Pease Anthony, Behan Ashley, Bohart George
College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA.
Vet Radiol Ultrasound. 2012 Jan-Feb;53(1):92-5. doi: 10.1111/j.1740-8261.2011.01855.x.
Horses with intracranial lesions and severe ataxia are not good anesthesia candidates; however, only one method to obtain cerebrospinal fluid (CSF) from the cervical region in a standing horse has been reported. This method is not performed routinely due to the difficulty for sample acquisition. Our hypothesis is that standing cervical centesis can be performed in horses without complication. Ultrasound-guided centesis of the CSF between C1 and C2 in 11 clinically normal horses and two horses with neurologic signs were performed. Horses were sedated and ultrasound was used to identify the subarachnoid space and spinal cord between C1 and C2. With ultrasound guidance, a needle was introduced into the dorsal aspect of the subarachnoid space using a lateral approach. Ten milliliters of CSF was obtained and analyzed. Two normal horses in this study had moderate red blood cell contamination in the CSF (940 and 612 RBC/microl). One horse had 11 RBC/microl and the remaining horses had < 4 RBC/microl. The total procedure time was approximately 2 min. No reaction was observed and no complications were detected up to 48 h after the procedure. Ultrasound-guided centesis between C1 and C2 is a rapid procedure that causes minimal to no reaction in standing, sedated horses used in this study. The use of ultrasound to guide a standing C1-2 centesis of the subarachnoid space provides an additional route to obtain CSF for analysis in the equine patient.
患有颅内病变和严重共济失调的马匹不是理想的麻醉对象；然而，据报道，在站立的马匹中，从颈部获取脑脊液（CSF）的方法只有一种。由于样本采集困难，这种方法并未常规实施。我们的假设是，站立位颈椎穿刺术可在马匹中进行且无并发症。对11匹临床正常的马匹和2匹有神经症状的马匹进行了超声引导下的C1和C2之间脑脊液穿刺。对马匹进行镇静，然后使用超声识别C1和C2之间的蛛网膜下腔和脊髓。在超声引导下，采用外侧入路将针插入蛛网膜下腔的背侧。获取10毫升脑脊液并进行分析。本研究中有2匹正常马匹的脑脊液中存在中度红细胞污染（每微升940个和612个红细胞）。1匹马每微升有11个红细胞，其余马匹每微升红细胞数<4个。整个操作过程约2分钟。术后48小时内未观察到反应，也未检测到并发症。超声引导下C1和C2之间的穿刺是一种快速的操作，在本研究中使用的站立、镇静马匹中引起的反应极小或无反应。使用超声引导站立位C1 - 2蛛网膜下腔穿刺为马属动物患者获取脑脊液进行分析提供了一条额外途径。
