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Veterinary surgery : VS2021; 50(4); 816-822; doi: 10.1111/vsu.13610

Ultrasonographic guidance for perineural injections of the cervical spinal nerves in horses.

Abstract: To evaluate the accuracy of ultrasonographic guidance for injection near the ventral rami of the cervical spinal nerves (VRCSN). Methods: Ex vivo study. Methods: Ten cadavers (n = 40 injections). Methods: Left and right VRCSN at C4/5 and C5/6 were infiltrated at the intervertebral foramen (IVF) under ultrasonographic guidance. A vertically orientated 3.5-MHz curvilinear probe was used to identify the craniocaudal midpoint of the articular process joint (APJ). The probe was moved ventrally until the IVF was identified. An 18-gauge 15-cm-long spinal needle was aimed immediately below the ventral margin of the cranial articular process, where 1 mL of latex was injected. Cadavers were dissected, and the location of the latex was recorded relative to the ventral ramus, the spinal cord, and the vertebral artery. Results: Direct infiltration of the ventral ramus occurred in 73% (29/40) of injections; 15% (6/40) of injections were  0.5 cm (maximum 1.5 cm). Latex was located at a mean of 2.4 cm (range, 0.8-4) from the spinal cord and 0.9 cm (range, 0-1.5) from the vertebral artery. Conclusions: Ultrasonographic guidance of perineural injections of the caudal VRCSN was repeatable and accurate, with 88% of injections located within 0.5 cm of the ventral ramus. Iatrogenic damage was limited to one penetration into the vertebral artery. Conclusions: Ultrasonographic guidance of perineural injections of the caudal VRCSN may be considered by operators experienced in cervical APJ scanning in horses with suspected cervical spinal nerve compression.
© 2021 The American College of Veterinary Surgeons.
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Publication Date: 2021-03-10 PubMed ID: 33751588DOI: 10.1111/vsu.13610Google 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 study was aimed at testing the precision of ultrasonographic guidance for injections targeting the ventral rami of cervical nerves in horses. This technique was found to be reliable and accurate, suggesting its potential use by veterinary professionals handling horses with suspected cervical spinal nerve compression.

Methodology

  • The study employed an ex vivo design and used ten horse cadavers, involving a total of 40 injections.
  • The left and right ventral rami of the cervical spinal nerves (VRCSN) at C4/5 and C5/6 were infiltrated at the intervertebral foramen (IVF) using ultrasonographic guidance.
  • A vertically aligned 3.5-MHz curvilinear probe identified the craniocaudal midpoint of the articular process joint (APJ). Moving the probe ventrally identified the IVF.
  • An 18-gauge 15-cm-long needle was aimed slightly beneath the ventral margin of the cranial articular process. Approximately 1 mL of latex was then injected.
  • The location of the latex was subsequently recorded, determining its relative positions to the ventral ramus, the spinal cord, and the vertebral artery.

Results

  • The results showed that the ventral ramus was directly infiltrated in 73% (29/40) of the injections.
  • Around 15% (6/40) of the injections ended up less than 0.5 cm from the ventral ramus.
  • About 13% (5/40) of the injections were more than 0.5 cm away (up to a maximum of 1.5 cm) from the ventral ramus.
  • The latex was found to be at an average of 2.4 cm (between 0.8 cm and 4 cm) from the spinal cord and 0.9 cm (ranging from 0 to 1.5 cm) from the vertebral artery.

Conclusions

  • The ultrasonographic guidance for perineural injections around the caudal VRCSN proved to be reliable and accurate, with 88% of injections located within 0.5 cm of the ventral ramus.
  • Any potential harm resulting from the procedure appeared minimal, with only one incident of penetration into the vertebral artery recorded.
  • The researchers concluded that qualified operators might consider employing this method for horses suffering from suspected cervical spinal nerve compression.

Cite This Article

APA
Wood AD, Sinovich M, Prutton JSW, Parker RA. (2021). Ultrasonographic guidance for perineural injections of the cervical spinal nerves in horses. Vet Surg, 50(4), 816-822. https://doi.org/10.1111/vsu.13610

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 50
Issue: 4
Pages: 816-822

Researcher Affiliations

Wood, Andrew Douglas
  • Liphook Equine Hospital, Hampshire, UK.
Sinovich, Matthew
  • Liphook Equine Hospital, Hampshire, UK.
Prutton, James Stephen Winter
  • Liphook Equine Hospital, Hampshire, UK.
Parker, Russell Alexander
  • Liphook Equine Hospital, Hampshire, UK.

MeSH Terms

  • Animals
  • Cadaver
  • Horses
  • Injections, Spinal / methods
  • Injections, Spinal / veterinary
  • Neck
  • Reproducibility of Results
  • Spinal Nerves / diagnostic imaging
  • Ultrasonography / veterinary

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Citations

This article has been cited 2 times.
  1. Fouquet G, Abbas G, Johnson JP, Pompermayer E, Harel C, Aldous E, Puchalski S, David F. Ultrasound-guided injection technique of the equine cervical nerve roots. Front Vet Sci 2022;9:992208.
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  2. Nocera I, Di Franco C, Sorvillo B, Aliboni B, Bucchioni E, Sgorbini M, Sala G, Citi S. Evaluation of the feasibility of equine in-vivo ultrasound technique for the medial branch of the dorsal ramus of the cervical spinal nerves. Vet Q 2024 Dec;44(1):1-5.
    doi: 10.1080/01652176.2024.2403456pubmed: 39267500google scholar: lookup
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