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Topic:Cervical

The cervical region in horses refers to the neck area, which is composed of seven cervical vertebrae. This anatomical section is pivotal for various functions including movement, support, and flexibility of the head and neck. It is also a site where numerous muscles, ligaments, and nerves converge, playing a significant role in the overall biomechanics of the horse. Disorders affecting the cervical region, such as cervical vertebral stenotic myelopathy (CVSM) and osteoarthritis, can impact a horse's performance and quality of life. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, pathology, and treatment of cervical conditions in horses, offering insights into diagnostic techniques and therapeutic approaches.
Evaluation of the diagnostic value of transcranial electrical stimulation (TES) to assess neuronal functional integrity in horses.
Frontiers in neuroscience    April 11, 2024   Volume 18 1342803 doi: 10.3389/fnins.2024.1342803
Journée SL, Journée HL, Bergmann W, Chantziaras I, Vanderperren K, Raes E, Reed SM, de Bruijn CM, Berends HI, Delesalle CJG.Medical imaging allows for the visualization of spinal cord compression sites; however, it is impossible to assess the impact of visible stenotic sites on neuronal functioning, which is crucial information to formulate a correct prognosis and install targeted therapy. It is hypothesized that with the transcranial electrical stimulation (TES) technique, neurological impairment can be reliably diagnosed. Unassigned: To evaluate the ability of the TES technique to assess neuronal functional integrity in ataxic horses by recording TES-induced muscular evoked potentials (MEPs) in three different mu...
Closure of the neuro-central synchondrosis and other physes in foal cervical spines.
Equine veterinary journal    April 9, 2024   doi: 10.1111/evj.14093
Olstad K, Bugge MD, Ytrehus B, Kallerud AS.The neuro-central synchondrosis (NCS) is a physis responsible for the growth of the dorsal third of the vertebral body and neural arches. When the NCS of pigs is tethered to model scoliosis, stenosis also ensues. It is necessary to describe the NCS for future evaluation of its potential role in equine spinal cord compression and ataxia (wobbler syndrome). Objective: To describe the NCS, including when it and other physes closed in computed tomographic (CT) scans of the cervical spine of foals, due to its potential role in vertebral stenosis. Methods: Post-mortem cohort study. Methods: The cerv...
Equine skeletal scintigraphy: Comparing lesion detection ability of methylene diphosphonate and hydroxymethylene diphosphonate in the caudal cervical and proximal metacarpal/metatarsal regions.
The Veterinary record    April 5, 2024   e4069 doi: 10.1002/vetr.4069
Sielaff S, Gerlach K, Brunk J, Sill V, Jahn W, Pelli AC.Data regarding the lesion detection ability of different radiotracers are lacking in equine bone scintigraphy. Methods: In this prospective study, hydroxymethylene diphosphonate (HMDP) and methylene diphosphonate (MDP) were compared in horses with increased radiopharmaceutical uptake either in the caudal cervical region (CS group) or in the proximal metacarpal/metatarsal region (PMR group). Region of interest analysis was used to determine normal bone-to-soft tissue ratios, lesion-to-normal bone ratios and lesion-to-soft tissue ratios. Qualitative scoring and total count rates were recorded fo...
Metastatic cutaneous myxosarcoma in an adult horse.
Veterinary clinical pathology    March 3, 2024   Volume 53, Issue 1 116-121 doi: 10.1111/vcp.13329
Rabelo AA, Maranhão RPA, de Miranda ALS, Ocarino NM, Amaral CI, Paes PRO, Monteiro NCC, Fantini P.A 25-year-old mixed-breed equine with separate nodular cutaneous lesions in the right thoracic limb (RTL) and right ventral abdominal region was admitted to a Veterinary Hospital in Belo Horizonte, Minas Gerais. Fine-needle aspiration cytology was performed on the RTL lesion and superficial cervical lymph node, and the results were suggestive of a malignant neoplasm known as myxosarcoma. Due to the unfavorable prognosis, the animal was euthanized. Based on the macroscopic and microscopic findings, the diagnosis of metastatic cutaneous myxosarcoma was confirmed. Although rare, this tumor should...
Standing hand-assisted laparoscopic ovariohysterectomy to treat chronic pyometra in a mare.
