Stubbs N C, Riggs C M, Hodges P W, Jeffcott L B, Hodgson D R, Clayton H M, McGowan C M
Mary Anne McPhail Equine Performance Center, Large Animal Clinical Sciences, College of Veterinary medicine, Michigan State University, East Lansing, USA.
Equine Vet J Suppl. 2010 Nov(38):654-61. doi: 10.1111/j.2042-3306.2010.00258.x.
The multifidus muscle plays a key role in spinal stabilisation. Multifidus atrophy ipsilateral to the side of osseous pathology has been demonstrated in man and pigs but has not been investigated in horses.
To measure cross-sectional area (CSA) left/ right symmetry of equine multifidus ultrasonographically and relate asymmetry of multifidus with osseous spinal pathology in Thoroughbred racehorses. We hypothesised that ipsilateral multifidus CSA would be reduced when osseous pathological changes are present leading to left/right asymmetry in CSA.
Twenty-two racehorses presented for euthanasia for primary reasons other than back pain were examined clinically. Ultrasonographic images on left/right sides were acquired at 5 thoracolumbosacral levels and CSA's of multifidus or sacrocaudalis dorsalis calculated. At necropsy, osseous pathological of the TL spine and pelvis were recorded by spinal level, anatomical site, and graded (0-3) according to severity. The mean typical measurement error in estimating multifidus/sacrocaudalis dorsalis CSA was used to determine the significance of left/right asymmetries. An association between multifidus CSA asymmetry and asymmetrical grading of pathological lesions was sought using Pearson's χ(2) analysis.
All horses had significant left/right asymmetry of multifidus CSA at >2 spinal levels, most commonly at L5 with total of 74 sites affected (22 horses). Seventeen horses had severe (grade 3) pathology, 16 of these had ipsilateral atrophy of multifidus/sacrocaudalis dorsalis. There was a significant association between pathological grade and degree of multifidus asymmetry.
Severe osseous pathological changes were common in this population of Thoroughbred racehorses and were associated with measurable left/right asymmetry in multifidus at or close to the level of pathology.
Ultrasonography of multifidus may be a useful clinical tool in diagnosis of back problems in horses.
多裂肌在脊柱稳定中起关键作用。在人和猪身上已证实,多裂肌萎缩与骨病理同侧,但尚未在马身上进行研究。
通过超声测量马多裂肌的横截面积(CSA)左右对称性,并将多裂肌的不对称性与纯种赛马的脊柱骨病理联系起来。我们假设,当存在骨病理变化导致CSA左右不对称时,同侧多裂肌CSA会减小。
对22匹因非背痛等主要原因而安乐死的赛马进行临床检查。在胸腰荐部5个水平获取左右两侧的超声图像,并计算多裂肌或背侧荐尾肌的CSA。尸检时,记录胸腰段脊柱和骨盆的骨病理情况,按脊柱水平、解剖部位进行记录,并根据严重程度分级(0 - 3级)。使用估计多裂肌/背侧荐尾肌CSA时的平均典型测量误差来确定左右不对称的显著性。使用Pearson卡方分析寻找多裂肌CSA不对称与病理病变不对称分级之间的关联。
所有马匹在超过2个脊柱水平存在多裂肌CSA的显著左右不对称,最常见于L5,共有74个部位受影响(22匹马)。17匹马有严重(3级)病理改变,其中16匹有多裂肌/背侧荐尾肌同侧萎缩。病理分级与多裂肌不对称程度之间存在显著关联。
在这群纯种赛马中,严重的骨病理改变很常见,并且与病理水平或接近病理水平处多裂肌的可测量左右不对称有关。
多裂肌超声检查可能是诊断马背部问题的一种有用的临床工具。