Question: My horse is missing the dorsal spinal processes of the two highest vertebrae of the wither (by palpation, no X-rays), presumably as the result of a fall onto them as a youngster. Does this disrupt the continuity and integrity of the nuchal ligament [a large, strong band of connective tissue that provides support for the neck]? Does that, in turn, affect her athletic abilities? I would not want to ask her to learn anything that is beyond her physical ability.
Answer: Fracture and displacement of the most dorsal (or superficial) portion of the dorsal spinous processes of the vertebrae composing the withers is not an uncommon result when a horse flips over backward, especially if he lands on a hard surface such as concrete. The fragments are usually displaced laterally to one side or the other, and are not actually "missing." The vast majority of these injuries heal with rest alone, though the recuperation time is generally lengthy (six to 12 months). Once the soft tissue in the area has healed, the subsequent flattened wither generally causes no problems.
Such an injury rarely requires surgical removal of the fragments. In fact, surgery is contraindicated for such an injury unless the fragments begin to degenerate and cause persistent drainage from the area. That scenario is an exceedingly rare occurrence. There is no significant disruption of the nuchal ligament (at the withers or nape of the neck) associated with this injury.
I have had personal experiences with at least 10 horses over the years who have had very successful athletic careers as show horses after this kind of injury. Those horses have been both hunters and jumpers (including a mare long-listed for the Olympics), racehorses (flat, steeplechase--a multiple stakes winning gelding--and timber) and two eventers, both of whom competed at the advanced level. I have not, however, dealt personally with a dressage horse in this situation.
Nonetheless, my advice would be to continue your mare's training, stopping only if an impediment that can be attributed to the wither area is encountered. Obviously, the horses with which I am familiar have had to make considerable use of their necks and backs and have shown no restrictions that limited their success in extremely strenuous careers. Often the major concern with these horses is proper saddle fit, as the disfiguration can make this a somewhat more difficult process.
Midge Leitch, VMD, is a Diplomate of the American College of Veterinary Surgeons. She has traveled extensively with the U.S. Equestrian Team, including trips to the 1996 and 2000 Olympic Games and the 1998 and 2002 World Equestrian Games. She practices at Londonderry Equine Clinic in Kennett Square, Pennsylvania.
This article first appeared in the September 2001 issue of Dressage Today.