Journal of the American Veterinary Medical Association    January 5, 2024   Volume 262, Issue 3 1-3 doi: 10.2460/javma.23.11.0646
Thurston CC, Sertich PL, McDonnell SM, Parente EJ.To describe a standing hand-assisted laparoscopic ovariohysterectomy in a mare. Methods: A 15-year-old maiden Oldenburg mare. Unassigned: The mare was presented for evaluation of bucking under saddle and uncharacteristic aggressive behavior. Evaluation of a 24-hour video of the mare in a stall showed behavior consistent with caudal visceral abdominal discomfort. Reproductive evaluation revealed a pyometra secondary to complete transluminal cervical adhesions. The mare was initially managed medically with disruption of the adhesions and uterine lavage, but the adhesions reformed within 6 weeks ...
Dural and deep cervical musculature anesthetic blockade for atlantoaxial collection of cerebrospinal fluid in horses.
Journal of equine veterinary science    December 21, 2023   Volume 132 104987 doi: 10.1016/j.jevs.2023.104987
Pereira GF, Fenelon ACG, Horr M, Nogueira GM, Delfiol DJZ.The analysis of cerebrospinal fluid has diagnostic, prognostic, and therapeutic value in neurological illnesses in horses. There are different methods for obtaining cerebrospinal fluid, with the collection between the C1 and C2 vertebrae being a more recent methodology, which allows the procedure to be performed in standing patients, without the limitations of general anesthesia and with a low contamination of the sample with blood, presenting itself as a practical alternative. This study evaluated the efficacy and safety of a local dural blockade in healthy horses submitted to cerebrospinal f...
Standing left recurrent laryngeal neurectomy for prospective evaluation of laryngeal hemiplegia evaluated by a high-speed treadmill test.
American journal of veterinary research    December 16, 2023   1-6 doi: 10.2460/ajvr.23.08.0185
Lean NE, Franklin SH, Ahern BJ.To describe left recurrent laryngeal neurectomy (LRLn) performed under standing sedation and evaluate the effect of LRLn on upper respiratory tract function using a high-speed treadmill test (HST). We hypothesized that (1) unilateral LRLn could be performed in standing horses, resulting in ipsilateral arytenoid cartilage collapse (ACC); and (2) HST after LRLn would be associated with alterations in upper respiratory function consistent with dynamic ACC. Methods: 6 Thoroughbred horses. Methods: The horses were trained and underwent a baseline HST up to 14 m/s at 5% incline until fatigue. Evalua...
Clinical and histopathological features in horses with neuroaxonal degeneration: 100 cases (2017-2021).
Journal of veterinary internal medicine    December 14, 2023   Volume 38, Issue 1 431-439 doi: 10.1111/jvim.16969
Brown KA, Bender SJ, Johnson AL.Adult horses with proprioceptive ataxia and behavior changes that have histologic lesions consistent with neurodegenerative disease have been increasingly recognized. Objective: Describe the history, clinical findings and histopathologic features of horses presented to a referral institution with neuroaxonal degeneration. Methods: One hundred horses with a necropsy diagnosis of neuroaxonal degeneration compatible with neuroaxonal dystrophy/degenerative myeloencephalopathy (eNAD/EDM). Methods: Retrospective study of horses presented to the University of Pennsylvania, New Bolton Center, between ...
Transient Horner’s syndrome in horses following cervical plexus local anesthesia.
Veterinary surgery : VS    November 27, 2023   doi: 10.1111/vsu.14053
Pearce DJ, Raffetto J, Vallance SA.To report the development of transient Horner's syndrome in horses following local anesthesia of the cervical plexus. Methods: A total of 37 horses. Methods: Observational retrospective short case series. Methods: Medical records of cases undergoing ultrasound-guided cervical plexus anesthesia for standing prosthetic laryngoplasty at a single referral institution were evaluated (2019-2020). Results: Five of 37 horses (14%) developed transient signs of Horner's syndrome postoperatively. Obvious clinical signs began 2 to 5 h following local anesthesia and persisted for two to 4 h. Profuse un...
Historic Horse Family Displaying Malformations of the Cervicothoracic Junction and Their Connection to Modern German Warmblood Horses.
