet Clin North Am - Equine Pract 1999;15(1):71-85.
    doi: 10.1016/s0749-0739(17)30164-5google scholar: lookup
  21. Dyce KM, Sack WO, Wensing CJG. The nervous system.. In: Dyce KM, Sack WO, Wensing CJG, editors. Textbook of Veterinary Anatomy, 4th edn. St. Louis: Saunders Elsevier; 2010. p. 268-232.
  22. Vandeweerd JM, Desbrosse F, Clegg P. Innervation and nerve injections of the lumbar spine of the horse: A cadaveric study.. Equine Vet J 2007;39(1):59-63.
    doi: 10.2746/042516407x153147google scholar: lookup
  23. Budras K-D, Sack WO, Röck S. Selected Body System in Tabular Form.. In: Budras K-D, Sack WO, Röck S, editors. Anatomy of the Horse, 5th edn. Hannover: Schlütersche Verlagsgesellschaft; 2008. p. 88-110.
  24. Furr M. Disorders of the Peripheral Nervous System.. In: Furr M, Reed S, editors. Equine Neurology, 1st edn. Ames: Blackwell Publishing Ltd; 2007. p. 329-36.
  25. Budras K-D, Sack WO, Röck S. Thoracic Limb.. In: Budras K-D, Sack WO, Röck S, editors. Anatomy of the Horse, 5th edn. Hannover: Schlütersche Verlagsgesellschaft; 2008. p. 4-15.
  26. Orsini PG, Sack WO. Neck.. In: Orsini PG, Sack WO, editors. Rooney’s Guide to Dissection of the Horse, 7th edn. Ithaca: Veterinary Textbooks; 2003. p. 3-17.
  27. Pasquini C, Spurgeon T, Pasquini S. Nervous system.. In: Pasquini C, Spurgeon T, Pasquini S, editors. Anatomy of Domestic Animals, 11th edn. Pilot Point, Texas: Sudz; 2007. p. 470-500.
  28. Orsini PG, Sack WO. Thorax.. In: Orsini PG, Sack WO, editors. Rooney’s Guide to Dissection of the Horse, 7th edn. Ithaca: Veterinary Textbooks; 2003. p. 17-31.
  29. Orsini PG, Sack WO. Abdomen.. In: Orsini PG, Sack WO, editors. Rooney’s Guide to Dissection of the Horse, 7th edn. Ithaca: Veterinary Textbooks; 2003. p. 32-50.
  30. Evans HE, de Lahunta A. Spinal Nerves.. In: Evans HE, de Lahunta A, editors. Miller’s Anatomy of the Dog, 4th edn. St. Louis: Saunders Elsevier; 2012. p. 611-57.
  31. Budras K-D, Sack WO, Röck S. Abdominal Wall and Cavity.. In: Budras K-D, Sack WO, Röck S, editors. Anatomy of the Horse, 5th edn. Hannover: Schlütersche Verlagsgesellschaft; 2008. p. 64-71.
  32. Forsythe WB, Ghoshal NG. Innervation of the canine thoracolumbar vertebral column.. Anat Rec 1984;208(1):57-63.
    doi: 10.1002/ar.1092080107google scholar: lookup
  33. Saito T, Steinke H, Miyaki T. Analysis of the posterior ramus of the lumbar spinal nerve: The structure of the posterior ramus of the spinal nerve.. Anesthesiology 2013;118(1):88-94.
    doi: 10.1097/aln.0b013e318272f40agoogle scholar: lookup
  34. Bogduk N. The lumbosacral dorsal rami of the cat.. J Anat 1976;122(3):653-62.
  35. Bogduk N. The Innervation of the Lumbar Spine.. Spine 1983;8(3):286-93.
    doi: 10.1097/00007632-198304000-00009google scholar: lookup
  36. Blythe LL, Kitchell RL. Electrophysiologic studies of the thoracic limb of the horse.. Am J Vet Res 1982;43(9):1511-24.
  37. Bogduk N, Wilson AS, Tynan W. The human lumbar dorsal rami.. J Anat 1982;134(Pt 2):383-97.
  38. Saito T, Yoshimoto M, Yamamoto Y. The medial branch of the lateral branch of the posterior ramus of the spinal nerve.. Surg Radiol Anat 2006;28(3):228-34.
    doi: 10.1007/s00276-006-0090-3google scholar: lookup
  39. Carlson H. Morphology and contraction properties of cat lumbar back muscles.. Acta Physiol Scand 1978;103(2):180-97.
    doi: 10.1111/j.1748-1716.1978.tb06206.xgoogle scholar: lookup
  40. Bogduk N, Long DM. The anatomy of the so-called “articular nerves” and their relationship to facet denervation in the treatment of low back pain.. J Neurosurg 1979;51(2):172-7.
    doi: 10.3171/jns.1979.51.2.0172google scholar: lookup
  41. Edgar MA, Ghadially JA. Innervation of the lumbar spine.. Clin Orthop Relat Res 1976;115:35-41.
  42. Corraretti G, Vandeweerd JM, Hontoir F, Vanderperren K, Palmers K. Anatomy and Ultrasound-Guided Injection of the Medial Branch of the Dorsal Ramus of the Cervical Spinal Nerves in the Horse: A Cadaveric Study.. Vet Comp Orthop Traumatol 2020;33(06):377-86.
    doi: 10.1055/s-0040-1714301google scholar: lookup
  43. Ehrle A, Ressel L, Ricci E, Singer ER. Structure and Innervation of the Equine Supraspinous and Interspinous Ligaments.. J Vet Med Ser C Anat Histol Embryol 2017;46(3):223-31.
