Incidence of Complications Following Diagnostic and Therapeutic SI Injections in Horses

Practitioners describe their experiences with complications following diagnostic, therapeutic, and combined SI joint region injections in horses.
In this cross-sectional questionnaire, clinicians reported that horses experienced complications more commonly following diagnostic SI injections than therapeutic or combined injections. | iStock

A cross-sectional questionnaire survey aimed to describe complications following diagnostic, therapeutic, and combined sacroiliac (SI) joint region injections in horses. It also collected details on how a large number of clinicians routinely perform these procedures.

Clinicians (members of American and European specialist colleges and veterinarians known to the authors) who had performed one or more SI joint region injections were invited to complete an online questionnaire. Data collected included the clinicians’ experience in diagnostic, therapeutic, and combined SI joint region injections; details of the injection technique; volume and substance used; and the type of complications seen following SI joint region anaesthesia, medications, and combined injections, respectively. Descriptive data analysis was performed. The association between any complications seen and the clinicians’ experience, technique, volume, and substance used were assessed using binary logistic regression.

Incidence of Complication Following SI Injections in Horses

Of the 212 respondents, 110 had performed diagnostic, 187 therapeutic, and 49 combined injections. Clinicians experienced significantly more complications after diagnostic (53/110) than after therapeutic (33/187) or combined (6/49) injections (p<0.01). Most clinicians used a cranial contralateral blind approach for diagnostic injections (74/110). The most common complications were hindlimb weakness/ataxia after all types of injections (diagnostic: 44/110, 40%, 95% CI 30.8-49.8; therapeutic: 15/187, 8.0%, 95% CI 4.6-12.9; combined: 2/49, 4.1%, 95% CI 0.5-14.0). Death or horses requiring euthanasia were reported (after therapeutic injections: 5/187; diagnostic injections: 1/110).

Bottom Line

Complications were experienced more commonly following diagnostic injections than after therapeutic or combined SI joint region injections, but the types and distribution of complications were similar. 

https://beva.onlinelibrary.wiley.com/doi/10.1111/evj.13929

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