Animals : an open access journal from MDPI    November 3, 2023   Volume 13, Issue 21 3415 doi: 10.3390/ani13213415
Zimmermann E, Ros KB, Pfarrer C, Distl O.Malformations of the equine cervicothoracic junction affect the C6 and C7 cervical vertebrae, the T1 thoracic vertebra and in variable extent the first and second sternal ribs. To date, the clinical impact of this malformation, its prevalence and mode of inheritance in equine populations are not yet determined. We examined five skeletons for signs of malformation of the cervicothoracic junction, including three skeletons from widely used Thoroughbred stallions affected with the malformation and two skeletons serving as a comparison. The three affected historical horses were the Thoroughbred st...
Adult spinal Dmrt3 neurons receive direct somatosensory inputs from ipsi- and contralateral primary afferents and from brainstem motor nuclei.
The Journal of comparative neurology    October 10, 2022   Volume 531, Issue 1 5-24 doi: 10.1002/cne.25405
Vieillard J, Franck MCM, Hartung S, Jakobsson JET, Ceder MM, Welsh RE, Lagerström MC, Kullander K.In the spinal cord, sensory-motor circuits controlling motor activity are situated in the dorso-ventral interface. The neurons identified by the expression of the transcription factor Doublesex and mab-3 related transcription factor 3 (Dmrt3) have previously been associated with the coordination of locomotion in horses (Equus caballus, Linnaeus, 1758), mice (Mus musculus, Linnaeus, 1758), and zebrafish (Danio rerio, F. Hamilton, 1822). Based on earlier studies, we hypothesized that, in mice, these neurons may be positioned to receive sensory and central inputs to relay processed commands to mo...
Sex differences in cervical spinal cord and spinal canal development in Thoroughbred horses.
The Journal of veterinary medical science    August 10, 2022   Volume 84, Issue 10 1363-1367 doi: 10.1292/jvms.22-0234
Kondo T, Sato F, Tsuzuki N, Yamada K.Cervical vertebral stenotic myelopathy (CVSM), a common cause of cervical spinal cord compression, is a neurological disease characterized by general proprioceptive ataxia and weakness of hindlimbs that tends to develop in young adult Thoroughbred horses. Although male horses seem to be at increased risk for CVSM, the mechanism for the occurrence of sex differences in the prevalence of CVSM is still poorly understood. Hence, we hypothesized that sex differences in the development of cervical spinal cord and spinal canal would affect the development of CVSM. This study aimed to evaluate sex dif...
Investigation of a contributing factor for cervical vertebral stenotic myelopathy using computed tomography for measuring the cervical vertebral volume.
The Journal of veterinary medical science    June 8, 2022   Volume 84, Issue 8 1084-1087 doi: 10.1292/jvms.22-0188
Kondo T, Mashimo Y, Sato F, Tsuzuki N, Yamada K.Thoroughbred horses appear to be particularly predisposed to cervical vertebral stenotic myelopathy (CVSM), also known as wobbler syndrome. We hypothesized that variations in the cervical vertebral volumes can affect the dynamic instability of the cervical vertebrae. This observational study aimed to clarify whether cervical vertebral volume could be considered as a contributing factor in CVSM in Thoroughbred horses. Computed tomography (CT) was used to investigate a total of 21 male Thoroughbred horses (age range, 217-1,002 days; mean, 542.3 days). The study population comprised 17 CVSM horse...
Meningitis After Tooth Extraction and Sinus Lavage in a Horse.
Journal of equine veterinary science    November 16, 2020   Volume 97 103323 doi: 10.1016/j.jevs.2020.103323
Zetterström S, Groover E, Lascola K, Cole R, Velloso A, Boone L.A five-year-old Thoroughbred mare was evaluated because of chronic, malodorous, unilateral nasal discharge, and suspected maxillary cheek tooth root abscess. Skull radiographs revealed bilateral sinusitis suspected secondary to tooth root abscessation of 109 and 210. Following oral extraction of 109, bilateral conchofrontal sinus trephination and lavage; fever, tachycardia, and cervical stiffness developed. A lumbosacral cerebrospinal fluid tap was performed, and a presumptive diagnosis of bacterial meningitis was made. Targeted therapy consisted of antibiotic treatment with penicillin, enrofl...
