Diagnostic Imaging of the Cervical Spine

The best diagnostic imaging tool for the cervical spine is MRI, rather than widely used radiographs.
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MRI machine
MRI allows for better differentiation between structures in images of the cervical spine. | Anne M. Eberhardt/The Horse

Advances in regenerative medicine, orthobiologic treatments, and equine imaging have transformed how equine practitioners treat their patients. Stefanie Veraa, DVM, Dipl. ECVDI, assistant professor of diagnostic imaging in the Department of Clinical Sciences at Utrecht University, in the Netherlands, presented key information about diagnostic imaging of the equine cervical spine at the Equine Regenerative Medicine and Orthobiologics Online Summit held Oct. 2-25, 2022.

The horse’s cervical spine forms the neck and comprises seven vertebrae beginning at the base of the skull and ending at the thoracic portion of the backbone near the withers. Over the past few years, whole genome sequencing in horses has garnered attention, said Veraa. As a result of genome sequencing in horses, researchers have noted a higher frequency of vertebral anomalies, especially in sport horses, she said.

Medical imaging has also accelerated rapidly over the past 25 years, allowing veterinarians to better understand the equine cervical spine. When the vertebral disc space is damaged, it causes an inflammatory response that transfers to the bone, Veraa explained. Magnetic resonance imaging (MRI) allows veterinarians to make a differentiation between inflammation, fatty infiltration, and sclerosis (formation of new or excessive bone). “With MRI we can see abnormalities, and the damage, and bone surrounding lesions, which is something we don’t appreciate in radiography or ultrasonography,” she said.

The entire spinal unit can be affected by abnormal biomechanical loading and not just one component, Veraa added. “I think if we’re treating one component, that helps, but it will not always improve the entire spinal unit. Many things are going on not only in the intervertebral disk space but also in the articular process joints because of the dysfunction of the spinal unit.”

Veraa recommended veterinarians highlight the effects of biomechanics on the cervical spine by taking flexed, neutral, and extended views in their imaging modality of choice, so they can evaluate the positioning of the vertebrae and the intervertebral space.

Lesions, bone mineralization, and fragments of the joints are more visible on an MRI than on a radiograph, Veraa noted. “Many times, when we look at a radiograph, there’s a bit of new information, but with MRI, we can see more changes than what we can see in imaging modalities that are mainly available to us,” she said. “Of course, we need to work with radiography and ultrasonography, but it’s very important to be aware that it doesn’t show everything, and a lot of things we need to be able to see. We’re always looking for new information.”

The Equine Regenerative Medicine and Orthobiologics Online Summit helps veterinarians worldwide connect current research to their clinical experiences and provides a flexible forum for discussion with equine veterinarians worldwide. Members can access the organization’s video library exploring new approaches to equine regenerative medicine and orthobiologics. The Equine High Performance Sports Group organized the summit.

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Anna Sochocky, MALS, is a freelance equine writer based in Santa Fe, New Mexico. Her mission at Equi-Libris LLC is to educate, inspire, and document distinctive narratives about horses, health, and history.

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