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Fractured dorsal spinal processes of a 5 year old gelding.

Nicky Desailly MNAVP

Veterinary diagnosis and treatment

Fracture of the dorsal spinous processes (DSP) T3 to T9 due to a suspect trauma whilst stabled. X ray screening confirmed the diagnosis showing the DSP’s displaced to the left. T9 was detached and appeared to be floating. The horse was treated by NSAID for a month and underwent 3 months box rest before referral for rehabilitation. At this point the horse was referred for physiotherapy and introduction of remedial exercise.

Dynamic assessment

Rehabilitation was addressed with the aim of correcting the neuromotor deficit addressing proprioceptive re education, disuse atrophy and muscular re education due to enforced immobility as well as supportive physiotherapy to assist healing and compensatory muscle issues that had developed. At this point it was not clear if there was any neurological involvement as a result of the injury.

Static examination and palpation

The fractured DSP’s were displaced to the left giving an asymmetric aspect to the cranial boarders of the scapulae and wither region. Areas of tightness and muscle soreness were present in the dorsal muscles of the neck and poll and lateral ventral muscles at the base of the neck and wither region. A left ventral rotation of the altas was present. Muscle tightness was palpable through the back and the pelvic muscles affecting more the left side.

Passive range of movement showed restriction and discomfort on movement of the left scapula, protraction and retraction of the left forelimb and abduction of the same limb. The horse was unable to weigh bear on the left limb initially.

The photo to the right shows the degree of deformation of the wither area giving the horse a somewhat downhill appearance.

Physiotherapy treatment

The horse received daily physiotherapy for a period of four weeks alongside the remedial exercise programme based on the use of pulsed magnetic field therapy daily initially for pain relief and therapy, massage and muscle release work. Long wave therapeutic ultrasound and H Wave electrotherapy were used periodically during this period. Passive mobilisation and stretch exercises were used to maintain and improve joint mobility and range of movement.

Exercise programme

The horse followed a rehabilitation programme over a 3 month period. A progressive programme of water treadmill exercise was commenced involving 10 minutes water treadmill exercise twice daily. This allowed the horse to exercise in a controlled environment with no distractions – hand walking at this point had proved difficult to manage. This programme was gradually built up to include hand walking on a hard surface, lunge and long rein exercise in an indoor arena and hand walking and grazing. The horse was exercised twice a day and built up to an hour’s varied exercise with 20 minutes recreational time such as hand grazing.

Conclusion and future management

This horse was discharged after 3 months rehabilitation but it is anticipated that this horse may need 9 to 12 months to allow complete calcification of the fracture site before ridden work can commence. He will undergo approximately six months of ground based exercise such as lunging and long reining including pole exercises supported by physiotherapy through this period before mounted work is reintroduced.

Nicky Desailly has been a NAVP member for many years and works freelance covering Berkshire, Wiltshire, Oxfordshire, Hampshire and France . She works with some of the top veterinary surgeons in the UK. Before becoming a NAVP veterinary physiotherapist, Nicky was a senior equine nurse in the UK and France working for a large equine hospital alongside one of Frances top orthopaedic equine surgeons.

She has evented professionally up to advanced/CCI level and uses her extensive knowledge of the competition horse in her rehabilitation programmes, she also ran a hydrotherapy center before becoming freelance.

For contact details see Members page.