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PloS one2025; 20(5); e0323083; doi: 10.1371/journal.pone.0323083

Retrospective radiographic myelogram measurements and long-term outcomes in horses undergoing cervical interbody fusion surgery: 22 cases.

Abstract: Site selection for cervical stabilization surgery in horses with spinal ataxia frequently relies on measurements derived from radiographic myelography. A variety of measurement criteria exist and can provide conflicting results. The main objectives of this study were to assess the correlation between two commonly used myelographic measures, dorsal contrast column reduction (DCCR) and dural diameter reduction (DDR), and their association with previously selected operative sites in a population of horses operated at a tertiary clinic. Secondary objectives were to determine if articular process joint (APJ) atrophy occurred in a subset of operated horses with radiographic follow-up, and to describe complications of cervical stabilization surgery and long term outcomes. The study was primarily cross-sectional using previously recorded medical information and images from horses operated between 2008 and 2022: three masked raters assessed previously acquired pre-operative myelograms obtained in neutral, flexed and extended neck positions from horses that had subsequently undergone stabilization surgery consisting of cervical interbody fusion via a Kerf-cut cylinder technique at one or two sites. A veterinary radiologist evaluated changes in APJ in radiographs obtained in a subset of horses re-evaluated >18 months after surgery. DCCR was unremarkable at nearly all articulations in all horses, while DDR met reduction criteria at over 50% of articulations in flexed position. Neither DCCR nor DDR distinguished operated from non-operated sites at most intervertebral junctions, except at the C6-7 articulation in neutral and extended position. The two measures were also poorly correlated at most sites and in most positions. Surgical complications included a high incidence of laryngeal hemiplegia. Comparison of operated to non-operated sites within individuals radiographed years later showed consistent, mildly reduced APJ opacity at most operated sites without a consistent decrease in APJ height or area ratios. Our results suggest that DCCR and DDR measures did not reliably predict surgical site selection in this surgical cohort except at C6-7, and that the two measures yielded conflicting diagnostic classification at many sites and positions. Complication rates from stabilization surgery were high; and predictable reduction in APJ height or area after surgery was not demonstrated by radiography in this study.
Copyright: © 2025 England et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Publication Date: 2025-05-07 PubMed ID: 40333898PubMed Central: PMC12057888DOI: 10.1371/journal.pone.0323083Google 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 discusses a study examining the correlation of two measures used in choosing the location for cervical stabilization surgery in horses and how well these measures predicted the actual chosen surgery site. The study also considers any consequences of the surgery, such as articular process joint atrophy, and long-term outcomes.

Overview of the Research Study

This study is a retrospective analysis of horses who underwent cervical interbody fusion surgery at a tertiary clinic. The objective was to assess the effectiveness of two commonly used measurements, dorsal contrast column reduction (DCCR) and dural diameter reduction (DDR), in the selection of operative sites. Investigating any complications from the surgery and its long-term outcomes served as secondary objectives.

  • The research team used previously recorded medical information and images of horses operated on between 2008 and 2022.
  • Three raters, who were blinded to the information, assessed the pre-operative myelograms taken from different neck positions of the horses that underwent the surgery.
  • To investigate the potential post-operative complication of articular process joint (APJ) atrophy, a veterinary radiologist studied the changes in APJ in radiographs obtained from a subgroup of horses that went through re-evaluation over 18 months after surgery.

Results of the Research Study

Through the study, the team found several key results.

  • DCCR was almost always unremarkable at nearly all articulations in all horses, while DDR met reduction criteria at over half of articulations in flexed positions.
  • Both DCCR and DDR failed to differentiate operated from non-operated sites at most intervertebral junctions, except for the C6-7 articulation in neutral and extended positions.
  • DCCR and DDR were poorly correlated at most sites and positions.
  • The surgery had a high incidence of laryngeal hemiplegia as a complication.
  • Comparing operated to non-operated sites within the radiographs of individuals years later revealed consistent, slightly reduced APJ opacity at most operated sites. No consistent decrease in APJ height or area ratios was shown.

Conclusions of the Research

The study suggests that neither DCCR nor DDR measures were reliable predictors of surgical site selection, except at the C6-7 site. Moreover, these measures often provided conflicting diagnostic classifications at many sites and positions. The complication rate from the stabilization surgery was found to be high, and patterns of reduction in APJ height or area after surgery were not detectable through radiography in this study.