Case-Control Comparison of Cervical Spine Radiographs From Horses With a Clinical Diagnosis of Cervical Facet Disease With Normal Horses.
Journal of equine veterinary science    June 20, 2020   Volume 92 103176 doi: 10.1016/j.jevs.2020.103176
Koenig JB, Westlund A, Nykamp S, Kenney DG, Melville L, Cribb N, Oberbichler D.The accuracy of using radiographs to diagnose cervical facet osteoarthritis (CFA) in horses is undetermined. Further investigation is required to determine the clinical significance of radiographic evidence of CFA, the prevalence of radiographic changes in horses without clinical signs, and the long-term efficacy of intra-articular CFA treatment. The objectives of this study is to compare degenerative changes of the cervical facet joints of the cervical vertebrae on radiographs of horses with clinical signs of CFA with healthy cohort-matched horses, to compare clinical findings between groups,...
[Cervical Stent for Long-term Treatment of Pyometra in Mares].
Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere    October 21, 2019   Volume 47, Issue 5 327-328 doi: 10.1055/a-1004-9876
Krohn J, Ennen S, Hospes R et al. Use of a cervical stent for long-term treatment of pyometra in the mare: A report of three cases. Reprod Dom Anim 2019; 55: 1155–1159 DIE PYOMETRA DER STUTE IST EIN CHRONISCHER ENTZüNDUNGSZUSTAND DES ENDOMETRIUMS, DER HäUFIG MIT DER AKKUMULATION GROßER MENGEN AN SEKRET EINHERGEHT. PRäDISPONIERT SIND STUTEN MIT VERäNDERUNGEN DER ZERVIX, DURCH DIE DIE UTERINE CLEARANCE BEEINTRäCHTIGT WIRD. DIE HäUFIG UNSPEZIFISCHEN SYMPTOME UMFASSEN LEISTUNGSMANGEL, KONDITIONSVERLUST, SUBFEBRILE TEMPERATUR ODER KOLIKARTIGE SCHMERZEN. MANCHE TIERE PRäSENTIEREN SICH SYMP...
Caudal cervical vertebral morphological variation is not associated with clinical signs in Warmblood horses.
Equine veterinary journal    July 16, 2019   Volume 52, Issue 2 219-224 doi: 10.1111/evj.13140
Veraa S, de Graaf K, Wijnberg ID, Back W, Vernooij H, Nielen M, Belt AJM.Variation in equine caudal cervical spine morphology at C6 and C7 has high prevalence in Warmblood horses and is suspected to be associated with pain in a large mixed-breed group of horses. At present no data exist on the relationship between radiographic phenotype and clinical presentation in Warmblood horses in a case-control study. Objective: To establish the frequency of radiographically visible morphologic variation in a large group of Warmblood horses with clinical signs and compare this with a group without clinical signs. We hypothesised that occurrence of morphologic variation in the ...
Quantitative evaluation of cervical cord compression by computed tomographic myelography in Thoroughbred foals.
Journal of equine science    December 15, 2016   Volume 27, Issue 4 143-148 doi: 10.1294/jes.27.143
Yamada K, Sato F, Hada T, Horiuchi N, Ikeda H, Nishihara K, Sasaki N, Kobayashi Y, Nambo Y.Five Thoroughbred foals (age, 8-33 weeks; median age, 31 weeks; weight, 122-270 kg; median weight, 249 kg) exhibiting ataxia with suspected cervical myelopathy (n=4) and limb malformation (n=1) were subjected to computed tomographic (CT) myelography. The areas of the subarachnoid space and cervical cord were measured on transverse CT images. The area of the cervical cord was divided by the area of subarachnoid space, and stenosis ratios were quantitatively evaluated and compared on the basis of histopathological examination. The sites with a ratio above 52.8% could have been primary lesion sit...
Cervical Vertebral Lesions in Equine Stenotic Myelopathy.
Veterinary pathology    July 13, 2015   Volume 52, Issue 5 919-927 doi: 10.1177/0300985815593127
Janes JG, Garrett KS, McQuerry KJ, Waddell S, Voor MJ, Reed SM, Williams NM, MacLeod JN.Skeletal lesions in the articular processes of cervical vertebrae C2 to C7 were compared between Thoroughbred horses with cervical stenotic myelopathy (17 males, 2 females; age, 6-50 months) and controls (6 males, 3 females; age, 9-67 months). Lesions identified by magnetic resonance imaging occurred with an increased frequency and severity in diseased horses and were not limited to sites of spinal cord compression. Lesions involved both the articular cartilage and trabecular bone and were further characterized using micro-computed tomography and histopathology. The most common histologic lesi...
