Objectives

To develop an ultrasound-guided cervical perineural injection technique for horses and to evaluate and compare the distribution of contrast agent among perineural, intra-articular and periarticular injections.

Study design

Prospective, experimental cadaveric study.

Animals

A total of 14 equine cadaveric necks.

Methods

Bilateral ultrasound-guided perineural injection technique for the caudal cervical spinal nerve roots (CSNRs 5–7) was developed. Paramagnetic or iodinated contrast was injected and the distribution of contrast was evaluated using magnetic resonance (MR) or computed tomography (CT) imaging, respectively. The presence of contrast in the CSNR region was determined by an observer unaware of the technique used for each injection performed. The ability of the perineural injection technique to distribute contrast agent to the CSNR region was compared with intra-articular and periarticular injection techniques.

Results

Perineural injection delivered contrast agent to the CSNR region 100% of the time and was significantly different when compared with intra-articular injection (p = 0.008). There was no difference in ability to deliver contrast agent to the CSNR region between the perineural and periarticular injection techniques or between the intra-articular and periarticular injection techniques.

Conclusion and clinical relevance

The ultrasound-guided perineural injection technique developed in this study accurately delivered contrast agent to the CSNR region in equine cadavers. This technique could potentially be used for the diagnosis and treatment of cervical pain in horses, particularly in cases where intra-articular cervical articular process joint injections have not been beneficial. Further studies are necessary to assess the effectiveness of the ultrasound-guided perineural injection technique in live horses.

中文翻译：

---

超声引导下马尸体颈椎尾神经根周围注射的研究

目标

开发一种用于马的超声引导颈椎周围注射技术，并评估和比较造影剂在神经周围、关节内和关节周围注射中的分布。

学习规划

前瞻性、实验性尸体研究。

动物

共有14个马尸体脖子。

方法

开发了用于颈椎尾神经根的双侧超声引导的神经周围注射技术（CSNRs 5-7）。注射顺磁或碘对比剂，并分别使用磁共振 (MR) 或计算机断层扫描 (CT) 成像评估对比剂的分布。CSNR 区域中对比度的存在是由不知道每次注射所用技术的观察者确定的。将神经周围注射技术将造影剂分配到 CSNR 区域的能力与关节内和关节周围注射技术进行了比较。

结果

神经周围注射将造影剂输送到 CSNR 区域的时间为 100%，与关节内注射相比有显着差异 ( p  = 0.008)。神经周围和关节周围注射技术之间或关节内和关节周围注射技术之间将造影剂输送到 CSNR 区域的能力没有差异。

结论和临床相关性

本研究中开发的超声引导的神经周围注射技术准确地将造影剂输送到马尸体的 CSNR 区域。这种技术有可能用于诊断和治疗马的颈椎疼痛，特别是在关节内颈椎关节突关节注射无效的情况下。需要进一步的研究来评估超声引导下神经周围注射技术在活马中的有效性。