This Neck Surgery Is Changing Equine Neurology and UC Davis Is One of the Few Places Offering It

For horses with unexplained neck pain, nerve related lameness, or puzzling neurologic signs, answers have often been frustratingly out of reach. That is starting to change. UC Davis is now offering equine foraminotomy surgery, one of the most specialized procedures in equine orthopedics and neurosurgery, performed by only about a dozen veterinarians nationwide. The launch of this service at the William R. Pritchard Veterinary Medical Teaching Hospital marks a major step forward for horses suffering from cervical foraminal stenosis and for the clinicians who manage them.

Cervical foraminal stenosis occurs when the opening where a spinal nerve exits the vertebral column becomes narrowed. In horses, this narrowing often develops near the cervicothoracic junction and can be caused by osteoarthritis, bone spurs, disc herniation, or thickened ligaments. The result is nerve root compression that can present as neck pain, numbness, lameness, reduced performance, and behavioral changes. Clinical signs may include ataxia, skipping or inconsistent gait, headshaking, and vague performance decline that can be difficult to localize with traditional diagnostics. For years, these cases have lived in a gray zone between orthopedic and neurologic disease. Advanced imaging and targeted surgical intervention are now bringing clarity.

The CT scanner that makes it possible

Accurate diagnosis of cervical foraminal stenosis in horses requires large bore equine CT imaging. Until recently, UC Davis only had a traditional CT scanner that limited imaging to the head and distal limbs. The installation of a dedicated large bore equine CT scanner in the new All Species Imaging Center changed that overnight. This technology allows detailed visualization of the lower cervical spine and nerve root exits, an area that has historically been challenging to assess. Few veterinary hospitals have this capability, which has been a major bottleneck for diagnosis and treatment nationwide.

Foraminotomy surgery itself is performed using a minimally invasive endoscopic approach. Surgeons use specialized instruments to carefully burr the foramen larger, relieving pressure on the affected nerve root. The technique was first performed in horses in Europe in 2020, building on decades of experience with similar procedures in human medicine. One of the most striking aspects of equine foraminotomy is how quickly some patients respond. Many horses show noticeable improvement in pain and neurologic signs in less than 24 hours after surgery.

The availability of this surgery at UC Davis is driven in large part by the addition of Dr. Carter Judy to the faculty. Dr. Judy performed equine foraminotomies for a year at his previous clinic and began offering the procedure at UC Davis immediately upon arrival, initially relying on imaging acquired from outside hospitals. Now, with onsite large bore CT imaging, the process is faster and far more accessible for clients. Travel requirements and wait times for affected horses have been significantly reduced. In addition, UC Davis surgeons Drs. Scott Katzman and Heidi Reesink completed foraminotomy training this year. This expanded surgical team increases appointment availability and positions the VMTH as a national referral center for this rare procedure.

One of the early beneficiaries of this program is Frida, a 4 year old Oldenburg mare from Washington. Osteoarthritis affecting multiple facet joints led to foraminal stenosis, causing hind limb weakness, reduced range of motion, and coordination deficits. Following foraminotomy surgery, the nerve compression was relieved. Frida continues to show improvement, offering a compelling example of how targeted intervention can change the trajectory for young performance horses with neurologic disease.

What this means for referring veterinarians

For equine practitioners, the availability of foraminotomy surgery at UC Davis adds a powerful option to the referral toolbox. Horses with chronic neck pain, unexplained lameness, or subtle neurologic signs may now have a treatable underlying cause. As advanced imaging and minimally invasive techniques continue to reshape equine medicine, procedures like foraminotomy highlight what is possible when specialized expertise and cutting edge technology align. For many horses, this surgery may be the difference between progressive neurologic decline and a return to comfort and function.

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