Experimental comparison of caudal wedge ostectomy to cranial wedge ostectomy for surgical treatment of overriding/impinging spinous processes in horses.


Connaughton, Maurice Thomas ORCID: 0009-0001-5060-0691, MacDonald, Eilidh Janet ORCID: 0009-0009-2576-0309, Ireland, Jo L ORCID: 0000-0002-5737-1502, Rocchigiani, Guido ORCID: 0000-0002-3742-7636 and Stack, John David ORCID: 0000-0003-0064-7923 (2025) Experimental comparison of caudal wedge ostectomy to cranial wedge ostectomy for surgical treatment of overriding/impinging spinous processes in horses. Equine veterinary journal, 57 (5). pp. 1395-1404. ISSN 0425-1644, 2042-3306

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Abstract

<h4>Background</h4>Caudal wedge ostectomy has not been investigated for overriding or impinging spinous processes (SPs).<h4>Objectives</h4>To establish the feasibility of caudal wedge ostectomy and compare measures of surgical trauma and error between hypothetical caudal and cranial wedge ostectomies on SPs of different inclinations.<h4>Study design</h4>Experimental, method comparison study.<h4>Methods</h4>Computed tomography and caudal wedge ostectomy surgery were performed on four cadavers. Observations, technical difficulties, and surgical errors were recorded. Radiographs from 67 horses with overriding/impinging SPs were reviewed. Hypothetical 'ideal' caudal and cranial wedge ostectomies, and 'error' ostectomies 12° from ideal, were drawn at sites of impingement. Ostectomy area/SP width, ostectomy length/SP width, absolute difference of exit angles (angle ostectomy exits the SP) from 90°, and number of error ostectomies failing to exit the SP (never-ending-cuts [NEC]) were calculated. Continuous variables were compared between techniques in caudally and cranially inclined SP groups using Wilcoxon signed-rank tests. Proportions of NEC were compared using McNemar's tests.<h4>Results</h4>No surgical errors were recorded with caudal wedge ostectomy. Median ostectomy area/SP width was lower for caudal versus cranial wedge ostectomy in caudally (14.32, interquartile-range [IQR] 9.72-20.34 vs. 25.57, IQR 17.74-33.06; p < 0.001) and cranially inclined SP groups (11.78, IQR 7.98-17.19 vs. 19.62, IQR 13.65-28.68; p < 0.001). Median difference in exit angles from 90° was smaller for caudal versus cranial wedge ostectomies in caudally (34.77°, IQR 26.85°-45.91° vs. 67.54°, IQR 58.13°-74.55°; p < 0.001) and cranially inclined SP groups (49.14°, IQR 35.61°-59.33° vs. 62.84°, IQR 55.34°-70.61°; p < 0.001). The proportion of NEC was lower for caudal versus cranial wedge ostectomy in caudally (37.6%, 95% confidence interval [CI] 29.4%-45.8%; n = 50/133 vs. 96.2%, 95% CI 93.0%-99.5%; n = 128/133; p < 0.001), but not in cranially inclined SP groups (76.8%, 95% CI 70.9%-82.7%; n = 152/198 vs. 84.3%, 95% CI 79.3%-89.4%, n = 167/198; p = 0.06).<h4>Main limitations</h4>Potential bias drawing 'ideal' ostectomy.<h4>Conclusions</h4>Experimentally, caudal wedge ostectomy was feasible, removed less bone, and resulted in fewer NEC in caudally inclined SPs. Further investigation of the technique is warranted.

Item Type: Article
Uncontrolled Keywords: Animals, Horses, Spinal Diseases, Horse Diseases, Cadaver, Tomography, X-Ray Computed, Osteotomy, Female, Male
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 28 Mar 2025 13:31
Last Modified: 09 Aug 2025 02:31
DOI: 10.1111/evj.14498
Open Access URL: https://doi.org/10.1111/evj.14498
Related Websites:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3191115
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