Assessment of the Utility of Using Intra‐ and Intervertebral Minimum Sagittal Diameter Ratios in the Diagnosis of Cervical Vertebral Malformation in Horses

Hahn, Caroline; Handel, Ian; Green, Sherril L.; Bronsvoort, Barend M. deC.; Mayhew, I. G.

doi:10.1111/j.1740-8261.2007.00308.x

Cited by 90 publications

(126 citation statements)

References 8 publications

(9 reference statements)

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“…The minimum intervertebral and intravertebral diameter ratios of C3/C4 to C6/C7, resp. C3 to C7, were greater than 0.48 (Hahn et al 2008). The abnormal lower head posture with pain in the caudal neck area on the left hand side and the gait abnormality (ataxia in the hind-limbs) did not improve within six months after discharge.…”

Section: Casementioning

confidence: 80%

Cervical Vertebral Compressive Myelopathy associated with articular processes osteoarthritis in three horses

Adam¹,

Arnold²,

Ehlers³

et al. 2016

PHK

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Summary: Cervical vertebral compressive myelopathy is a neuropathy resulting in ataxia in horses. Three horses with different signs of incoordination were presented for further evaluation. A five-year-old gelding with a long history of abnormal head and neck carriage, a six-yearold gelding with a history of previous neurological episodes and a two-day history of acute episodes of walking difficulties, and a sixteenyear-old mare with a one-month history of left fore-limb ataxia were diagnosed with osteoarthritis of the facet joints of the caudal cervical vertebrae. Lateral radiographs of caudal cervical vertebrae confirmed osteoarthritis of the articular processes. Radiographic changes, such as enlargement of the articular process joint, periarticular new bone and reduction or narrowing of the intervertebral foramen, were observed in all three cases. Cervical vertebral compressive myelopathy should be considered in ataxic horses with normal laboratory findings.

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Section: Casementioning

confidence: 80%

Cervical Vertebral Compressive Myelopathy associated with articular processes osteoarthritis in three horses

Adam¹,

Arnold²,

Ehlers³

et al. 2016

PHK

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“…Intravertebral sagittal ratios were measured for the 4th cervical vertebrae through the 7th on all radiographs available for review. Sagittal diameter ratios of less than 0.5 were considered abnormal in this study for C4‐C6, rather than the cut‐off of 0.485 reported in the study by Hahn et al, to ensure that these cases were more closely inspected for neurologic examination abnormalities and other radiographic findings . There were no significant differences between the mean intravertebral sagittal ratios at any location between groups (Table ).…”

Section: Resultsmentioning

confidence: 95%

“…Diagnosis of CVM is typically made based on neurologic exam findings and examination of plain lateral cervical radiographs or myelography in addition to ruling out other possible causes of inflammatory disease, such as equine protozoal myeloencephalitis (EPM), viral encephalidities, lameness caused by musculoskeletal injury, or equine degenerative myelopathy . Compressive lesions resulting in CVM are accurately identified using radiographic sagittal diameter ratios of ≤0.485; however, myelographic evidence of ≥50% obstruction of the dorsal contrast column or >20% reduction in the cord diameter, gross and histopatholgical postmortem examination findings of cord compression, or both have been considered the gold standard for lesion localization in cases where the site of cord compression cannot be identified based on plain radiographs …”

mentioning

confidence: 99%

Prognosis for Racing with Conservative Management of Cervical Vertebral Malformation in Thoroughbreds: 103 Cases (2002–2010)

