A Systematic Review of Clinical Signs Associated With Degenerative Conditions and Morphological Variations of the Equine Caudal Neck.
Authors: Kernot Nicole, Butler Raquel, Randle Hayley
Journal: Journal of equine veterinary science
Summary
# Editorial Summary: Clinical Signs of Caudal Cervical Pathology in Horses Despite frequent clinical suspicion that lower cervical conditions (C5–C7) cause specific patterns of lameness and neurological dysfunction in horses, a robust evidence base linking particular clinical signs to defined pathologies remains surprisingly sparse. Kernot, Butler and Randle conducted a systematic review following PRISMA guidelines, searching peer-reviewed literature for studies documenting clinical presentations associated with three categories of caudal cervical disease: vertebral malformation, spinal cord compression (cervical myelopathy), and articular process joint (APJ) arthropathy. The review identified only 12 eligible studies, revealing inconsistent reporting of clinical indicators across the literature and limited evidence to confidently differentiate one condition from another based on clinical examination alone. For farriers, veterinarians and rehabilitation specialists, this highlights a pressing need for prospective studies establishing diagnostic criteria; current clinical decision-making often relies on inferences that lack robust validation. Standardised protocols for documenting gait abnormalities, neurological deficits and palpation findings—alongside advanced imaging—would substantially improve diagnosis and prognosis for this frustratingly common yet poorly characterised source of equine dysfunction.
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Practical Takeaways
- •Clinical signs associated with caudal neck problems are non-specific; diagnosis cannot be reliably made on clinical presentation alone and imaging is essential.
- •Recognize that anatomical variations, myelopathy, and joint changes in the caudal neck may present similarly—maintain index of suspicion for cervical involvement in horses with subtle or atypical neurological signs.
- •Encourage referral for advanced imaging (MRI/CT) when caudal cervical pathology is suspected, as clinical examination alone cannot differentiate between specific conditions.
Key Findings
- •Systematic review of 12 studies identified associations between caudal cervical spine conditions (C5-C7) and various clinical signs, but heterogeneity in clinical presentations limits specificity.
- •Anatomical malformations, spinal cord compression, and articular process joint arthropathy are recognized caudal cervical conditions but clinical indicators remain poorly isolated and characterized.
- •Current literature provides insufficient evidence to reliably link specific clinical signs to individual caudal cervical pathologies, highlighting need for further targeted investigation.