Background Computed tomography in standing horses has revolutionized diagnostic imaging. The O-arm®, a cone beam computed tomography (CBCT) scanner with a gantry opening of 96.5 cm is routinely used for image-guided spine and neurosurgery in humans. The aim of this study is to describe the set-up and first experiences using the O-arm® to achieve CBCT imaging of the head in standing horses. CT imaging of the predefined region of interest (ROI) was tested on 2 cadaveric heads, concentrating on centering issues within the gantry, as well as determining the number of scans needed per ROI. All horses presented with head-related diseases and subjected to a CBCT examination between February 2015 and November 2016 for CBCT were included. Per scan, a limited field of view, i.e. a cylindrical volume of 21 cm in diameter and 16 cm in height was acquired within 13 s. Depending on the dimensions of the ROI, the minimum number of scans could range from one to six, if the entire equine head is to be examined in an adult horse. Results Sixty-eight horses were included, five of which had a follow-up CBCT exam, and two of which were presented twice for two different indications (75 clinical cases). A total number of 449 acquired three-dimensional (3D) scans were recorded for these 75 cases. Two-hundred and forty-two 3D scans (54%) were considered as diagnostic quality. The imaging procedure was generally well tolerated by the sedated, standing equid, and diagnostic studies were performed in 73 out of 75 cases (97.3%). Motion artefacts and inadequate centering of the ROI were the most common reasons for non-diagnostic quality images and repeat scans of the same ROI. Conclusions CBCT is a valuable imaging modality for the equine head. Advantages of the O-arm® compared to a conventional multi-slice helical CT for imaging of the head in standing equids include the rapid image acquisition, the gantry’s mobility in all dimensions, and the free movability of the entire imaging unit. Disadvantages include the considerable sensitivity to motion artefact, increased scatter, low soft tissue contrast and the limited dimensions of the field of view.
ObjectiveTo describe clinical applications of computer‐assisted orthopedic surgery (CAOS) in horses with a navigation system coupled with a cone beam computed tomography unit.Study designRetrospective clinical case series.AnimalsThirteen adult horses surgically treated with CAOS.MethodsMedical records were searched for horses that underwent CAOS between 2016 and 2019. Data retrieved included signalment, diagnosis, lameness grade prior to surgery, surgical technique and complications, anesthesia and surgery time, and information pertaining to the perioperative case management and outcome.ResultsIn 10 cases, surgical implants were placed in the proximal phalanx, third metatarsal bone, ulna, or medial femoral condyle. In one case, navigated transarticular drilling was performed to promote ankylosis of the distal tarsal joints. In another case, an articular fragment of the middle phalanx was removed with the help of CAOS guidance. In the final case, a focal osteolytic lesion of the calcaneal tuber was curetted with the aid of CAOS. In seven cases, a purpose‐built frame was used for the surgical procedure. All surgeries were performed successfully and according to the preoperative plan.ConclusionComputer‐assisted orthopedic surgery can be an integral part of the clinical case management in equine surgery. To optimize workflow and time‐efficiency, the authors recommend designating one team for operative planning and another for the execution of the surgical plan. Specialized equipment, such as the purpose‐built frame, will further improve CAOS applications in equine surgery.Clinical significanceAfter they have become familiar with the operational principles, equine surgeons can readily apply CAOS for a broad spectrum of indications.
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