Axial Skeleton

Question 1

What is anatomy of the cervical spine?

Answer 1

• 7 vertebrae
• 3rd, 4th + 5th vertebra have no identifying features
• C1 = atlas = no body or articular processes, develop in 2 halves that ossify
• C2 = axis = 4 centres of ossification
• C6 shorter than C5, has a transverse process
• C7 shorter than C6, + small dorsal spinous process

Question 2

What are signs of neck pain?

Answer 2

• Stiffness, pain, locking
• Acute trauma
• Poor performance / problems performing specific manoeuvres
• Ataxia

Question 3

How would you examine the neck?

Answer 3

• Visualisation = natural position, lowered head / extended, position of limbs
• Palpation = symmetry / atrophy, pain, fasciculations / spasms
• Range of motion
• Neuro exam
• Dynamic exam
• Imaging

Question 4

What are common + rare conditions of the neck?

Answer 4

• Common =
  -Developmental = Cervical Vertebral Malformation
  -Degenerative = Osteoarthritis
  -Trauma = Fractures
• Rare =
  -Neoplasia
  -Congenital malformations
  -Infectious

Question 5

What is done with Cervical vertebral malformations?

Answer 5

• If marked changes = often identified as young horse 1-4yrs
• If mild = horses can manage for years - eventually causing OA, ataxia + pain in later life

Question 6

What are causes of Osteoarthritis / arthropathy? What can it lead to?

Answer 6

• Old age
• Cervical vertebral malformation
• previous trauma
• New bone formation can compress nerves = ataxia

Question 7

Tx of dorsal articular facet arthropathy?

Answer 7

• NSAIDs
• Intra-articular meds = corticosteroids, hyaluranon
• Physiotherapy
• Exercise
• Often Palliative

Question 8

How are cervical fractures treated?

Answer 8

• Conservative Tx only realistic chance
• Many not treatable

Question 9

How do you know what thoracolumbar vertebrae is which?

Answer 9

• T15 - standing upright - before pointed backwards after pointed forward
• 18 thoracic vertebrae

Question 10

How do you identify lumbar spine?

Answer 10

• Large dorsal processes

Question 11

Where is normal lumbosacral junction? Abnormal significance?

Answer 11

• Normal = Between L6 + S1
• Sometimes divergence between L5+L6 - can cause pain in jumping horses

Question 12

What are common condition of the equine thoracolumbar spine? CS?

Answer 12

• Traumatic / Degenerative
• CS = poor performance, behavioural changes, Stiffness, back spasm, bucking + rearing

Question 13

How would you check for thoracolumbar spine problems?

Answer 13

• Conformation + BCS - swayback / roachback
• Swelling / presence of white hairs
• Flexion of back - use blunt object
• Lunge + under saddle examination
• Imaging - radiography, US, Scintigraphy

Question 14

What are common conditions of the back?

Answer 14

• Fractures of the withers
• Saddle induced trauma
• Ligament damage - supraspinous
• Impingement of the dorsal spinous processes
• Dorsal articular facet arthropathy (spine arthritis)

Question 15

How would you treat fractures of the withers?

Answer 15

• Rest - 2-3mo box rest
• NSAIDs
• Fibrous union

Question 16

How would you treat saddle induced trauma?

Answer 16

• Rest / ice
• Ultrasound therapy
• Correct inciting cause

Question 17

How would you diagnose + treat ligament injury? (supraspinous)

Answer 17

• Dx = Ultrasound
• Tx = Acute = cold compress, NSAIDs + rest
  -Chronic = Physio, shockwave

Question 18

How would you diagnose IDSP?

Answer 18

• Imaging - radiograph
• Intra-lesional LA

Question 19

How would you treat IDSP?

Answer 19

• Medical / conservative =
  -NSAIDs
  -Shockwave therapy / physiotherapy
  -Removal of dorsal spinous processes
• Surgical = remove all / part of the affected DSP

Question 20

How would you diagnose + treat dorsal articular facet arthropathy?

Answer 20

• Dx = diagnostic analgesia + rule out other causes
• Tx = light plane of work +/-
  -NSAIDs, Oral supp, physio, US-guided injections