Cite This Article

APA
England D, Newsom L, White C, McKenzie E. (2025). Retrospective radiographic myelogram measurements and long-term outcomes in horses undergoing cervical interbody fusion surgery: 22 cases. PLoS One, 20(5), e0323083. https://doi.org/10.1371/journal.pone.0323083

Publication

PloS one
ISSN: 1932-6203
NlmUniqueID: 101285081
Country: United States
Language: English
Volume: 20
Issue: 5
Pages: e0323083
PII: e0323083

Researcher Affiliations

England, Devon
  • Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, United States of America.
Newsom, Lauren
  • Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, United States of America.
White, Constance
  • Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, United States of America.
McKenzie, Erica
  • Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, United States of America.

MeSH Terms

  • Horses
  • Animals
  • Cervical Vertebrae / surgery
  • Cervical Vertebrae / diagnostic imaging
  • Spinal Fusion / veterinary
  • Spinal Fusion / methods
  • Myelography / veterinary
  • Myelography / methods
  • Retrospective Studies
  • Male
  • Female
  • Treatment Outcome
  • Horse Diseases / surgery
  • Horse Diseases / diagnostic imaging

Conflict of Interest Statement

The authors have declared that no competing interests exist.

References

This article includes 29 references
  1. Papageorges M, Gavin PR, Sande RD, Barbee DD, Grant BD. Radiographic and Myelographic Examination of the Cervical Vertebral Column in 306 Ataxic Horses. Vet Rad 1987;28(2):53–9.
  2. Moore BR, Reed SM, Biller DS, Kohn CW, Weisbrode SE. Assessment of vertebral canal diameter and bony malformations of the cervical part of the spine in horses with cervical stenotic myelopathy. Am J Vet Res 1994;55(1):5–13.
    doi: 10.2460/ajvr.1994.55.01.5pubmed: 8141496google scholar: lookup
  3. van Biervliet J, Mayhew J, de Lahunta A. Cervical Vertebral Compressive Myelopathy: Diagnosis. Clinical Techniques in Equine Practice 2006;5(1):54–9.
  4. Butler JA, Colles CM, Dyson SJ, Kold SE, Poulos PW. Clinical Radiology of the Horse, 4th Edition. Chichester, West Sussex, UK: John Wiley & Sons, Ltd. 2017.
  5. Nout YS, Reed SM. Cervical vertebral stenotic myelopathy. Equine Vet Educ 2003;15(4):212–23.
  6. van Biervliet J, Scrivani PV, Divers TJ, Erb HN, de Lahunta A, Nixon A. Evaluation of decision criteria for detection of spinal cord compression based on cervical myelography in horses: 38 cases (1981-2001). Equine Vet J 2004;36(1):14–20.
    pubmed: 14756366
  7. Morgan RE. Spinal ataxia: How to distinguish types of spinal cord compression. Equine Veterinary Education 2021;34(6):286–9.
    doi: 10.1111/eve.13585google scholar: lookup
  8. Levine JM, Adam E, MacKay RJ, Walker MA, Frederick JD, Cohen ND. Confirmed and Presumptive Cervical Vertebral Compressive Myelopathy in Older Horses: A Retrospective Study (1992-2004 ). J Vet Int Med 2007;21(4):812-9.
    pubmed: 17708404
  9. Woodie B, Johnson AL, Grant B. Cervical Vertebral Stenotic Myelopathy. Vet Clin North Am Equine Pract 2022;38(2):225–48.
    pubmed: 35953144
  10. Estell K, Spriet M, Phillips KL, Aleman M, Finno CJ. Current dorsal myelographic column and dural diameter reduction rules do not apply at the cervicothoracic junction in horses. Vet Radiol Ultrasound 2018;59(6):662–6.
    doi: 10.1111/vru.12662pmc: PMC6218286pubmed: 29998490google scholar: lookup
  11. Walmsley JP. Surgical treatment of cervical spinal cord compression in horses: a European experience. Eq Vet Educ 2005;17(1):39–43.
  12. Kühnle C, Fürst AE, Ranninger E, Suárez Sánchez-Andrade J, Kümmerle JM. Outcome of Ventral Fusion of Two or Three Cervical Vertebrae with a Locking Compression Plate for the Treatment of Cervical Stenotic Myelopathy in Eight Horses. Vet Comp Orthop Traumatol 2018;31(5):356–63.
    doi: 10.1055/s-0038-1666979pubmed: 30138950google scholar: lookup
  13. Hudson NPH, Mayhew IG. Radiographic and myelographic assessment of the equine cervical vertebral column and spinal cord. Eq Vet Educ 2005;17(1):34–8.
