Levine Jonathan M, Adam Emma, MacKay Robert J, Walker Michael A, Frederick Jeremy D, Cohen Noah D
Department of Small Animal Clinical Sciences , College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station 77843, USA.
J Vet Intern Med. 2007 Jul-Aug;21(4):812-9. doi: 10.1892/0891-6640(2007)21[812:capcvc]2.0.co;2.
Cervical vertebral compressive myelopathy (CVCM) is a common cause of myelopathy in horses aged 6 months to 4 years. Little information is available regarding the types of lesions, treatment, and outcomes in horses with CVCM that are > or =4 years old.
Twenty-two affected horses (10 with a confirmed diagnosis of CVCM and 12 presumptive cases) and 210 contemporaneous control horses.
Horses > or =4 years old that were diagnosed with CVCM between January 1992 and January 2004 were identified from medical records at Texas A&M University and the University of Florida. Data analyzed included history, signalment, neurologic examination findings, lesion location, treatment, and outcome. Signalment was also recorded in a population of contemporaneous controls.
Horses identified had a median age of 8.4 years, and there was a greater percentage of male horses among the cases than among the controls. The most common breeds represented were warmblood (n=6) and quarter horse (n=5) types; warmbloods were significantly (P < .05) overrepresented relative to control horses. The caudal cervical vertebral column was the most common site of CVCM lesions, and the C5-C6 (4/9) and C6-C7 (3/9) articulations were most often identified as abnormal via myelography. The most common lesions seen with radiography and myelography were articular process osteophytes. Of the 22 affected horses, 8 were euthanized and a diagnosis of CVCM was confirmed by necropsy for all; 5 of 8 of these horses had spinal cord compression caused, entirely or in part, by articular process osteophytes. Medical management was the therapy chosen in all horses, and administration of corticosteroids and nonsteroidal anti-inflammatory drugs resulted in improvement in the greatest number of horses.
CVCM should be a differential diagnosis in older horses with cervical myelopathy. Articular process osteophytes are the most frequently identified cause of spinal cord compression in this group. Male horses and horses of warmblood or Tennessee Walking Horse breeds may be predisposed to this condition.
颈椎压迫性脊髓病（CVCM）是6月龄至4岁马匹脊髓病的常见病因。关于年龄≥4岁的CVCM马匹的病变类型、治疗方法及预后的信息较少。
22匹患病马（10匹确诊为CVCM，12匹疑似病例）和210匹同期对照马。
从德克萨斯农工大学和佛罗里达大学的病历中识别出1992年1月至2004年1月期间诊断为CVCM的年龄≥4岁的马匹。分析的数据包括病史、特征、神经学检查结果、病变位置、治疗方法及预后。同期对照群体的特征也有记录。
确诊的马匹中位年龄为8.4岁，病例中雄性马的比例高于对照组。最常见的品种是温血马（n = 6）和夸特马（n = 5）；相对于对照马，温血马的比例显著过高（P <.05）。颈尾椎是CVCM病变最常见的部位，通过脊髓造影最常发现C5 - C6（4/9）和C6 - C7（3/9）关节异常。X线摄影和脊髓造影中最常见的病变是关节突骨赘。在22匹患病马中，8匹实施了安乐死，尸检确诊均为CVCM；其中8匹中的5匹脊髓压迫完全或部分由关节突骨赘引起。所有马匹均选择药物治疗，使用皮质类固醇和非甾体抗炎药使最多数量的马匹病情得到改善。
CVCM应作为老年颈椎脊髓病马匹的鉴别诊断。关节突骨赘是该组中最常发现的脊髓压迫原因。雄性马以及温血马或田纳西走马品种的马可能易患此病。