Gross anatomy of the deep perivertebral musculature in horses.
American journal of veterinary research    April 26, 2014   Volume 75, Issue 5 433-440 doi: 10.2460/ajvr.75.5.433
Rombach N, Stubbs NC, Clayton HM.To determine the gross morphology of the multifidus, longus colli, and longus thoracis muscles in the cervical and cranial thoracic portions of the equine vertebral column. Methods: 15 horse cadavers. Methods: The vertebral column was removed intact from the first cervical vertebra (C1) to the seventh thoracic vertebra (T7). After removing the superficial musculature, detailed anatomic dissections of the multifidus, longus colli, and longus thoracis muscles were performed. Results: The multifidus cervicis muscle consisted of 5 bundles/level arranged in lateral, medial, and deep layers from C2 ...
Prognosis for racing with conservative management of cervical vertebral malformation in thoroughbreds: 103 cases (2002-2010).
Journal of veterinary internal medicine    March 10, 2013   Volume 27, Issue 2 317-323 doi: 10.1111/jvim.12053
Hoffman CJ, Clark CK.Cervical vertebral malformation (CVM) is seen in young, rapidly growing horses, and is commonly associated with a poor prognosis for racing. 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. Methods: 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 ...
The use of magnetic resonance imaging in evaluating horses with spinal ataxia. Mitchell CW, Nykamp SG, Foster R, Cruz R, Montieth G.To determine the accuracy of magnetic resonance imaging for diagnosing cervical stenotic myelopathy in horses, 39 horses with spinal ataxia and 20 control horses underwent clinical and neurologic examinations, cervical radiographs, euthanasia, magnetic resonance (MR) imaging of the cervical spine and necropsy. Twenty-four horses were diagnosed with cervical stenotic myelopathy, 5 with cervical vertebral stenosis, 7 with idiopathic ataxia, 3 horses had other causes of ataxia, and 20 were controls. The MR images were assessed for spinal cord intensity changes, presence of spinal cord compression...
Distribution of mast cells in vaginal, cervical and uterine tissue of non-pregnant mares: investigations on correlations with ovarian steroids.
Reproduction in domestic animals = Zuchthygiene    September 27, 2011   Volume 47, Issue 2 e29-e31 doi: 10.1111/j.1439-0531.2011.01897.x
Walter J, Klein C, Wehrend A.Mast cells constitute part of the cellular immune system of the genital tract. They play a potential role in cervical remodelling during parturition and are subject to the influence of ovarian steroids. In this study, the influence of oestradiol-17β and progesterone on the distribution of mast cells in equine vaginal, cervical and uterine tissue was evaluated. Genital tracts were retrieved from healthy mares at a local slaughterhouse. The cervix was divided along the longitudinal axis into five equivalent regions from cranial to caudal (R1 to R5). Toluidine blue staining was used for the dete...
What is your diagnosis? Cervical vertebral compressive myelopathy at C6-7.
Journal of the American Veterinary Medical Association    June 16, 2011   Volume 238, Issue 12 1559-1560 doi: 10.2460/javma.238.12.1559
Sparks HD, Nixon AJ, Watts AE.No abstract available
Comparative analysis of cytokine gene expression in cerebrospinal fluid of horses without neurologic signs or with selected neurologic disorders.
American journal of veterinary research    August 3, 2006   Volume 67, Issue 8 1433-1437 doi: 10.2460/ajvr.67.8.1433
Pusterla N, Wilson WD, Conrad PA, Mapes S, Leutenegger CM.To determine gene transcription for cytokines in nucleated cells in CSF of horses without neurologic signs or with cervical stenotic myelopathy (CSM), West Nile virus (WNV) encephalitis, equine protozoal myeloencephalitis (EPM), or spinal cord trauma. Methods: 41 horses (no neurologic signs [n = 12], CSM [8], WNV encephalitis [9], EPM [6], and spinal cord trauma [6]). Methods: Total RNA was extracted from nucleated cells and converted into cDNA. Gene expression was measured by use of real-time PCR assay and final quantitation via the comparative threshold cycle method. Results: Cytokine genes ...
