Authors: Touzot-Jourde Gwenola, Geffroy Olivier, Tallaj Amélie, Gauthier Olivier, Denoix Jean-Marie
Journal: Frontiers in veterinary science
Summary
# Editorial Summary Selective perineural injection offers a potentially valuable tool for targeted analgesia in horses, yet the anatomical feasibility of blocking the cervical nerve roots has not been systematically evaluated until now. Touzot-Jourde and colleagues conducted a cadaver study on four horses, performing ten perineural injections (five each of C7 and C8 ramus ventralis) under ultrasound guidance and subsequently dissecting the cervical spine to assess dye distribution patterns. All injections successfully stained the target nerves; eight achieved uniform transversal staining with longitudinal spread exceeding 2 cm, whilst two showed incomplete patterns with coverage under 2 cm, and notably, five injections resulted in epidural space diffusion—a finding more common when needle placement occurred within 1 cm distal to the articular processes. Injection volume did not significantly influence staining extent, suggesting precise needle positioning matters more than fluid quantity in achieving selective nerve blockade. For equine practitioners, these findings indicate that ultrasound-guided C7 and C8 perineural injection is technically achievable and could support multimodal pain management strategies, particularly for forelimb and thoracic conditions; however, clinical application remains premature until controlled trials establish safe drug protocols, optimal doses, and functional efficacy in living horses.
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Practical Takeaways
- •Ultrasound-guided C7/C8 perineural injection is technically feasible and reproducible in cadavers, offering potential for targeted cervical analgesia in clinical cases—but clinical efficacy and safety data are still needed before routine adoption
- •Injection site location matters: positioning >1 cm distal to articular processes may reduce unwanted epidural spread, though this requires validation in live horses
- •This technique could expand multimodal pain management options for cervical conditions, but practitioners should await clinical trials defining optimal drug selection, dosing, and volumes before applying it
Key Findings
- •Ultrasound-guided perineural injection of C7 and C8 ventral rami was successfully visualized and performed in all 4 cadavers with selective nerve staining achieved in all 10 injection attempts
- •Eight of ten injections resulted in uniform transversal nerve staining with longitudinal coverage >2 cm, demonstrating consistent dye diffusion patterns
- •Five injections showed epidural space diffusion, which was more likely when injection site was within 1 cm distal to articular processes
- •Injection volume had no appreciable effect on extent of nerve staining, suggesting technique precision rather than volume determines distribution