Ultrasonography-Guided Perineural Injection of the Ramus ventralis of the 7 and 8th Cervical Nerves in Horses: A Cadaveric Descriptive Pilot Study.
Abstract: To describe the feasibility and dye diffusion of selective perineural injection of the 7 and 8th cervical nerve (C7 and C8) under ultrasonographic guidance in horses. Prospective experimental pilot cadaver study. Four equine cadavers of similar body weight (420-480 kg) and neck conformation. Five C7 and five C8 were perineurally injected with a dye solution. Anatomic dissections including vertebral canal opening were conducted to confirm nerve dye staining and describe the extent of color diffusion. The of the spinal cervical nerves was visualized in all cadavers. All the injections were successful in staining a portion of the nerve trunk. Eight had a uniform transversal staining of the nerve trunk that longitudinally covered a distance >2 cm. One C7 and one C8 nerve trunk showed incomplete transversal staining with a more concentrated color on its half cranial aspect and a longitudinal coverage of <2 cm. Five injections resulted in dye extending proximally and medially into the epidural space. Volume had no appreciable effect on the extent of nerve staining. A greater proportion of epidural diffusion was found with injections done within less than one cm distally to the articular processes. All injections were considered to be selective for the targeted nerve. Ultrasonography-guided perineural injection of C7 and C8 is a feasible technique that may have multiple applications in multimodal analgesia in horses. Further clinical study will be necessary to determine the appropriate drug, dosage, and volume to inject and to confirm its usefulness.
Copyright © 2020 Touzot-Jourde, Geffroy, Tallaj, Gauthier and Denoix.
Publication Date: 2020-02-25 PubMed ID: 32158773PubMed Central: PMC7052177DOI: 10.3389/fvets.2020.00102Google Scholar: Lookup
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Summary
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The research is a pilot study investigating the feasibility and dye diffusion of selective perineural injection of the 7th and 8th cervical nerves in horses using ultrasonography guidance.
Methodology
- The researchers conducted this study on four equine cadavers with similar body weights ranging from 420 to 480 kg and neck conformations.
- Five 7th (C7) and five 8th (C8) cervical nerves were selected for perineural injection of a dye solution. Perineural injection refers to the injection of medication around a nerve for pain relief, and in this case, a dye is used to visualize needle placement and injection diffusion.
Procedure and Findings
- After the injection, anatomical dissections of the cadavers were performed, including the opening of the vertebral canal. This step was carried out to verify the staining of the nerve by the dye and to describe how far the color spread.
- The spinal cervical nerves were visualized in all cadavers, and all injections successfully stained a part of the nerve trunk.
- Among those, in eight cases, a uniform transversal staining of the nerve trunk that longitudinally covered a distance of more than 2 cm was achieved. However, in two cases (one C7 and one C8 nerve trunk), the transversal staining was incomplete with a more concentrated color on half of its cranial aspect and covered a longitudinal distance of less than 2 cm.
Epidural Space Involvement and Volume Effect
- Five injections resulted in dye extending proximally and medially into the epidural space. The epidural space is the area between the dura mater (a membrane around the spinal cord) and the vertebral wall, filled with fat and blood vessels.
- The volume of dye used in the injection had no noticeable effect on the extent of nerve staining, and injections performed within less than one cm distally to the articular processes resulted in a higher proportion of epidural diffusion.
- All injections were found to be selective for the targeted nerve, meaning the dye injection primarily affected the intended nerve without involving surrounding structures.
Potential Applications and Future Directions
- The research suggests that ultrasonography-guided perineural injection of the 7th and 8th cervical nerves in horses is a feasible method and might have numerous applications in multimodal analgesia (pain relief).
- However, more clinical studies will be necessary to establish the appropriate drug, dosage, and volume to be used for injection and to confirm the effectiveness and safety of this technique in clinical settings.
Cite This Article
APA
Touzot-Jourde G, Geffroy O, Tallaj A, Gauthier O, Denoix JM.
(2020).
Ultrasonography-Guided Perineural Injection of the Ramus ventralis of the 7 and 8th Cervical Nerves in Horses: A Cadaveric Descriptive Pilot Study.
Front Vet Sci, 7, 102.
https://doi.org/10.3389/fvets.2020.00102 Publication
Researcher Affiliations
- INSERM, UMR 1229, Regenerative Medecine and Skeleton, University of Nantes, ONIRIS, Department of Veterinary Clinical Sciences, Nantes, France.
- INSERM, UMR 1229, Regenerative Medecine and Skeleton, University of Nantes, ONIRIS, Department of Veterinary Clinical Sciences, Nantes, France.
- INRA/ENVA, UMR 957, Biomechanics and Equine Locomotor Pathology Research Unit, Centre for Imaging and Research in Equine Locomotor Disorders (CIRALE), National Veterinary School of Alfort, Maisons-Alfort, France.
- INSERM, UMR 1229, Regenerative Medecine and Skeleton, University of Nantes, ONIRIS, Department of Veterinary Clinical Sciences, Nantes, France.
- INRA/ENVA, UMR 957, Biomechanics and Equine Locomotor Pathology Research Unit, Centre for Imaging and Research in Equine Locomotor Disorders (CIRALE), National Veterinary School of Alfort, Maisons-Alfort, France.
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Citations
This article has been cited 4 times.- 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.
- Johnson JP, Vinardell T, David F. Ultrasound-guided injections of the equine head and neck: review and expert opinion. J Equine Sci 2021 Dec;32(4):103-115.
- Portela DA, Moura RA, Cavalcanti M, Regier PJ, Romano M, Stern AW, Vettorato E, Otero PE. Development of a Pericapsular Elbow Desensitization Technique in Dogs-A Canine Cadaveric Study. Vet Sci 2025 Apr 17;12(4).
- 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.
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