Diseases of the cervical spine

Question 1

How many cervical vertebrae does horse have

Answer 1

7

Question 2

Where do we see most disease in the neck

Answer 2

in C6 and C7- degenerative disease

Question 3

How many articulations are there between adjacent vertebrae

Answer 3

2
Articular process joint and intervertebral joint

Question 4

Where do spinal nerves leave the vertebrae

Answer 4

intervertebral foramen

Question 5

List the 3 main manifestations of cervical disease

Answer 5

1. Neck pain/dysfunction
2. Forelimb lameness
3. Ataxia – cervical stenotic myelopathy

Question 6

List 4 ways that neck pain can be seen in horse

Answer 6

Reduced range of motion during baited stretches
Changes in position or posture
Palpation findings – enlarged joints
Reduction in muscle mass

Question 7

What are the 2 ways that cervical pain can cause forlimb lameness

Answer 7

1. consequence of muscle dysfunction
2. Radiculopathy- neuropathic pain

Question 8

what forelimbe lameness is generally seen with cervical pain

Answer 8

Classically an outside limb lameness, often describes as “hopping” type.

Question 9

how does Radiculopathy (neuropathic pain) occur

Answer 9

Compression of a spinal nerve root in the caudal cervical region (feeding brachial plexus)
Enlarged APJs are the culprit

Question 10

What is the best advanced imaging modalities for looking at horse neck

Answer 10

CT is the only 3D imaging modality that can accommodate the equine neck

Question 11

How do we manage cervical joint disease

Answer 11

Intra-articular medication with corticosteroids- ultrasound guided
Cannot reverse bone remodeling but can alleviate pain and reduce associated soft tissue inflammation

Question 12

what is the prognosis for neck disease

Answer 12

Prognosis is variable and often unpredictable

In general:
Neck Pain only > Radiculopathy > Spinal Ataxia