Page 8 - Clinical Connections - Autumn 2025

RVC RESEARCH STUDY VETERINARY SERVICES RVC.AC.UK
Equine
PIONEERING TREATMENT FOR EQUINE
CERVICAL SPINAL NERVE COMPRESSION

Alex Hawkins, Lecturer in Equine Surgery

ollowing the installation of the new vertebral canal through the intervertebral Because the IVF is bordered by
Qalibra CT machine at the RVC’S foramina (IVF), openings located bilaterally two dynamic joints, it is vulnerable to
F Equine Referral Hospital earlier this between vertebrae. pathological changes affecting either
year, we are now able to offer the pioneering component. Degenerative or developmental
technique of uniportal endoscopic alterations – particularly osteochondrosis
foraminotomy to treat horses with cervical or osteoarthritis – can narrow the IVF and
spinal nerve compression. compress the cervical spinal nerve.
Cervical spinal nerve compression can Cervical APJ osteoarthritis is a relatively
be an extremely debilitating and painful common disorder in horses, especially in
condition for horses – and affected horses the caudal cervical region, and may result in
have historically often been euthanised. neck pain, stiffness or neurological deficits.
This novel treatment therefore can save the The RVC Equine surgical team conducts
lives of horses who would have previously clinical examinations to assess the suitability
not survived. of candidates for this surgical procedure..
Horses experiencing cervical spinal This assessment uses the recently installed
nerve compression can exhibit a number Qalibra CT machine. The minimally invasive
of symptoms that can be distressing for procedure is then performed under general
themselves and their owners. These include anaesthesia to remove excess bone, relieve
neck pain and stiffness, intermittent or nerve compression and create more space
persistent forelimb lameness, proprioceptive CT of normal foramen (above) and narrowed within the spinal canal.
deficits (i.e. falls and stumbling) and poor (red arrow) below
performance. Funding
This innovative surgery offers new Funding support to enable uniportal
hope for owners with horses suffering endoscopic foraminotomy to be offered by
from chronic or debilitating neck pain, the RVC came from the RVC’s charity the
helping to improve their comfort, mobility, Animal Care Trust, Betty Phillips Charitable
and overall quality of life. It also offers Trust and the Follett Trust.
referring veterinarians a reliable, evidence- The grants also enabled the RVC’s
based option for managing cervical spinal equine surgeons to undertake specialist
nerve compression. As foraminotomy is a training under the guidance of Jan-
minimally invasive procedure, the risk to Hein Swagemakers, who developed the
patients is low and recovery times are short. technique in Germany. Dr Swagemakers
The RVC’s Equine Referral Hospital is is the team veterinarian to the German
one of the few centres in Europe offering showjumping team
uniportal endoscopic foraminotomy to
treat the condition. Previously only limited The team training
options were available to prevent long- The IVF represents the lateral portion
term suffering. While mild articular process of the spinal canal that connects the
joint (APJ) osteoarthritis may respond intraspinal and extraspinal spaces, serving
to treatments such as intra-articular or as the pathway for neurovascular structures
perineural steroid injections, severe cases exiting the spine. Its boundaries are unique,
with marked bony proliferation can lead to consisting of two movable joints: ventrally
mechanical compression of the spinal nerve the non-synovial intervertebral joint and
roots. In these situations, surgery is often the dorsally the synovial articular process joint
only effective option to relieve compression (APJ).
and restore proper function. In the cervical region, the spinal nerve lies
ventral to the articular margin of the APJ,
Anatomy and procedure midway between the vertebral notches of
The spinal cord is enclosed within the bony adjacent vertebrae. After exiting the IVF, the
spinal canal formed by adjacent vertebrae. nerve courses ventromedially toward the
Segmental pairs of spinal nerves arise from caudal tubercle of the transverse process
the spinal cord and extend into the periphery, of the cranial vertebra, passing dorsal to the
transmitting neural signals between the vertebral artery and vein, which run cranially For equine referrals, please call: 01707
brain and the body. These nerves exit the to caudally. 666297
Email:
equinehospital@rvc.ac.uk

8 Autumn 2025