Oxytocin does not contribute to the effects of cervical dilation on progesterone secretion and embryonic development in mares.
Theriogenology    June 14, 2006   Volume 66, Issue 5 1397-1404 doi: 10.1016/j.theriogenology.2006.04.032
Handler J, Hoffmann D, Weber F, Schams D, Aurich C.The aim of the present study was, to investigate the effects of oxytocin administration on Day 7 post-ovulation on progesterone secretion, pregnancy rate and embryonic growth in mares. Endogenous stimulation of oxytocin release was compared to the administration of native oxytocin or the long-acting oxytocin analogue carbetocin. At Day 7 after ovulation, mares had to undergo four treatments in a crossover design: (a) control, (b) oxytocin (10 IU i.v.), (c) carbetocin (280 microg i.m.) and (d) cervical dilation. On Day 13, all mares (8 of 8 mares) were pregnant on groups control, oxytocin and c...
Varices with thrombosis in the cervix and uterus of a mare.
The Canadian veterinary journal = La revue veterinaire canadienne    June 1, 1997   Volume 38, Issue 6 375-376 
Foster RA, Gartley CJ, Newman S.Cervical and uterine varices with thrombosis were observed at the necropsy of a virgin 16-year-old Peruvian Paso that had previous episodes of hemorrhage from the uterus. Practitioners and pathologists should be alert to the possibility of ruptured varices in mares with hemorrhage into the uterus or from the vulva.
Three methods of oxytocin-induced parturition and their effects of foals.
Journal of the American Veterinary Medical Association    March 15, 1997   Volume 210, Issue 6 799-803 
Macpherson ML, Chaffin MK, Carroll GL, Jorgensen J, Arrott C, Varner DD, Blanchard TL.To compare effects of 3 oxytocin-based induction techniques on fetal and neonatal foals. Methods: Prospective randomized controlled trial. Methods: 16 pregnant mares. Methods: Parturition was induced in mares by use of 3 treatments: group 1, 75 U of oxytocin, IM; group 2, 15 U of oxytocin, IM, q 15 minutes, for a maximum of 75 U; group 3, 75 U of oxytocin in 1 L of 0.9% NaCl solution IV (1 U/min), for a maximum of 75 U. Blood gas values and indices of vitality were measured in foals, and variables describing parturition were measured in mares. Results: Group-3 mares had a shorter interval from...
Evaluation of the thoraco-laryngeal reflex (‘slap test’) as an aid to the diagnosis of cervical spinal cord and brainstem disease in horses.
Equine veterinary journal    September 1, 1994   Volume 26, Issue 5 358-361 doi: 10.1111/j.2042-3306.1994.tb04403.x
Newton-Clarke MJ, Divers TJ, Delahunta A, Mohammed HO.A study was conducted over a 12 month period to assess the specificity and sensitivity of the 'slap test', using endoscopic evaluation, in the detection of cervical spinal cord and caudal brainstem lesions in horses. Fifteen ataxic horses were subjected to the 'slap test' and subsequently examined post mortem. Twelve out of the 15 had histopathological lesions consistent with their clinical signs. Thirteen horses with no history of neurological dysfunction and no histopathological evidence of cervical spinal cord or brainstem disease were used as controls. The laryngeal adductory responses exh...
Forelimb lameness associated with radiographic abnormalities of the cervical vertebrae.
Equine veterinary journal    September 1, 1993   Volume 25, Issue 5 422-426 doi: 10.1111/j.2042-3306.1993.tb02984.x
Ricardi G, Dyson SJ.Eight horses had forelimb lameness which was considered unrelated to primary forelimb pain, but was associated with radiographic abnormalities of one or more cervical vertebrae. There was no evidence of ataxia or weakness. The degree and character of the forelimb lameness varied between horses. In 4 horses, selective local analgesic techniques were used to rule out lameness associated with pain in the forelimb. In the other 4 horses, radiographic examination of the cervical region was performed on the basis of forelimb lameness seen in conjunction with neck stiffness and/or neck pain. Three ho...