Editorial Type:
Musculoskeletal System

Clinical effects of computed tomography–guided lumbosacral facet joint, transforaminal epidural, and translaminar epidural injections of methylprednisolone acetate in healthy dogs

Annalisa P. Liotta Diagnostic Imaging Section, Department of Small Animals and Equidae, Fundamental and Applied Research for Animals and Health, Faculty of Veterinary Medicine, University of Liège, 4000 Sart-Tilman, Belgium

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 DVM
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Maud Girod Small Animal Internal Medicine Section, Department of Small Animals and Equidae, Fundamental and Applied Research for Animals and Health, Faculty of Veterinary Medicine, University of Liège, 4000 Sart-Tilman, Belgium

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Dominique Peeters Small Animal Internal Medicine Section, Department of Small Animals and Equidae, Fundamental and Applied Research for Animals and Health, Faculty of Veterinary Medicine, University of Liège, 4000 Sart-Tilman, Belgium

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Charlotte Sandersen Anesthesia Section, Department of Small Animals and Equidae, Fundamental and Applied Research for Animals and Health, Faculty of Veterinary Medicine, University of Liège, 4000 Sart-Tilman, Belgium

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Thierry Couvreur Department of Medical Imaging, Centre Hospitalier Chrétien, Liège, Belgium.

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Géraldine Bolen Diagnostic Imaging Section, Department of Small Animals and Equidae, Fundamental and Applied Research for Animals and Health, Faculty of Veterinary Medicine, University of Liège, 4000 Sart-Tilman, Belgium

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DOI:
https://doi.org/10.2460/ajvr.77.10.1132
Volume/Issue:
Volume 77: Issue 10
Online Publication Date:
01 Oct 2016
Restricted access
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Abstract

OBJECTIVE To determine clinical effects of CT-guided lumbosacral facet joint, transforaminal epidural, and translaminar epidural injections of methylprednisolone acetate in healthy dogs.

ANIMALS 15 healthy Beagles.

PROCEDURES Dogs were randomly assigned to 3 groups (5 dogs/group) and received a single CT-guided lumbosacral facet joint, transforaminal epidural, or translaminar epidural injection of methylprednisolone acetate (0.1 mg/kg). Contrast medium was injected prior to injection of methylprednisolone to verify needle placement. Neurologic examinations were performed 1, 3, 7, and 10 days after the injection. In dogs with neurologic abnormalities, a final neurologic examination was performed 24 days after the procedure.

RESULTS Methylprednisolone injections were successfully performed in 14 of the 15 dogs. In 1 dog, vascular puncture occurred, and the methylprednisolone injection was not performed. No major or minor complications were identified during or immediately after the procedure, other than mild transient hyperthermia. During follow-up neurologic examinations, no motor, sensory, or postural deficits were identified, other than mild alterations in the patellar, withdrawal, cranial tibial, and perineal reflexes in some dogs. Overall, altered reflexes were observed in 11 of the 14 dogs, during 27 of 65 neurologic examinations.

CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that CT-guided lumbosacral facet joint, transforaminal epidural, and translaminar epidural injections of methylprednisolone acetate were associated with few complications in healthy dogs. However, the number of dogs evaluated was small, and additional studies are needed to assess clinical efficacy and safety of these procedures.

Abstract

OBJECTIVE To determine clinical effects of CT-guided lumbosacral facet joint, transforaminal epidural, and translaminar epidural injections of methylprednisolone acetate in healthy dogs.

ANIMALS 15 healthy Beagles.

PROCEDURES Dogs were randomly assigned to 3 groups (5 dogs/group) and received a single CT-guided lumbosacral facet joint, transforaminal epidural, or translaminar epidural injection of methylprednisolone acetate (0.1 mg/kg). Contrast medium was injected prior to injection of methylprednisolone to verify needle placement. Neurologic examinations were performed 1, 3, 7, and 10 days after the injection. In dogs with neurologic abnormalities, a final neurologic examination was performed 24 days after the procedure.

RESULTS Methylprednisolone injections were successfully performed in 14 of the 15 dogs. In 1 dog, vascular puncture occurred, and the methylprednisolone injection was not performed. No major or minor complications were identified during or immediately after the procedure, other than mild transient hyperthermia. During follow-up neurologic examinations, no motor, sensory, or postural deficits were identified, other than mild alterations in the patellar, withdrawal, cranial tibial, and perineal reflexes in some dogs. Overall, altered reflexes were observed in 11 of the 14 dogs, during 27 of 65 neurologic examinations.

CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that CT-guided lumbosacral facet joint, transforaminal epidural, and translaminar epidural injections of methylprednisolone acetate were associated with few complications in healthy dogs. However, the number of dogs evaluated was small, and additional studies are needed to assess clinical efficacy and safety of these procedures.

Contributor Notes

Address correspondence to Dr. Liotta (apliotta@ulg.ac.be).
Cover American Journal of Veterinary Research
American Journal of Veterinary Research
Publication Date:
01 Oct 2016

  • 1. Meij BP, Bergknut N. Degenerative lumbosacral stenosis in dogs. Vet Clin North Am Small Anim Pract 2010;40: 983–1009.

