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Home / Equine Research Bank / PLoS One / Retrospective radiographic myelogram measurements and long-t...
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

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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.

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