Hoffman

Clark

2013

Veterinary Internal Medicne

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Background: Cervical vertebral malformation (CVM) is seen in young, rapidly growing horses, and is commonly associated with a poor prognosis for racing.Hypothesis/Objective: To examine the records of a population of Thoroughbreds with a presumptive diagnosis of CVM and to determine which radiographic findings and neurologic exam findings have an effect on these horses achieving athletic function when managed conservatively.Animals: One hundred and three thoroughbreds presumptively diagnosed with CVM and treated conservatively between 2002 and 2010.Methods: Racing records were reviewed in this retrospective study to determine which horses raced after treatment. Horses were separated into groups based on whether or not they raced. Medical records were reviewed, and results of neurologic examination, radiographic and laboratory findings, treatments, and outcome were assessed and compared between groups.Results: Sixteen horses were excluded because of insufficient information. Of the remaining horses, thirty-three were euthanized after diagnosis, while the remaining seventy were discharged for treatment. Twenty-one of 70 horses treated medically (30%) went on to race. Horses that went on to race had a significantly lower neurologic grade (P = .0002), with a median of 1.0 in the thoracic limbs and 2.0 in the pelvic limbs. Euthanized horses and nonstarters were more likely to have kyphosis (P = .041) or cranial stenosis (P = .041) on standing lateral cervical radiographs.Conclusions and Clinical Importance: Some horses can race after the diagnosis of CVM. Neurologic examination and radiographic findings can be helpful in predicting racing prognosis.

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“…All radiographs were anonymized and evaluated for any abnormalities by a blinded, board‐certified radiologist. Additionally, the intra‐ and intervertebral sagittal diameter ratios of the vertebral canal were measured at each cervical vertebra as described . For both ratios, a cutoff value of 0.485 was used to distinguish between a normal and a narrowed vertebral canal indicative for spinal cord compression …”

Section: Methodsmentioning

confidence: 99%

Accuracy of transcranial magnetic stimulation and a Bayesian latent class model for diagnosis of spinal cord dysfunction in horses

Rijckaert

Raes

Buczinski

et al. 2020

Veterinary Internal Medicne

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Background Spinal cord dysfunction/compression and ataxia are common in horses. Presumptive diagnosis is most commonly based on neurological examination and cervical radiography, but the interest into the diagnostic value of transcranial magnetic stimulation (TMS) with recording of magnetic motor evoked potentials has increased. The problem for the evaluation of diagnostic tests for spinal cord dysfunction is the absence of a gold standard in the living animal. Objectives To compare diagnostic accuracy of TMS, cervical radiography, and neurological examination. Animals One hundred seventy‐four horses admitted at the clinic for neurological examination. Methods Retrospective comparison of neurological examination, cervical radiography, and different TMS criteria, using Bayesian latent class modeling to account for the absence of a gold standard. Results The Bayesian estimate of the prevalence (95% CI) of spinal cord dysfunction was 58.1 (48.3%‐68.3%). Sensitivity and specificity of neurological examination were 97.6 (91.4%‐99.9%) and 74.7 (61.0%‐96.3%), for radiography they were 43.0 (32.3%‐54.6%) and 77.3 (67.1%‐86.1%), respectively. Transcranial magnetic stimulation reached a sensitivity and specificity of 87.5 (68.2%‐99.2%) and 97.4 (90.4%‐99.9%). For TMS, the highest accuracy was obtained using the minimum latency time for the pelvic limbs (Youden's index = 0.85). In all evaluated models, cervical radiography performed poorest. Clinical Relevance Transcranial magnetic stimulation‐magnetic motor evoked potential (TMS‐MMEP) was the best test to diagnose spinal cord disease, the neurological examination was the second best, but the accuracy of cervical radiography was low. Selecting animals based on neurological examination (highest sensitivity) and confirming disease by TMS‐MMEP (highest specificity) would currently be the optimal diagnostic strategy.

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Assessment of the Utility of Using Intra‐ and Intervertebral Minimum Sagittal Diameter Ratios in the Diagnosis of Cervical Vertebral Malformation in Horses

Cited by 90 publications

References 8 publications

Cervical Vertebral Compressive Myelopathy associated with articular processes osteoarthritis in three horses

Cervical Vertebral Compressive Myelopathy associated with articular processes osteoarthritis in three horses

Prognosis for Racing with Conservative Management of Cervical Vertebral Malformation in Thoroughbreds: 103 Cases (2002–2010)

Accuracy of transcranial magnetic stimulation and a Bayesian latent class model for diagnosis of spinal cord dysfunction in horses

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