Fractures of the cervical vertebral odontoid in four horses and one pony.
Authors: Vos N J, Pollock P J, Harty M, Brennan T, de Blaauw S, McAllister H
Journal: The Veterinary record
Summary
# Editorial Summary: Cervical Odontoid Fractures in Horses and Ponies Fractures of the odontoid peg (the dens of the second cervical vertebra) are rare but significant injuries that can compromise spinal stability and neurological function in equines. Between them, Vos and colleagues identified five cases—four horses aged one to eleven years and one pony—presenting with clinical signs including neck stiffness, reluctance to move, depression, and gait abnormalities, all of which required radiographic confirmation for diagnosis. The team identified two distinct fracture patterns and found that treatment approach should be individualised according to the severity of neurological signs, the animal's intended future use, and owner finances, with optimal management requiring techniques that achieve decompression, anatomical realignment, and stabilisation of the fracture site. Where neurological signs were mild and peripheral pain sensation remained intact, conservative management proved viable, mirroring approaches established in human medicine—and this approach succeeded in all cases except the pony, which did not recover. These findings emphasise the importance of maintaining radiographic vigilance in horses presenting with acute cervical pain or neurological deficits, and highlight that prognosis need not be uniformly poor if early diagnosis allows for thoughtful case selection and tailored intervention.
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Practical Takeaways
- •Suspect odontoid fracture in horses presenting with reluctance to move the neck, dullness, and gait abnormalities; radiography is essential for confirmation
- •Conservative management can be effective in milder cases where the animal retains peripheral pain sensation, similar to human surgical practice
- •Treatment must be individualized based on fracture severity, neurological status, intended use, and owner resources; optimal outcomes require decompression, alignment, and stabilization
Key Findings
- •Five equine cases (4 horses, 1 pony) ranging 1–11 years old presented with odontoid fractures causing neck pain and gait abnormalities
- •Radiography was essential for diagnosis of two different types of odontoid peg fractures
- •Treatment approach varied by severity of neurological signs, intended use, and financial constraints
- •Four of five animals (all horses) achieved full recovery; conservative treatment was successful in cases without severe neurological deficits and with preserved peripheral pain sensation