ISSN 2398-2977      

Cranial nuchal bursa bursoscopy

pequis

Synonym(s): bursitis septic non-septic endoscopic endoscope surgery surgical


Introduction

  • Surgical management of septic or non-septic cranial nuchal bursitis Nuchal bursa: bursitis allowing exploration of the bursa, endoscopically guided debridement, and copious lavage.

Uses

Advantages

  • Minimally invasive approach allows smaller surgical incisions, less hospitalization time and costs, better visualization of the entire bursa, and better long-term cosmetic results.
  • Allows thorough exploration of bursa and provides additional diagnostic information.
  • Facilitates debridement and extensive lavage of the bursa.

Disadvantages

  • Requires specialist equipment and surgical skills.
  • Increased costs in acquiring and maintaining specialist equipment.
  • Potential damage to adjacent structures.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • The only series of cases published so far looked at 30 horses with follow-up for 12 months. Fourteen horses were treated medically of which four (33%) had recurrence of signs and needed surgical treatment. Only one of the horses treated surgically after failed medical treatment returned to soundness. Approximately 68% of all medical cases returned to previous exercise levels.
  • Sixteen horses had solely surgical treatment by nuchal bursoscopy with 29% having recurrence of clinical signs and 79% eventually returning to previous exercise levels. Several horses had more than one surgery.
  • It has been suggested that cases where there is significant synovial proliferation and echogenic tissue within the bursa on ultrasound examination should undergo surgical debridement and lavage as soon as possible, bypassing intrabursal medical therapy. Such horses do not appear to respond well to medical treatment, are more likely to develop complications and return of clinical signs, and thus have a worse prognosis for successful return to their previous level of exercise.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Bergren A L et al (2018) Diagnosis, treatment and outcome of cranial nuchal bursitis in 30 horses. Equine Vet J 50 (4), 465-469 PubMed.
  • García-López J M (2018) Neck, Back, and Pelvic Pain in Sport Horses. Vet Clin Equine 34 (2), 235-251 PubMed.
  • Abuja G A et al (2014) The cranial nuchal bursa: anatomy, ultrasonography, magnetic resonance imaging and endoscopic approach. Equine Vet J 46 (6), 745-750 PubMed.
  • García-López J M et al (2010) Diagnosis and management of cranial and caudal nuchal bursitis in four horses. J Am Vet Med Assoc 237 (7), 823-829 PubMed.

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