Diagnose und prognose neurologischer erkrankungen der halswirbelsaule beim pferd

Neurological disorders affecting the neck area are common in horses of many breeds. The number one cause can be traumatic cervical fracture or vertebral dislocation, and degenerative disorders of the cervical vertebrae leading to either dynamic or stenotic myelopathy were the number two cause of neurological disorders in the horses in France. In young horses cervical infectious osteomyelitis can lead to abscess formation. Incidentally cysts can lead to stenotic myelopathy. OCD lesions are known to be present also in the cervical joints, which might play a role development of frequently diagnosed osteoarthritis. Cervical (vertebral) stenotic myelopathy (C[[]V]SM), cervical vertebral malformation syndrome (CVMS), Cervical vertebral stenosis (CVS), Wobbler syndrome: many terms are used to describe either dynamic or stenotic malformation of the cervical vertebrae leading to similar clinical signs such as walking on different tracks," irregular irregular " gait, hyper-, hypo- or dysmetria, toe dragging, paresis, stumbling or knuckling over and abduction of the outer leg when asked to circle. In many cases local muscle atrophy and increased muscle tone around the affected area is present. Signs of denervation are often bilateral but can be asymmetrical. Lameness that cannot be blocked by local anesthesia can occur if nerve root pain is present. On many occasions reluctance to work, disobedience, diminished or no progress in performance is a complaint of the owner. A presumptive diagnosis and location of the lesion can be made after thorough clinical examination. Confirmation of the diagnosis is made by plain radiographs of the suspected region. Myelography can be performed to evaluate narrowing of the vertebral canal with compression of the spinal cord, despite its limited correlation with histopathological localization of lesion. Ultrasonographic examination can be helpful to determine remodeling, synovial effusion and synovial membrane thickening of facet joints and guiding local injections. Quantitative EMG needle examination proved to be very helpful in determining the extend and location of cervical lesions, as well as in determining the significance of radiological abnormalities. Postmortem MR! and CT scans combined with histopathological examination of bony tissue as well as nervous tissue have been helpful in the understanding of abnormalities found however correlation amongst these different techniques remain unsatisfactory.