  • 2. Dewey CW. Disorders of the cauda equina. In: Dewey CW, ed. A pratical guide to canine and feline neurology. 2nd ed. Ames, Iowa: Wiley-Blackwell, 2008; 389–404.

    • Search Google Scholar
    • Export Citation

  • 3. Sharp NJH, Wheeler SJ. Lumbosacral disease. In: Small animal spinal disorders: diagnosis and surgery. 2nd ed. Philadelphia: Elsevier Mosby, 2005; 181–185.

    • Search Google Scholar
    • Export Citation

  • 4. Saulnier-Troff F, De Busscher V, Motta L. Improved exposure of the lumbosacral foramen using iliac osteotomy: preliminary results in 5 dogs with severe foraminal stenosis, in Proceedings. 7th Eur Soc Vet Orthop Traumatol Cong 2014;363–364.

    • Search Google Scholar
    • Export Citation

  • 5. Watanabe AT, Nishimura E, Garris J. Image-guided epidural steroid injections. Tech Vasc Interv Radiol 2002;5: 186–193.

  • 6. Peh W. Image-guided facet joint injection. Biomed Imaging Interv J 2011; 7(1): Se4.

  • 7. Silbergleit R, Mehta BA, Sanders WP, et al. Imaging-guided injection techniques with fluoroscopy and CT for spinal pain management. Radiographics 2001;21: 927–939.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 8. Wilkinson I, Cohen SP. Epidural steroids for spinal pain and radiculopathy: a narrative, evidence-based review. Curr Opin Anaesthesiol 2013;26: 562–572.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 9. Johnson BA, Schellhas KP, Pollei SR. Epidurography and therapeutic epidural injections: technical considerations and experience with 5334 cases. AJNR Am J Neuroradiol 1999;20: 697–705.

    • Search Google Scholar
    • Export Citation

  • 10. Lima RM, Navarro LH, Carness JM, et al. Clinical and histological effects of the intrathecal administration of methylprednisolone in dogs. Pain Physician 2010;13: 493–501.

    • Search Google Scholar
    • Export Citation

  • 11. AbdeleRahman KT, Rakocevic G. Paraplegia following lumbosacral steroid epidural injections. J Clin Anesth 2014;26: 497–499.

  • 12. Bartynski WS, Grahovac SZ, Rothfus WE. Incorrect needle position during lumbar epidural steroid administration: inaccuracy of loss of air pressure resistance and requirement of fluoroscopy and epidurography during needle insertion. AJNR Am J Neuroradiol 2005;26: 502–505.

    • Search Google Scholar
    • Export Citation

  • 13. Hoeltje J, Bruening R, Kastler B, et al. Interventional pain management. In: Mahnken AH, Wilhem KE, Ricke J, eds. CT- and MR-guided interventions in radiology. Berlin: Springer, 2013; 363–419.

    • Search Google Scholar
    • Export Citation

  • 14. Janssens L, Beosier Y, Daems R. Lumbosacral degenerative stenosis in the dog. The results of epidural infiltration with methylprednisolone acetate: a retrospective study. Vet Comp Orthop Traumatol 2009;22: 486–491.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 15. Liotta A, Sandersen C, Couvreur T, et al. Technique, difficulty and accuracy of computed tomography-guided injections in dogs: a study of translaminar and transforaminal lumbosacral epidural and intraarticular lumbar facet joint injections. Vet Radiol Ultrasound 2016;57: 191–198.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 16. Kozlov N, Benzon HT, Malik K. Epidural steroid injections: update on efficacy, safety, and newer medications for injection. Minerva Anestesiol 2015;81: 901–909.

    • Search Google Scholar
    • Export Citation

  • 17. Liotta A, Busoni V, Carrozzo MV, et al. Feasibility of ultrasound-guided epidural access at the lumbo-sacral space in dogs. Vet Radiol Ultrasound 2014;56: 220–228.

    • Search Google Scholar
    • Export Citation

  • 18. Wagner AL. CT fluoroscopy-guided epidural injections: technique and results. AJNR Am J Neuroradiol 2004;25: 1821–1823.

  • 19. Weininger M, Mills JC, Rumboldt Z, et al. Accuracy of CT guidance of lumbar facet joint block. AJR Am J Roentgenol 2013;200: 673–676.

  • 20. Miller JB. Hyperthermia and fever of unknown origin. In: Ettinger SJ, Feldman EC, eds. Textbook of veterinary internal medicine: diseases of the dog and the cat. 7th ed. St Louis: Elsevier Sanders, 2010; 41–45.

    • Search Google Scholar
    • Export Citation

  • 21. Thomas WB, Dewey CW. Performing the neurological examination. In: Dewey CW, ed. A practical guide to canine and feline neurology. 2nd ed. Ames, Iowa: Wiley-Blackwell, 2008; 389–404.

    • Search Google Scholar
    • Export Citation

  • 22. Armon C, Argoff CE, Samuels J, et al. Assessment: use of epidural steroid injections to treat radicular lumbosacral pain: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2007;68: 723–729.

    • Crossref
    • Search Google Scholar
    • Export Citation

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