The cranial nuchal bursa: anatomy, ultrasonography, magnetic resonance imaging and endoscopic approach.

The paper is about a study that focused on the cranial nuchal bursa in horses, analyzing its anatomy, ultrasonographic features, magnetic resonance images, and ways it can be accessed endoscopically. The study was aimed at providing a detailed understanding of the cranial nuchal bursa, contributing to diagnosis and treatment of conditions affecting it in horses.

Study Method

• The study was conducted as an experimental cadaver study with various methods applied.
• Four cranial nuchal bursae were dissected to understand their anatomy.
• Another four were frozen to prepare anatomical sections.
• Two more specimens were injected with latex to reveal the surface landmarks and topographical anatomy, which further helped in identifying possible sites for endoscopic access.
• Six cadaveric specimens were used to describe the ultrasonographic and magnetic resonance features of the cranial nuchal bursa before and after intrabursal injection.
• Endoscopic appearance of the bursa was determined using sixteen cadaver specimens; they were evaluated with a rigid arthroscope and gross dissection.

Key Findings

• Through magnetic resonance and ultrasonographic images, the cranial nuchal bursa could be consistently identified in all specimens, both prior and post injection.
• The endoscopic approaches developed for the cranial nuchal bursa introduced cranial and caudal instrument portals.
• Using these approaches, all parts of the bursa could be accurately evaluated, however, unique approaches for left and right compartments of the bursa were needed. This was due to limited maneuverability when inspecting the compartment on the opposite side.

Conclusions

• The study concluded that the cranial nuchal bursa in horses can be identified using ultrasonographic and magnetic resonance images.
• An endoscopic approach to the cranial nuchal bursa is clinically doable, providing a simple and repeatable entry into the cranial nuchal bursa, enabling adequate observation of the structures within the bursa.
• This research could aid in diagnosing and treating conditions impacting the cranial nuchal bursa in horses.