  14. Huggons N. Tri-level surgical treatment of cervical spinal cord compression in a Thoroughbred yearling. Can Vet J 2007;48(6):635–8.
    pmc: PMC1876198pubmed: 17616065
  15. Pezzanite LM, Easley JT, Bayless R, Aldrich E, Nelson BB, Seim HB III. Outcomes after cervical vertebral interbody fusion using an interbody fusion device and polyaxial pedicle screw and rod construct in 10 horses (2015-2019). Eq Vet J 2022;54(2):347–58.
    pmc: PMC8505580pubmed: 33844334
  16. Anderson JDC. Wobbler surgery: What is the evidence?. Eq Vet Educ 2020;32(3):166–8.
  17. Szklarz M, Skalec A, Kirstein K, Janeczek M, Kasparek M, Kasparek A. Management of equine ataxia caused by cervical vertebral stenotic myelopathy: A European perspective 2010–2015. Equine Veterinary Education 2018;30(7):370–6.
    doi: 10.1111/eve.12777google scholar: lookup
  18. Szklarz M, Lipinska A, Slowikowska M, Niedzwiedz A, Marycz K, Janeczek M. Comparison of the clinical and radiographic appearance of the cervical vertebrae with histological and anatomical findings in an eight-month old warmblood stallion suffering from cervical vertebral stenotic myelopathy (CVSM). BMC Vet Res 2019;15(1):296.
    doi: 10.1186/s12917-019-2047-xpmc: PMC6694563pubmed: 31416466google scholar: lookup
  19. Scrivani PV, Levine JM, Holmes NL, Furr M, Divers TJ, Cohen ND. Observer agreement study of cervical-vertebral ratios in horses. Equine Vet J 2011;43(4):399–403.
    doi: 10.1111/j.2042-3306.2010.00300.xpubmed: 21496073google scholar: lookup
  20. Hughes KJ, Laidlaw EH, Reed SM, Keen J, Abbott JB, Trevail T. Repeatability and intra- and inter-observer agreement of cervical vertebral sagittal diameter ratios in horses with neurological disease. J Vet Intern Med 2014;28(6):1860–70.
    doi: 10.1111/jvim.12431pmc: PMC4895627pubmed: 25410955google scholar: lookup
  21. Furr M, Reed S, Aleman M. Equine neurology. Second edition. Ames, Iowa: Wiley Blackwell; 2015.
  22. Seed P. CI2: Stata module to compute confidence intervals for correlations. Statistical Software Components [Internet] 2003 Jan 6. [cited 2024 May 26]. Available from: https://ideas.repec.org//c/boc/bocode/s423603.html.
  23. Klein D. Implementing a General Framework for Assessing Interrater Agreement in Stata. The Stata Journal: Promoting communications on statistics and Stata 2018;18(4):871–901.
    doi: 10.1177/1536867x1801800408google scholar: lookup
  24. Seed P. DIAGT: Stata module to report summary statistics for diagnostic tests compared to true disease status. Statistical Software Components [Internet] 2010 Feb 19. [cited 2024 Jun 17]. Available from: https://ideas.repec.org//c/boc/bocode/s423401.html.
  25. Mandrekar JN. Receiver operating characteristic curve in diagnostic test assessment. J Thorac Oncol 2010;5(9):1315–6.
    doi: 10.1097/JTO.0b013e3181ec173dpubmed: 20736804google scholar: lookup
  26. Hayashi T, Wang JC, Suzuki A, Takahashi S, Scott TP, Phan K. Risk factors for missed dynamic canal stenosis in the cervical spine. Spine (Phila Pa 1976) 2014;39(10):812–9.
    doi: 10.1097/BRS.0000000000000289pubmed: 24583725google scholar: lookup
  27. Lindgren CM, Wright L, Kristoffersen M, Puchalski SM. Computed tomography and myelography of the equine cervical spine: 180 cases (2013–2018). Eq Vet Educ 2021;33(9):475–83.
  28. Gough SL, Anderson JDC, Dixon JJ. Computed tomographic cervical myelography in horses: Technique and findings in 51 clinical cases. J Vet Intern Med 2020;34(5):2142–51.
    doi: 10.1111/jvim.15848pmc: PMC7517850pubmed: 32705729google scholar: lookup
  29. Schulze N, Werpy N, Gernhardt J, Fritsch G, Hildebrandt T, Vanderperren K. Dynamic three-dimensional computed tomographic imaging facilitates evaluation of the equine cervical articular process joint in motion. Equine Vet J 2023;55(1):83–91.
    doi: 10.1111/evj.13560pubmed: 35043993google scholar: lookup

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