Percutaneous full endoscopic foraminotomy for treatment of cervical spinal nerve compression in horses using a uniportal approach: Feasibility study.
Authors: Swagemakers Jan-Hein, Van Daele Peter, Mageed Mahmoud
Journal: Equine veterinary journal
Summary
# Percutaneous Endoscopic Cervical Foraminotomy in Horses: A Minimally Invasive Approach to Nerve Compression Cervical spinal nerve compression resulting from articular process osteoarthropathy is a recognised but challenging cause of caudal cervical lameness in horses, and conventional surgical decompression carries significant morbidity. Swagemakers and colleagues have demonstrated the technical feasibility of percutaneous endoscopic foraminotomy (PEF)—a minimally invasive technique using a 6.9 mm endoscope under fluoroscopic guidance to widen the intervertebral foramen by selective removal of compressive bone—through both cadaveric validation (n=3) and two clinical cases presenting with forelimb lameness. Operating time in clinical cases averaged 98±24 minutes, with uncomplicated post-operative recovery and complete resolution of clinical signs at 12-month follow-up in both cases. Whilst these preliminary results are encouraging for practitioners dealing with cervical nerve compression, the authors appropriately acknowledge that the small clinical cohort, absence of detailed tissue assessment in cadavers, and lack of longer-term comparative data preclude firm recommendations for routine clinical adoption at present. This work represents an important proof-of-concept that warrants larger prospective studies to establish safety parameters, anatomical limits, and patient selection criteria before PEF can be integrated into standard protocols for managing cervical foraminal stenosis.
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Practical Takeaways
- •This minimally invasive technique offers a potential alternative to traditional open surgery for cervical nerve compression in lame horses, with promising short-term outcomes and faster recovery
- •Currently this procedure should be considered experimental; more clinical cases and formal comparisons with conventional approaches are needed before widespread adoption
- •Horses with caudal cervical lameness refractory to conservative management may be candidates for referral to centres offering this technique, pending further research validation
Key Findings
- •Percutaneous endoscopic cervical foraminotomy is technically feasible in horses using a uniportal approach with 6.9mm endoscopic instruments
- •Mean surgical time in clinical cases was 98±24 minutes with smooth post-operative recovery in all cases
- •Clinical signs resolved completely at 12-month follow-up in both clinical cases with no recurrence
- •Procedure enables bone removal and nerve decompression via minimal invasive technique under fluoroscopic guidance