Chapter 53 - Vertebral column thorax coccygeal Flashcards
What type of vertebral injuries is more common in adult horses than in foals?
Thoracolumbar
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In horses, life-threatening vertebral fractures are most often seen in what activity?
Jumping
Which parts of the thoracolumbar spine are typically involved in fractures?
Vertebral body and dorsal spinous processes
Where do the most common vertebral body fractures occur in horses?
First three thoracic vertebrae followed by T12
What is the recommended course of action for horses with severe disruption of the thoracolumbar spinal cord?
Euthanasia
Where do dorsal spinous process fractures tend to occur?
Thoracic vertebrae
What therapeutic approaches can be attempted when the spinal cord is intact?
Conservative therapy or stabilization with pins/plates
Fracture of the thoracic dorsal spinal processes in horses is often associated with what behavior?
Rearing and falling backward
In a report of 22 cases of thoracolumbar vertebral fractures, how many involved the vertebral body or neural arch?
15
What are common clinical signs of fractures of the dorsal spinous processes?
Local pain, swelling, and stiffness
What surgical procedure is performed for fractures of the dorsal spinous processes?
Subtotal ostectomy
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What is the preferred technique for the subtotal ostectomy of the dorsal spinous processes?
In the standing horse
For what reasons might surgery be required for dorsal spinous process fractures?
Sequestered bone fragments or position precluding saddle use
How long postoperatively is healing adequate to permit riding?
8-12 weeks
What does consist the conservative tx of thoracic and lumbar spinous processes fracture?
systemic and intralesional cortico +
shockwave/radial pressure wave therapy,
bisphosphonates
+ acupuncture careffully inserted
How do you perform the surgical intervention?
Surgical tx: sedation + local anesthesia nea incisionbut LR is preferred by most surgeons
Metalic markers forradio control ofexactly the sites of the DSPs to be resectedvLongitudinal inicision is made betweenthe most cranial and caudal of the affected DSPs
Supraspinous ligaments diveded sharply and longitudinally and retracted abaxially with Gelpi retractors
The dorsal part of DSP of 1 or morevertebra is resected àoscillating saw, osteotome, gigli wire
Gigli wire with custom-made wire guide is used hasess exposure and dissection is necessary which is why this is the preferredtechnique 2 types of procedure:
1.Resection of the entire DSP
2.Subtotal (cranial wedge) ostectomy(+ recent)
mandatory minimum of 5 mm between remaining bodies of each process resected
describe partial resection
Partial resection of the thoracic and lumbar dorsal spinousprocesses
Thedorsal 4 to 5 cm of the DSPs are dissected free of the supraspinous ligament +interspinous ligaments + adjacent muscle tissue
For the cranial wedge osteoctomy: 1stinterspinous ligament cranial to each affected DSP is sharply incised
With oscillation saw onlythe cranial portion of affected DSPs is removed in a caudodorsal-cranioventraldirection
The ventral extent of the resectionshould emerge ventral to the site of impingement
Once the** resection is complete à supraspinous ligament issutured in simple continous pattern** – skin with staples
In addition to radiography, which imaging modality is advised due to frequent oversight of fractures?
CT
What is used to document the extent of spinal cord compression in foals, small horses, ponies, and donkeys?
Myelography
What is the initial treatment for horses with little or no displacement of vertebral fragments?
Conservative management
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When is implant fixation indicated in vertebral body fractures?
When needed to provide stability
What position is the horse placed in for implant fixation surgery?
Sternal recumbency
How are the Steinmann pins inserted for stabilizing a fracture?
At an angle to the vertebra
What is critical to avoid when inserting the caudal pins?
Injuring the aorta and vena cava
What provides final rigidity in the stabilization process?
Cold-curing PMMA
Which diagnostic methods are used to examine back pain in horses?
Physical and complete orthopedic examination, including diagnostic analgesia, radiology, and scintigraphy
What conditions have been associated with back pain in horses?
Overriding DSPs,
osteoarthritis,
spondylosis
What is the common treatment for most horses with back pain?
Intralesional treatment with corticosteroids and agents like Sarapin
What surgical technique is used for the resection of the dorsal part of the DSP in horses?
esection using an oscillating saw, osteotome, gigli wire, or bone-cutting shears
Brown et al VS 2020 Long-term outcome and effect of diagnostic analgesia in horses undergoing interspinous ligament desmotomy for overriding dorsal spinous processe. Performance comparison of 159 Thoroughbred racehorses and matched cohorts before and after desmotomy of the interspinous ligamen- What was compared to determine the influence on long-term outcome? A) The type of ISLD performed
B) The use of preoperative diagnostic analgesia
C) The age of the horses
D) The breed of the horses
B) The use of preoperative diagnostic analgesia