Surgical treatment of kissing spines syndrome- 50 cases – Part l: diagnostic methods

Abstract

ZusammenfassungBei 50 am 'Kissing Spines Syndrom" erkrankten fferden wurde in einer retrospeKiven Studie eine Edolgsbeurteilung der Dornfortsatzresek tion vorgenommen. Zahkeiche mögliche thorakolumbale Erkrankungen und eine Reihe von Difierentialdiagnosen erschweren die Diagnose ,,Kissing Spines-Syndrom". Zur Absicherung der Diagnose sind mehrere diagnostische Teilschritte notwendig. Neben der Erfassung eines detaillierten Vorberichtes und einer eingehenden klinischen Untersuchung, sind weiterführende Untersuchungen notwendig. Dazu gehören eine röntgenologische und eventuell szintigraphische Untersuchung, eine Blutuntersuchung und die lokale Anästhesie der verdächtigen Dornfortsatzzwischenräume. Die Durchführung der genannten LJntersuchungen wird erläutert und difierent aldiagnostische Erkrankungen werden aufgeführt. Die Diskussion umfasst außerdem die Beurteilung der Befunde und nennt ergänzende diagnostische Verfahren wie z.B. die Lineartomographie und die Thermographie.Schlüsselwörtsn Kissing Spines, Thorakolumbales interspinales Syndrom, Diagnostik, Szintigraphie, Pferd Surgical treatment ol kissing spines syndrome -50 cases. Part l: diagnostic methods In a retrospective study the postoperative success of resection of the dorsal spinous processes of 50 horses sufiering from ,Kissing Spines" was evaluated. Multiple thoracoiumbar diseases and a number of differential diagnosis make the diagnosis ,Kissing Spines" difficult. For further confirmation of the diagnosis several diagnostic steps are necessary. In addition to a detailed history and a thorough clinical examination further information is necessary. These tests include radiographic and possibly scintigraphic examinations, a full heamatological and biochemical profile and local anesthesia of the suspected interspinous spaces. The procedure of the above mentioned examinations is described and differential diagnosis are listed. The discussion also deals with the evaluation of the findings and additional diagnostic procedures such as linear tomography and thermography are mentioned.

Relationship between scintigraphic and radiographic evaluations of spinous processes in the thoracolumbar spine in riding horses without clinical signs of back problems

“…These results indicate that mild IRU and narrow interspinous spaces may not influence performance, and to use the term 'abnormal' for these findings is, therefore, questionable. The limit between normal and narrow interspinous spaces in this study was set at 4 mm, following previous literature (Jeffcott 1979b;Kreling and Lauk 1996). This choice was supported by our results; the variation of the width of interspinous spaces was large, but the mean width of each interspinous space was never less than 4.4 mm.…”

“…It has also been speculated that 'crowding' and 'overriding' of dorsal spinous processes develop gradually with age, caused by the conformation of the horse or by repeated extension of the back (Jeffcott 1979b(Jeffcott , 1980. Several studies of horses with disorders of the thoracolumbar spine have described a wide range of radiographic and/or scintigraphic changes (Jeffcott 1980;Nowak 1988;Steckel 1991;Ueltschi 1993;Kreling and Lauk 1996;Gundel et al 1997;Walmsley et al 2002). These studies showed that various radiographic and/or scintigraphic findings were not always related to the clinical signs or to each other; and radiography has been considered the method with the lowest sensitivity of the two (Steckel 1991;Hendrickson 2002).…”

The radiographic frequency of impingement of the dorsal spinous processes at purchase examination and its clinical significance in 220 warmblood sporthorses

“…This standardised the intervertebral DSP distances and prevented over/under-estimation of the radiologic abnormalities of the DSPs. The location of radiologic abnormalities (mainly T14 -L2) was comparable with the previous reports (Jeffcott 1979(Jeffcott , 1980Townsend 1986;Kreling 1996;Haussler 1999, Erichsen 2004). …”

Influence of head and neck position on radiographic measurement of intervertebral distances between thoracic dorsal spinous processes in clinically sound horses

“…According to the German ‘Roentgenleitfaden’ (x‐ray guide) , intervertebral distances under 8 mm are a marginal variance from the norm. Other authors define only intervertebral distances under 4 mm as indicative of pathological changes , or only impingement of the dorsal spinous processes by themselves . In the present study, we determined that altering the horse's head and neck position affected the intervertebral distances between the thoracic dorsal spinous processes and therefore might influence the interpretation of radiographs of this area.…”