Arthroscopic anatomy of the equine cervical articular process joints

Summary Reason for performing study: Although arthropathy of the cervical articular process joints is common, descriptions of the arthroscopic technique of the cervical articular process joint (APJs) have not been reported previously. Objectives: To develop an arthroscopic approach to the APJs and to describe the arthroscopic anatomy of the APJs. Study design: Descriptive cadaver study and clinical case report. Methods: The regional anatomy was reviewed and the technique developed on fresh cadaver necks. A series of cadaveric APJs arthroscopies from C2-C3 to C6-C7 were performed t evaluate the procedure, which was then used 24 in 3 clinical patients. A description of the procedure and the potential complications encountered were recorded. Results: The equine APJs consist of cranioventral and caudodorsal recesses; a single entry pointat one of these recesses enables almost complete evaluation of cartilage surfaces and the synovial membrane and its villi. Successful entry into both APJ recesses was achieved in 22 cadaveric APJs and 5 APJs in the 3 clinical cases operated upon. An instrument portal was created to assess the feasibility of surgical arthroscopy. Complications were minor and dissection of the APJs following the arthroscopic exploration revealed that the cartilage and periarticular neurovascular structures were not damaged during the procedure. Conclusions: This study shows that arthroscopic examination of the APJs of equine cervical vertebra is feasible and can be performed in adult horses. Arthroscopy of the APJs may provide additional diagnostic information compared to conventional diagnostic techniques.