Epiduroscopy of the lumbosacral vertebral canal in the horse: Technique and endoscopic anatomy.
Authors: Prange T, Shrauner B D, Blikslager A T
Journal: Equine veterinary journal
Summary
# Epiduroscopy of the Lumbosacral Vertebral Canal in Horses Back pain remains a diagnostic challenge in equine practice, frequently manifesting as gait abnormalities or performance decline without clear imaging findings on conventional modalities. Prange and colleagues developed and refined an epiduroscopic technique for visualising the lumbosacral epidural space in standing horses, documenting the normal endoscopic anatomy and establishing technical parameters for safe instrument passage and visualisation. The procedure proved feasible in live horses, enabling direct visualisation of structures previously accessible only through advanced imaging or post-mortem examination, including nerve root sheaths, epidural vasculature, and localised pathology within the vertebral canal. This technique addresses a significant gap in diagnostic capability for cases where radiography, ultrasound, or MRI fail to explain clinical signs, potentially allowing practitioners to identify adhesions, fibrosis, or subtle compressive lesions responsible for performance problems. For veterinarians managing cases of poorly characterised back pain or persistent lameness with neurological components, epiduroscopy offers a minimally invasive method to directly visualise the lumbosacral region and potentially guide targeted therapeutic intervention, though the procedure requires specific training and specialised equipment currently available primarily in referral settings.
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Practical Takeaways
- •Epiduroscopy offers a potential advanced diagnostic tool for horses with persistent back pain that has not been clarified by standard imaging (radiography, ultrasound, MRI)
- •This technique may enable direct visualization and potentially therapeutic intervention in the epidural space, addressing cases where imaging has been inconclusive
- •Consider referral for epiduroscopy when dealing with performance horses with back pain where conventional diagnostics have not identified a clear cause
Key Findings
- •Epiduroscopy is a diagnostic and therapeutic technique successfully used in human patients with lower back pain that can be adapted for equine lumbosacral epidural space examination
- •Cervical epidural endoscopy has previously been reported in anaesthetised horses, suggesting feasibility of epidural endoscopy in equine patients
- •Conventional imaging modalities are frequently insufficient to isolate underlying pathology in equine back pain cases