Neurectomy for Navicular

While untenable pain due to navicular syndrome and caudal heel syndrome is the most common cause of performance horses’ being nerved, Madison said in Thoroughbred racehorses a wing fracture of the coffin bone often necessitates a neurectomy.
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Many people have heard of “nerving” a horse for navicular disease, as was mentioned in the Step-by-Step column in the August issue of The Horse. But did you know that the nerves in that heel area can grow and eventually allow the horse again to feel pain? This innervation or regrowing of the nerves is the norm rather than the exception with a neurectomy. According to equine surgeon John Madison, VMD, Diplomate ACVS, a neurectomy always should be considered a temporary procedure.

“You usually get one year of pain-free use of the horse on average,” said Madison, who owns Ocala Equine Hospital in Florida. “Sometimes you get more time, sometimes less time.”

A neurectomy involves cutting both palmar digital nerves below the base of the sesamoid, said Madison. “You don’t want to lose sensation in the entire foot, so you don’t go above that point,” he noted.

Madison said there are several methods of severing the nerves, with no research that shows one technique better than the other. He prefers the capping technique, considered a temporary procedure, which involves cutting the nerves with a sharp knife and then capping the ends of the nerves by taking the epineurium (tissue around the outside of the nerve) and making a cap over the end of the nerve

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Barrie Grant, DVM, Dipl. ACVS, is a board certified surgical veterinarian specializing in equine wobblers and cervical stabilization. He is a former partner in the San Louis Rey Equine Hospital. He left SLREH in 2008 and now has a consulting practice in Bonsall, Calif., where he enjoys surgery and working with veterinarians and their clients. More information about Dr. Grant can be found at his website,””arrie Grant

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