Back Pathology

Erector spinae plane block as part of a multimodal analgesic approach in an anaesthetised horse undergoing dorsal spinous process ostectomy and desmotomy

“…These diagnostic tests are frequently used to localise and determine the extension of the lesion, give a prognosis and determine the treatment (either medical or surgical). In cases where surgical treatment is recommended, the use of diagnostic analgesia will locate the most clinically relevant regions to be treated 15,21,22 . In the present case, epaxial infiltration of 400 mg of mepivacaine in between the T15 and L1 interspinous processes resulted in a mobility improvement during lameness assessment under saddle with less bucking and more willingness to canter.…”

“…Treatment of KSS will depend on the onset time and severity of the disease. Even though conservative treatment is normally the first‐line option, in some occasions, it may be necessary to combine it with surgical management 15,23 . The objective of the conservative treatment is to minimise the inflammation between adjacent dorsal SP.…”

“…For instance, short‐backed breeds, with the same number of vertebrae, have smaller space in between dorsal SP than long‐backed horses and therefore this is more likely to occur in the former 15 . It is typically diagnosed in horses at 5–9 years of age, but the degree of severity rises with increasing age, 15 and it is more commonly seen in mares when compared to gelding or stallions. Any breed can be affected, nevertheless, thoroughbred horses are more likely to be diagnosed than warmbloods or thoroughbred crosses 19,20 .…”

“…EBDs are classified as primary disorders, when the spinal structure is affected or as secondary, when the axial skeleton is involved. The aetiology of back pain includes fractures involving any back structure, degenerative conditions, neoplasia, supraspinous and dorsal sacroiliac ligaments pathologies and overriding of the dorsal spinal process (ORDSP) 15 . The latter occurs when the natural distance between two or more consecutive dorsal SP is lost.…”

“…Different techniques for subtotal ostectomy have been described. An open method can be achieved both under general anaesthesia or in a standing position with the help of sedation and local anaesthesia techniques 15,23–27 . As described by Perkins et al., this procedure is associated with less haemorrhage as well as fewer anaesthetic and sedation‐related complications 27 .…”