    doi: 10.1111/ahe.12261google scholar: lookup
  44. Ehrle A, Ressel L, Ricci E, Merle R, Singer ER. Histological examination of the interspinous ligament in horses with overriding spinous processes.. Vet J 2019;244:69-74.
    doi: 10.1016/j.tvjl.2018.12.012google scholar: lookup
  45. Stubbs NC, Riggs CM, Hodges PW. Osseous spinal pathology and epaxial muscle ultrasonography in Thoroughbred racehorses.. Equine Vet J 2010;42(S38):654-61.
    doi: 10.1111/j.2042-3306.2010.00258.xgoogle scholar: lookup
  46. Stubbs NC, Hodges PW, Jeffcott LB, Cowin G, Hodgson DR, Mcgowan CM. Functional anatomy of the caudal thoracolumbar and lumbosacral spine in the horse.. Equine Vet J 2006;38(S36):393-9.
    doi: 10.1111/j.2042-3306.2006.tb05575.xgoogle scholar: lookup
  47. Clayton HM. Equine back pain reviewed from a motor control perspective.. Comp Exerc Physiol 2012;8(3-4):145-52.
    doi: 10.3920/cep12023google scholar: lookup
  48. Sihvonen T, Herno A, Paljärvi L, Airaksinen O, Partanen J, Tapaninaho A. Local denervation atrophy of paraspinal muscles in postoperative failed back syndrome.. Spine 1993;18(5):575-81.
    doi: 10.1097/00007632-199304000-00009google scholar: lookup
  49. McGowan CM, Hodges PW, Jeffcott LB. Epaxial musculature and its relationship with back pain in the horse.. In: RIRDC Horse Projects Completed in 2006-07 and Horse Research in Progress. Rural Industries Research and Development Corporation.; 2007:37.
  50. Hodges P, Holm AK, Hansson T, Holm S. Rapid Atrophy of the Lumbar Multifidus Follows Experimental Disc or Nerve Root Injury.. Spine 2006;31(25):2926-33.
    doi: 10.1097/01.brs.0000248453.51165.0bgoogle scholar: lookup
  51. Boelderl A, Daniaux H, Kathrein A, Maurer H. Danger of damaging the medial branches of the posterior rami of spinal nerves during a dorsomedian approach to the spine.. Clin Anat 2002;15(2):77-81.
    doi: 10.1002/ca.1099google scholar: lookup
  52. Moyer W, Schumacher J, Schumacher JA. In: Moyer W, Schumacher J, Schumacher J, editors. Guide to Equine Joint Injection and Regional Anesthesia, 2nd edn. LLC: Academic Veterinary Sol; 2011.
  53. Gibson KT, Stashak TS. Employing intra-articular anesthesia to detect joint lesions in lame horses.. Vet Med 1989;84:1088-92.
  54. Snyder JR, Spier S. Selected intra-articular injections in the horse.. Proceedings of the 7th Geneva Congress of Equine Medicine and Surgery 2001:115-23.
  55. Bassage LH, Ross MW. Diagnostic analgesia.. In: Ross MW, Dyson SJ, editors. Diagnosis and Management of Lameness in the Horse, 1st edn. St. Louis: W. B. Saunders; 2003. p. 93-124.
  56. Greve L, Dyson SJ. An investigation of the relationship between hindlimb lameness and saddle slip.. Equine Vet J 2013;45(5):570-7.
    doi: 10.1111/evj.12029google scholar: lookup
  57. Zimmerman M, Dyson S, Murray R. Close, impinging and overriding spinous processes in the thoracolumbar spine: The relationship between radiological and scintigraphic findings and clinical signs.. Equine Vet J 2012;44(2):178-84.
    doi: 10.1111/j.2042-3306.2011.00373.xgoogle scholar: lookup
  58. Roethlisberger-Holm K, Wennerstrand J, Lagerquist U, Eksell P, Johnston C. Effect of local analgesia on movement of the equine back.. Equine Vet J 2006;38(1):65-9.
    doi: 10.2746/042516406775374351google scholar: lookup
  59. Brown KA, Davidson EJ, Ortved K. Long-term outcome and effect of diagnostic analgesia in horses undergoing interspinous ligament desmotomy for overriding dorsal spinous processes.. Vet Surg 2020;49(3):590-9.
    doi: 10.1111/vsu.13377google scholar: lookup
  60. Drevemo S, Johnston C, Roepstorff L, Gustås P. Nerve block and intra-articular anaesthesia of the forelimb in the sound horse.. Equine Vet J 1999;31(S30):266-9.
    doi: 10.1111/j.2042-3306.1999.tb05232.xgoogle scholar: lookup
  61. Denoix J-M, Dyson SJ. Thoracolumbar Spine.. In: Ross MW, Dyson SJ, editors. Diagnosis and Management of Lameness in the Horse, 2nd edn. Philadelphia: Elsevier Inc.; 2011. p. 592-605.
    doi: 10.1016/b978-1-4160-6069-7.00052-3google scholar: lookup
  62. Fuglbjerg V, Nielsen JV, Thomsen PD, Berg LC. Accuracy of ultrasound-guided injections of thoracolumbar articular process joints in horses: A cadaveric study.. Equine Vet J 2010;42(1):18-22.
    doi: 10.2746/042516409x454565google scholar: lookup
  63. Cousty M, Firidolfi C, Geffroy O, David F. Comparison of Medial and Lateral Ultrasound-Guided Approaches for Periarticular Injection of the Thoracolumbar Intervertebral Facet Joints in Horses.. Vet Surg 2011;40(4):494-9.
    doi: 10.1111/j.1532-950x.2011.00821.xgoogle scholar: lookup
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