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

Autor: Matthew Sinovich, Andrew Douglas Wood, James Stephen Winter Prutton, Russell A. Parker
Rok vydání: 2021
Předmět:
Zdroj: Veterinary Surgery. 50:816-822
ISSN: 1532-950X
0161-3499
DOI: 10.1111/vsu.13610
Popis: Objective To evaluate the accuracy of ultrasonographic guidance for injection near the ventral rami of the cervical spinal nerves (VRCSN). Study design Ex vivo study. Sample population 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. Conclusion 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. Clinical significance 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.
Databáze: OpenAIRE
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