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Equine veterinary journal2025; doi: 10.1111/evj.70094

Cone beam computed tomographic myelography in horses with cervical vertebral compressive myelopathy.

Abstract: While computed tomographic (CT) myelography is increasingly available and has been evaluated in alive horses, objective criteria for diagnosing cervical vertebral compressive myelopathy (CVCM) are lacking. Objective: To establish morphometric dimensions of the cervical vertebral canal and spinal cords from horses with CVCM and compare those to unaffected horses with the use of cone beam CT (CBCT). Methods: Prospective observational study. Methods: Four control horses and ten horses with CVCM underwent diagnostic imaging and histopathology. Morphometric measurements were obtained from cervical radiographs and radiographic and CBCT myelography. Receiver operating characteristic curves were generated to establish thresholds of measurements. Results: Intravertebral sagittal ratios were significantly different between CVCM and control horses. Dorsal myelographic column reduction was significantly different between compressed sites and non-compressed sites. Full myelographic area, dural area, and spinal cord area were significantly smaller in the CVCM horses, and were significantly smaller at compressed sites when compared to non-compressed sites. Reductions of full myelographic area and dural area and ratios of spinal cord area to full myelographic area and dural area were significantly larger at compressed sites when compared to non-compressed sites. Diagnostic thresholds to consider for CVCM are full myelographic area <294 mm, dural area <188 mm, and spinal cord area <104 mm. Compressed sites were associated with thresholds of full myelographic area <274 mm, dural area <188 mm, or reduction of full myelographic area >9%, reduction of dural area >14%, spinal cord area: full myelographic area >36.7%, and spinal cord area: dural area >57.9%. Conclusions: Small number of horses. CVCM horses were younger than control horses. Conclusions: CBCT myelography provides quantitative parameters that can support a diagnosis of CVCM and should be used alongside radiographic myelography.
© 2025 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2025-09-18 PubMed ID: 40968581DOI: 10.1111/evj.70094Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

  • This study aimed to define objective measurements from cone beam computed tomographic (CBCT) myelography to diagnose cervical vertebral compressive myelopathy (CVCM) in horses by comparing morphometric data between affected and unaffected horses.

Background

  • Cervical Vertebral Compressive Myelopathy (CVCM) is a condition in horses causing compression of the spinal cord, leading to neurological symptoms.
  • Computed tomographic (CT) myelography is a diagnostic imaging method increasingly available for live horses to assess spinal cord conditions.
  • Despite the availability of CT myelography, there has been a lack of objective diagnostic criteria to identify CVCM using this imaging technique.
  • Cone beam CT (CBCT) is a form of CT that can provide detailed images with potentially useful morphometric measurements of the spinal canal and cord.

Objective

  • The study aimed to establish quantitative morphometric dimensions of the cervical vertebral canal and spinal cord from horses diagnosed with CVCM.
  • It also sought to compare these measurements to those from unaffected control horses using CBCT myelography.

Methods

  • Design: Prospective observational study involving both control and affected horses.
  • Subjects: Four control horses without neurological issues and ten horses diagnosed with CVCM.
  • Imaging: All horses underwent cervical radiographs and myelography using both radiographic and CBCT methods.
  • Measurements: Morphometric data including intravertebral sagittal ratios, full myelographic area, dural area, spinal cord area, and reduction percentages were collected from the images.
  • Histopathology was used to confirm diagnoses in affected horses.
  • Statistical Analysis: Receiver operating characteristic (ROC) curves were employed to determine diagnostic thresholds of the measurements distinguishing CVCM from normal.

Results

  • Intravertebral sagittal ratios (the proportion of spinal canal size relative to vertebral dimensions) were significantly different between CVCM and control groups, with smaller ratios indicating compression.
  • Dorsal myelographic column reduction (narrowing of the dorsal contrast column in myelography) was significantly more pronounced at compressed sites within affected horses compared to their non-compressed sites.
  • The full myelographic area (entire contrast-filled spinal canal area), dural area (space within the dura mater), and spinal cord area were significantly smaller overall in CVCM horses compared to controls.
  • At localized compressed sites, these areas were further reduced compared to non-compressed sites within the same horse.
  • There were significant reductions in full myelographic and dural areas, along with increased ratios of spinal cord area relative to the full myelographic and dural areas at compressed sites indicating relative spinal cord enlargement or swelling at the site of compression.
  • Diagnostic thresholds identified were:
    • Full myelographic area less than 294 mm²
    • Dural area less than 188 mm²
    • Spinal cord area less than 104 mm²
  • For localized compressed sites within affected horses, thresholds included:
    • Full myelographic area less than 274 mm²
    • Dural area less than 188 mm²
    • Reduction of full myelographic area greater than 9%
    • Reduction of dural area greater than 14%
    • Spinal cord area to full myelographic area ratio greater than 36.7%
    • Spinal cord area to dural area ratio greater than 57.9%
  • CVCM horses in this study tended to be younger than the control horses examined.

Conclusions

  • CBCT myelography provides objective, quantifiable measurements of the cervical spine that differentiate horses with CVCM from unaffected horses.
  • Specific morphometric thresholds derived from this imaging technique support CVCM diagnosis and can be used to identify compressed vertebral sites with neurological involvement.
  • CBCT myelography should be used in conjunction with traditional radiographic myelography for more accurate and quantitative diagnosis of CVCM.
  • The study sample size was relatively small, suggesting further research is needed to validate the thresholds and findings.

Cite This Article

APA
González-Medina S, Barrett MF, Aboellail TA, Nelson BB, Nout-Lomas YS. (2025). Cone beam computed tomographic myelography in horses with cervical vertebral compressive myelopathy. Equine Vet J. https://doi.org/10.1111/evj.70094

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

González-Medina, Sonia
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado, USA.
Barrett, Myra F
  • Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado, USA.
Aboellail, Tawfik A
  • Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Nelson, Bradley B
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado, USA.
Nout-Lomas, Yvette S
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado, USA.

Grant Funding

  • 2016-05040 / U.S. Department of Agriculture

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