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highlighted by a recent study.
Impinging dorsal spinous processes (IDSP “Kissing spines”) can be associated with pain and discomfort, leading to behavioural and performance issues. However, not all horses with kissing spines show clinical signs and the condition may go unnoticed until it is found during a routine check-up or imaging.
Diagnosis typically includes radiographic examination of the back, to assess the spaces between the dorsal spinous processes of the vertebrae.
A study by O’Sullivan and colleagues aimed to ascertain if the thoracic vertebral interspinous space distances were increased by using facilitated thoracic flexion to alter the posture in horses diagnosed with IDSP.
Carried out at the Veterinary Teaching Hospital of the University of Helsinki, seven horses, (four geldings and three mares) took part in the study. They were presented to the hospital for investigation of back pain or had a previous diagnosis of IDSP (with at least one interspinous space <4mm). Horses with previous surgical treatment of thoracic IDSP were excluded.
The researchers compared the radiographic appearance of two sets of radiographs of each horse.
They explain: “All horses were made to stand in a square position, the head was held by the handler and the mouth was kept level with the point of the horse’s shoulder. This position was maintained throughout the initial and second set of radiographs.”
The first radiographs were taken in the horses’ spontaneous posture. For the second set, an investigator vigorously scratched along the sternum to produce a lift of the thoracic cage and reduce the lordotic posture of the thoracic spine. At the point of greatest postural change, the radiographer was instructed to take the image.
The digital images were anonymised by one investigator. A second investigator measured the interspinous space and was therefore blinded to the horse and owner identification, as well as the posture of the horse (i.e., either spontaneous or thoracic flexion) when the images were taken.
The researchers found that stimulating the horse to flex the spine increased every thoracic interspinous space (IS) distance in horses with IDSP. Furthermore, the changes in IS distances were large enough to decrease IDSP by 1–3 grades.
“The largest difference was at the mid-thoracic spine (T7-T13), with a 2.1–3.1 mm change.” They add: “Specifically, the greatest median distance change was between T7-T8 and T12-T13 (3.1 mm and 3.0 mm, respectively).”
They suggest that including such a dynamic and functional evaluation in diagnostic examinations may aid IDSP decision making.
“The results of this small study demonstrated that the median distance between dorsal spinous processes of the thoracic spine increased following manual facilitation of thoracic flexion and resulted in a reduced thoracic spinal lordosis. The results support the need for a more dynamic and functional evaluation prior to a diagnosis of IDSP, particularly when radiographic grading based on this interspinous distance may result in invasive intervention.”
For more details, see:
The effect of manually facilitated flexion of the thoracic spine on the interspinous space among horses with impinging dorsal spinous processes of the thoracic vertebrae.
S. O’Sullivan, C.M. McGowan, J. Junnila, H.K. Hyytiäinen,
The Veterinary Journal, 2022, Vol 289,105909.
https://doi.org/10.1016/j.tvjl.2022.105909
(Open access article published under a Creative Commons licence)
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