García-López said cranial nuchal bursitis in a large number of dressage and event horses which, in order to do their job, need to have significant neck and poll flexion. This which makes the nuchal ligament put repetitive pressure on the nuchal bursa and can lead to inflammation, but he said researchers aren't sure why some horses suffer from cranial nuchal bursitis and others don't. | Photo: iStock

In many horse health scenarios, it’s common practice to try conservative medical treatment before opting for surgery. But researchers recently determined that skipping straight to surgery appears most effective for treating horses with an uncommon condition which affects the poll called cranial nuchal bursitis.

Cranial nuchal bursitis occurs when one of the three bursae (a sack filled with synovial fluid near the joint) of the nuchal ligament (a ligament near the poll) becomes inflamed and sometimes infected. It generally causes inflammation, pain, limited head and neck flexion, and poor performance. In some cases it can involve a bacterial infection and associated oozing lesions.

Horses that fully recover from cranial nuchal bursitis have a fair chance of going back to their previous work level, but those chances might be enhanced if owner and veterinarians opt for surgery as a first line of treatment instead of medicine alone. This is especially true for certain types of the disease, said José M. García-López, DVM, Dipl. ACVS, ACVSMR, associate professor of large animal surgery and equine sports medicine director at Tufts University’s Cummings School of Veterinary Medicine, in North Grafton, Massachusetts