Clinically, occipital subluxation is seen as unevenness in the which is either visible or palpable, a palpable depression over the poll, asymmetry or unevenness of the eyes, temporomandibular joint dysfunction, cranial nerve deficits, or sudden death. Diagnosis can be made through clinical signs and symptoms and through a history of trauma to the poll or nuchal crest. Treatment includes NSAID’s, topical antibiotics if there is an open wound, cold hydrotherapy in the acute stage, adjustment, and massage to the muscles of the neck and head including fascial technique over the poll in the chronic stage. Fracture of the occipital bone or of the atlas must be ruled out before massage or chiropractic can be applied.
Vertebral Luxation or Subluxation
Complete luxation of the vertebrae is considered rare in horses.
Vertebral luxation or subluxation is usually caused by acute trauma, as is experienced during a fall, a trailer accident or a collision with another horse. No matter the exact cause, trauma forces the vertebrae out of normal alignment causing a disruption in the articulation between adjacent vertebrae. Malarticulation causes sprain of the intervertebral ligaments, irritates or tears the joint capsule and the articular cartilage, strains the surrounding musculature, damages the intervertebral discs and compresses or severs the nearby nervous tissue. Damage to any of these structures causes local inflammation and pain and may cause dysfunction. Horses with long, thin necks or long backs are predisposed to developing vertebral subluxation, as are horses ridden in poorly fitted saddles. Some experts believe that tying the tail while swimming or driving a horse may lead to vertebral subluxation, while others find that these activities provide traction to the vertebral column and aid in realigning the spine. The clinical manifestations of vertebral subluxation vary depending on the location of the subluxation. The clinical signs and symptoms include local inflammation, pain on palpation of the site of subluxation, palpable of the vertebrae, poor performance, reluctance to perform specific movements, unusual head or tail position, reluctance to lift the back when sternal stimulation is applied, lower motor neuron signs, thermal irregularity over the site of injury, and abnormal gait. These horses may appear cold back. Diagnosis of vertebral subluxation can be made through clinical signs and symptoms, palpation, radiography and thermography. Radiography of the spine in mature horses is difficult and results are often inconclusive. MRI or CT scan may give a better indication of the extent of damage, but both these imaging techniques require the horse be anaesthetized which can lead to further damage to the spine during recumbency and recovery. Treatment of vertebral subluxation is dependent on the clinical signs and symptoms, the area of injury and the degree of malarticulation present. Mild rotations or subluxations can be treated
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