Performance comparison of 159 Thoroughbred racehorses and matched cohorts before and after desmotomy of the interspinous ligament

Derham, Ann M.; O’Leary, John Mark; Connolly, Susan; Schumacher, James; Kelly, G.

doi:10.1016/j.tvjl.2019.05.004

Cited by 9 publications

(23 citation statements)

References 19 publications

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“…A recent retrospective study by Prisk and García‐López 14 describing the outcome of 56 horses that had undergone desmotomy of the interspinous ligament as treatment for back pain caused by impinging DSPs found that 91% (51/56) returned to performance, but disappointingly only 52% (27/51) returned to a level of performance equal to or greater than that before treatment, presumably because these horses still experienced back pain. That one‐third of the horses in that study continued to suffer from persistent back pain after surgery is in stark contrast to the success of desmotomy of the interspinous ligament as a treatment for poor performance caused by impinging DSPs, reported in previous studies 1,14,15 . The horses in the study by Prisk and García‐López 14 may have continued to suffer from back pain after desmotomy because of concurrent abnormalities of the back, such as osteoarthritis of the thoracolumbar process joints, which is reported to be present in 25% of horses with impinging DSPs, 3 or a soft tissue injury of the thoracolumbar region, which is reported to be present in 38% of horses with back pain 4 .…”

Section: Local Analgesia Of the Thoracolumbar Regionmentioning

confidence: 64%

“…Descriptive anatomical studies of the spinal nerves of humans, cats, and dogs have shown that the presence and course of the intermediate branch of the dorsal ramus of the thoracolumbar spinal nerves vary among spinal nerves of the thoracic, mid‐thoracic and lumbar regions. The intermediate branch of the dorsal ramus of the thoracolumbar spinal nerves of the horse also may vary in its existence, origin, and course, and this variability is likely the reason for the inconsistent development of neurogenic atrophy of the epaxial musculature in the cohort of horses reported by Derham et al (2019) 1 . We advise that care should be taken to avoid inserting the tip of the scissors into the contralateral epaxial musculature when inserting scissors to transect the interspinous ligament at an angle more obtuse than that described by Coomer et al (2012) 15 .…”

Section: Discussionmentioning

confidence: 99%

“…A recent study reported the occurrence of focal atrophy of the epaxial musculature of horses as a complication of transection of the interspinous ligament for treatment of horses for impinging DSPs 1 . Though the appearance of the affected horses was suggestive of atrophy of the m. longissimus dorsi , the authors failed to determine which epaxial muscles had atrophied.…”

Section: Neurogenic Atrophy Of the Epaxial Musclesmentioning

confidence: 99%

“…Impingement of two or more dorsal spinous processes (DSPs) has been reported to be a frequent cause of back pain of horses 1–6 . The first surgical treatment for impinging DSPs involved transversely amputating the affected portion of the DSP through a crescentic incision on the dorsal midline 7 .…”

Section: Introductionmentioning

confidence: 99%

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Implications of the neuroanatomy of the equine thoracolumbar vertebral column with regional anaesthesia and complications following desmotomy of the interspinous ligament

Derham

Schumacher

Leary

et al. 2021

Equine Veterinary Journal

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Impinging/overriding dorsal spinous processes (DSPs) of the thoracolumbar vertebrae are a common cause of poor performance in horses. In the last five decades, numerous surgical treatments have been reported on, from transverse transection of the affected DSPs, and endoscopic resection of the affected DSPs, to transection of the interspinous ligament. Until recently, cosmetic outcomes have been reported as good to excellent in studies. However, a previously unreported complication of neurogenic atrophy of the contralateral epaxial muscle following desmotomy of the interspinous ligament has been recently reported. The authors hypothesised that this was because of a more lateral approach than previously described, resulting in the scissors being too far across midline and transecting a nerve in the region. Considering this finding, we have reviewed the literature on the neuroanatomy of the thoracolumbar region in the horse. Literature on the neuroanatomy of the horse is lacking when compared with that of humans and companion animals, with most of the work extrapolated from companion animals. Based on the current literature, we hypothesise that transection of an intermediate branch of the dorsal spinal nerve supplying the m. longissimus is potentially the cause of the post‐operative neurogenic atrophy. The lack of detailed knowledge of the neural anatomy of the equine back has resulted in the role of local anaesthesia in localising pain in the equine back being poorly understood. The wide variation in techniques used for localising back pain may explain why some horses suffering from poor performance or an abnormal gait because of back pain improve to local anaesthesia of the back while others do not. This review article highlights a lack of anatomical knowledge regarding the equine thoracolumbar region in the literature despite diagnostic local anaesthesia, medication, and surgery in this area being relatively common.

