The influence of head and neck position on radiographic examination of the intervertebral foramina of the neck of horses at latero-lateral projection

Abstract

ZusammenfassungSpondylarthrotische Prozesse von Facettengelenken der Halswirbelsäule können durch Kompression des Rückenmarkes und der Nervenwurzeln zu Schmerzen und Steifheit des Halses führen und möglicherweise Ataxie und Vorderhandlahmheit verursachen. In der röntgenologi-schen Diagnostik sind diese pathologischen Veränderungen unter anderem durch Verkleinerungen der Foramina intervertebralia charakterisiert. Die vorliegende Studie geht der Hypothese nach, dass auch die Kopf-Hals-Haltung die röntgenologisch dargestellte Größe dieser Foramina verändert. Halswirbelsäulen klinisch unauffälliger Pferde wurden in drei verschiedenen Kopf-Hals-Haltungen mit seitlichem Strahlengang röntgenologisch dargestellt und die Länge der Wirbelkörper vermessen. Die Größe der Foramina intervertebralia wurde mit Hilfe der Distanz zwischen der Extremitas cranialis und den Processus articulares craniales desselben Wirbels und der Distanz zwischen der Extremitas caudalis und den Processus articulares craniales des darauf folgenden Wirbels bestimmt. Die Länge der Wirbelkörper und die Distanz zwischen der Extremitas cranialis und den Processus articulares craniales desselben Wirbels wiesen keine wesentlichen Unterschiede bei den getesteten Kopf-Hals-Haltungen auf. Die Distanz zwischen der Extremitas caudalis und den Processus articulares craniales des darauf folgenden Wirbels vom vierten bis zum siebten Halswirbel war bei Flexion signifikant größer als in Extension und physiologischer Kopf-HalsHaltung. Zwischen Extension und physiologischer Kopf-Hals-Haltungen fanden sich allerdings nur Unterschiede in der Distanz zwischen der Extremitas caudalis und den Processus articulares craniales des darauf folgenden Wirbels des siebten Halswirbels. Bei der Beurteilung von Röntgenaufnahmen der Halswirbelsäule von Pferden sollte daher immer die Kopf-Hals-Haltung berücksichtigt bzw. standardisiert werden.Schlüsselwörter: Pferd / Halswirbelsäule / Foramina intervertebralia / Flexion / Extension / Röntgen / bildgebende Diagnostik The influence of head and neck position on radiographic examination of the intervertebral foramina of the neck of horses at latero-lateral projection Spondylarthrosis of the cervical articular process joints can lead to compression of the spinal cord and the nerve roots. Affected horses may show neck pain and stiffness as well as ataxia and forelimb lameness. Among other signs, these pathological changes can be identified by the reduction of the intervertebral foramina on radiographs. This study tests the hypothesis that head and neck position influences the size of the intervertebral foramina as depicted radiographically. Radiographs in latero-lateral projection were taken of the cervical spines of clinically unaffected horses in three different head and neck positions and the lengths of the vertebral bodies were measured. The dimensions of the intervertebral foramina was determined with the aid of the distance between the extremitas cranialis and the cranial articular processes of the same vertebra and the distance betwee...

Should cervical radiographs be included in a pre‐purchase examination?

“…Professional personnel handling the horse can greatly assist the radiographer in ensuring the horse is evenly weight‐bearing and the spine is straight. This is important as different neck positions can affect the appearance of some structures and certain measurements, such as vertebral alignment angles and intervertebral sagittal ratios (Beccati et al., 2018; Berner et al., 2012; Veraa et al., 2021). Geometric distortion can also affect the shape of the vertebra positioned at the periphery of a radiograph (Djernæs et al., 2014).…”

CT measures of osseous cervicothoracic intervertebral foramina are repeatable and associated with CT measures of adjacent articular processes in horses

“…[3][4][5] Radiography is a standard imaging modality for evaluating affected horses, however assessments of IF size can be difficult due to superimposition and variations in positioning. 4,[6][7][8] For instance, ventral extension of the cervical articular processes (AP) and superimposition on the IF is identifiable on laterolateral cervical radiographs 4,7,9 but this is sometimes of no clinical relevance with 18% of asymptomatic horses showing AP ventral extension at C6-C7. 4,7,9 Computed tomography is a cross-sectional imaging technique with a high spatial resolution that can alleviate the superimposition limitations associated with radiographs 10 and CT is increasingly being used as an adjunct imaging technique for evaluating horses with suspected cervicothoracic spinal disease.…”

“…Narrowing of the cervicothoracic IF has been described as one of the causes for neck pain and IF narrowing between C5 and T2 has the potential to cause forelimb lameness in horses 3–5 . Radiography is a standard imaging modality for evaluating affected horses, however assessments of IF size can be difficult due to superimposition and variations in positioning 4,6–8 . For instance, ventral extension of the cervical articular processes (AP) and superimposition on the IF is identifiable on laterolateral cervical radiographs 4,7,9 but this is sometimes of no clinical relevance with 18% of asymptomatic horses showing AP ventral extension at C6‐C7 4,7,9 .…”

Diagnostic imaging of the equine cervical spine – Are radiographs enough?

“…For laterolateral radiographs, horses should be evenly weight‐bearing and have a straight head and neck position. The latter should be standardised as this can influence the appearance of some structures and measurement parameters (Beccati et al, 2018; Berner et al, 2012). Furthermore, as mentioned in the article by Fairburn et al, (2023), in patients presenting with abnormal alignment of the vertebrae such as scoliosis acquiring straight radiographs is more challenging and images have to be obtained with different angles to make sure they are acquired perpendicular to the vertebrae (Fairburn et al, 2023).…”