Equine veterinary journal2026; doi: 10.1002/evj.70187

Novel imaging protocol enables myelography of the cervical vertebral column using computed tomography with flexion and extension comparable to x-ray.

Schulze, N
·
Tull, T
·
Drumond, B
·
Reuter, T
·
Werpy, N

Abstract: Radiographic myelography is the traditional diagnostic method for detecting cervical spinal cord compression in horses but it is limited by superimposition and restriction to sagittal plane imaging. Computed tomography (CT) and CT myelography overcome many of these limitations yet previous CT protocols have not allowed dynamic imaging in flexion and extension comparable to radiographs. Objective: To describe and evaluate a novel CT myelography protocol that enables imaging of the equine cervical vertebral column (C to C/T) in flexion, neutral, and extension, and to compare intervertebral angle measurements with those obtained from radiographic myelography. Methods: Prospective clinical study. Methods: Eight horses with clinical signs related to the cervical vertebral column underwent CT myelography and radiographic myelography under general anaesthesia. A mobile gantry CT system combined with a custom support platform enabled controlled repositioning of the cervical vertebral column. Intervertebral angles (C to C/T) were measured in flexion, neutral, and extension by three blinded image reviewers. Agreement between modalities was assessed using ANOVA, Bland-Altman plot, and concordance correlation coefficients. Results: The entire dynamic CT myelography protocol was completed within 45 min. Across all positions and cervical segments, no statistically significant differences were found between CT and radiographic myelography angle measurements (p > 0.01). All horses recovered uneventfully from anaesthesia, and no contrast-related adverse effects were observed. Conclusions: Small sample size and the absence of repeated intra-observer measurements. Intervertebral angles served as a proxy for motion but did not directly assess the degree of spinal cord compression. Conclusions: Dynamic CT myelography is feasible, safe, and provides positional sensitivity comparable to radiographic myelography, while overcoming the limitations of superimposition and enabling multiplanar evaluation. This novel protocol offers a reliable diagnostic alternative for assessing cervical spinal pathology in horses and allows complete coverage of the cervical vertebral column from C to T.

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Publication Date: 2026-05-13 PubMed ID: 42130048DOI: 10.1002/evj.70187Google Scholar: Lookup

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Journal Article

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 introduces and evaluates a new computed tomography (CT) myelography protocol for imaging the cervical spine in horses during flexion, neutral, and extension positions.
The new CT method offers dynamic, multiplanar images comparable to traditional radiographic myelography but without superimposition limitations.

Background

Cervical spinal cord compression in horses is commonly diagnosed with radiographic myelography.
Traditional radiographic myelography is limited to sagittal plane imaging and suffers from superimposition, which can obscure details.
Computed tomography (CT) myelography provides overcoming of some limitations by enabling cross-sectional imaging, but previously did not allow dynamic range-of-motion imaging similar to x-ray studies (flexion and extension).

Objective

To develop and test a novel dynamic CT myelography protocol capable of imaging the equine cervical spine from the cervical vertebrae C through cervicothoracic junction (C/T) in flexion, neutral, and extension positions.
To compare measurements of intervertebral angles obtained by this CT protocol with those from conventional radiographic myelography.

Methods

Eight horses showing clinical signs related to cervical spinal pathology were studied prospectively under general anesthesia.
A mobile gantry CT system was combined with a custom support platform to controllably reposition the horse’s neck in desired postures (flexion, neutral, extension).
CT myelography and traditional radiographic myelography were both performed for every horse.
Three independent, blinded reviewers measured intervertebral angles at each cervical segment and position.
Statistical methods used to compare angle measurements included ANOVA, Bland-Altman plots, and concordance correlation coefficients.

Results

The dynamic CT myelography protocol, covering the entire cervical vertebral column, took less than 45 minutes to complete in all horses.
Measurements of intervertebral angles did not significantly differ between CT and radiographic methods across all positions and segments (p > 0.01), indicating strong agreement.
All horses recovered normally from anesthesia with no adverse effects related to myelographic contrast medium.

Limitations

The sample size was relatively small with eight horses, limiting generalizability.
Intra-observer repeatability (same reviewer measuring angles multiple times) was not performed.
Intervertebral angles were used as an indirect measure of spinal range of motion, not a direct assessment of spinal cord compression.

Conclusions and Significance

Dynamic CT myelography in horses is feasible, safe, and yields measurements comparable to traditional radiographic myelography.
The CT protocol overcomes the limitations of superimposition inherent in radiographs, allowing multiplanar evaluation of spinal anatomy.
This novel protocol exams the entire cervical spine (C to T) dynamically, providing a comprehensive diagnostic tool for cervical spinal pathology in horses.
It expands diagnostic options for equine veterinarians by offering detailed, dynamic imaging that can improve the detection and assessment of cervical spinal disorders affecting horses.

Cite This Article

APA

Schulze N, Tull T, Drumond B, Reuter T, Werpy N. (2026). Novel imaging protocol enables myelography of the cervical vertebral column using computed tomography with flexion and extension comparable to x-ray. Equine Vet J. https://doi.org/10.1002/evj.70187

Publication

Equine veterinary journal

ISSN: 2042-3306

NlmUniqueID: 0173320

Country: United States

Language: English

Researcher Affiliations

Schulze, N

Equine Clinic Seeburg GmbH, Dallgow-Döberitz, Germany.

Tull, T

Ocala Equine Hospital, Ocala, Florida, USA.

Drumond, B

Equine Diagnostic Imaging Inc., Archer, Florida, USA.

Reuter, T

ICM-Institut Chemnitzer Maschinen- und Anlagenbau e.V, Chemnitz, Germany.

Werpy, N

Equine Diagnostic Imaging Inc., Archer, Florida, USA.

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