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Section: Local Analgesia Of the Thoracolumbar Regionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Neurogenic Atrophy Of the Epaxial Musclesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Implications of the neuroanatomy of the equine thoracolumbar vertebral column with regional anaesthesia and complications following desmotomy of the interspinous ligament

Derham

Schumacher

Leary

et al. 2021

Equine Veterinary Journal

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“…The alternative to ostectomy is the ISLD, which is a minimally invasive technique. The ISLD has largely replaced ostectomies for treatment of mild cases of impinging DSPs; the success of ISLD is similar to ostectomy procedures with return to athletic function rates between 52.9% and 95% reported 2,7,8 . Nevertheless, an ISLD can be unsuccessful if the DSPs have formed a bony bridge and an ostectomy needs to be performed 2 .…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive cranial ostectomy for the treatment of impinging dorsal spinous processes in 102 standing horses

Souza¹,

Crowe²,

Bowles³

et al. 2021

Veterinary Surgery

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Objective To describe a minimally invasive cranial ostectomy for the treatment of impingement of dorsal spinous processes (DSPs) in the standing horse. Study Design Retrospective study. Animals One hundred two horses with impinging DSPs. Methods The case records of all horses that had the described technique between 2011 and 2019 were reviewed. All sites of impinging DSPs were treated under standing sedation and local anesthesia. The minimally invasive cranial ostectomy of the caudal DSP was performed with bone rongeurs through multiple small incisions. Results Of the 102 horses treated with this technique, no surgical complications were recorded. Median (range) long‐term follow‐up for all horses was 18 months (12–50 months) postoperatively. Of the 66 horses available for follow‐up that were still alive, 53 horses (80%) had complete resolution of clinical signs and returned to the intended work. There were 36 horses with a concurrent orthopedic issue presurgery, and 25/36 (69%) returned to the same level of intended work; of the horses with no evidence of another orthopedic issue presurgery, 28/30 (93%) returned to the same level of intended work. Conclusion Minimally invasive cranial ostectomy of the caudal DSP had a good success rate in horses with impingment of DSPs. Clinical Significance The described minimally invasive ostectomy technique in standing horses is a low‐risk procedure that provides success rates similar to other techniques.

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International survey of equine orthopaedic specialists reveals diverse treatment strategies for horses with overriding spinous processes

Treß,

Lischer,

Merle

et al. 2024

Veterinary Record

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BackgroundOverriding spinous processes, also known as ‘kissing spines’, are one of the most common causes of back pain in horses. The aim of this study was to investigate which options for diagnosis and treatment are preferred by equine orthopaedic specialists and assess which techniques are used for local injection.MethodsAn online survey was distributed among members of the European/American College of Veterinary Surgeons, the European/American College of Veterinary Sports Medicine and Rehabilitation, the International Society of Equine Locomotor Pathology and nationally recognised advanced equine orthopaedic practitioners.ResultsThe survey was completed by 353 respondents. The injection techniques most commonly used involve placing two needles abaxial to the interspinous space (42%) under ultrasonographic guidance (32%) or one needle in the midline (35%) between two spinous processes. The most popular combination for overriding dorsal spinous process therapy was local injection (26.7%) combined with controlled exercise (25.5%). Manual therapy was considered by 42% of European and 25% of American specialists (p = 0.01). Surgical intervention as a first‐line treatment was recommended mainly by specialists working in the United States, the UK or Ireland (p = 0.001). Overall, most equine orthopaedic veterinarians (71%; n = 201) preferred conservative management and recommended surgery only for horses that did not respond to conservative therapy.LimitationsRespondents’ personal bias may have skewed the findings.ConclusionsDespite a growing body of evidence, the therapeutic approach to ‘kissing spines’ in horses is influenced by professional specialisation and regional preferences. Variations in injection techniques and differing criteria for surgical intervention warrant further investigation.

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Performance comparison of 159 Thoroughbred racehorses and matched cohorts before and after desmotomy of the interspinous ligament

Cited by 9 publications

References 19 publications

Implications of the neuroanatomy of the equine thoracolumbar vertebral column with regional anaesthesia and complications following desmotomy of the interspinous ligament

Implications of the neuroanatomy of the equine thoracolumbar vertebral column with regional anaesthesia and complications following desmotomy of the interspinous ligament

Minimally invasive cranial ostectomy for the treatment of impinging dorsal spinous processes in 102 standing horses

International survey of equine orthopaedic specialists reveals diverse treatment strategies for horses with overriding spinous processes

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