Surgical treatment of headshaking by removal of a paracondylar process fragment via modified hyovertebrotomy approach: A detailed anatomical and surgical description in an adult horse.
Abstract: To describe, in detail, the relevant anatomy and surgical approach to access the paracondylar process (PCP) and report its application in a clinical case of headshaking. Methods: A seven-year-old, mixed breed mare. Methods: Experimental study/case report. Methods: A seven-year-old mixed breed mare was presented for investigation of acute onset progressing violent headshaking, resulting in the horse falling on multiple occasions. The horse was highly reactive to palpation over the right PCP. Standing computed tomographic (CT) investigation and ultrasonographic examination of the head detected a fracture of the right PCP. Five equine heads of mixed breeds and sizes were dissected to demonstrate the relevant anatomy surrounding the PCP with regard to surgical access. A modified hyovertebrotomy approach was used to remove the fracture fragment under general anesthesia. Results: The anatomy surrounding the PCP was described. The fragment was successfully removed resulting in gradual resolution of clinical signs. The horse recovered well postoperatively and was back into light levels of work with no signs of headshaking present two and a half years following surgery. Conclusions: The caudal meningeal artery and vein as well as the glossopharyngeal and hypoglossal nerves are adjacent to the PCP and must be avoided during dissections. The modified hyovertebrotomy approach allows safe surgical access to the PCP. Surgical excision of a PCP fragment can result in complete resolution of clinical signs of headshaking. Computed tomography and ultrasonography are valuable diagnostic tools to identify a fracture of the PCP.
© 2024 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
Publication Date: 2024-05-13 PubMed ID: 38739013DOI: 10.1111/vsu.14102Google Scholar: Lookup
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Summary
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This research describes the process of performing a surgical procedure on a horse with severe headshaking due to a fractured paracondylar process. The procedure, called the modified hyovertebrotomy approach, was successful in completely resolving the horse’s symptoms.
Background
- The research focuses on a surgical intervention implemented on an adult horse suffering from violent headshaking, which had led to the horse falling several times. The condition was traced to a fracture of the right paracondylar process (PCP).
Methods
- The researchers used standing CT scans and ultrasonography of the horse’s head to diagnose the fracture. This horse was reactive when palpated over the right PCP indicating pain and discomfort.
- The relevant anatomy around the PCP was investigated and demonstrated using dissections of five other equine heads from horses of varying breeds and sizes. This was to understand the most efficient and safe way to gain surgical access to the PCP.
- The surgery was performed using a modified hyovertebrotomy approach under general anesthesia.
Results
- The surgical procedure was successful and led to a gradual reduction and eventual cessation of the headshaking symptoms.
- Two and a half years after the surgery, the horse showed no signs of headshaking and had returned to light levels of work.
Conclusion and Implications
- The research concluded that the success of the surgery is dependent on ensuring the adjacent caudal meningeal artery and vein, as well as the glossopharyngeal and hypoglossal nerves, are not disrupted during the dissection and surgical process.
- This study validates the modified hyovertebrotomy approach as safe and effective for surgical access to the PCP in horses.
- The complete resolution of the horse’s headshaking symptoms suggests that surgical excision of a PCP fragment can be a promising solution for equine headshaking caused by a PCP fracture.
- Finally, the study highlights the valuable role of computed tomography and ultrasonography as diagnostic tools for identifying PCP fractures in horses.
Cite This Article
APA
Spiesshofer P, Hawkins AE, Berner D, Previdelli RL, Fiske-Jackson AR.
(2024).
Surgical treatment of headshaking by removal of a paracondylar process fragment via modified hyovertebrotomy approach: A detailed anatomical and surgical description in an adult horse.
Vet Surg, 53(5), 942-949.
https://doi.org/10.1111/vsu.14102 Publication
Researcher Affiliations
- Equine Referral Hospital, Royal Veterinary College, University of London, Hatfield, UK.
- Equine Referral Hospital, Royal Veterinary College, University of London, Hatfield, UK.
- Equine Referral Hospital, Royal Veterinary College, University of London, Hatfield, UK.
- Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK.
- Equine Referral Hospital, Royal Veterinary College, University of London, Hatfield, UK.
MeSH Terms
- Animals
- Horses / anatomy & histology
- Female
- Skull Fractures / veterinary
- Skull Fractures / surgery
- Skull Fractures / diagnostic imaging
- Tomography, X-Ray Computed / veterinary
References
This article includes 10 references
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