Musculus multifidus cervicis
The multifidus is a deep segmental muscle that spans 2–4 vertebral segments. It originates from the articular and transverse processes of vertebrae and inserts on the spinous processes of vertebrae 2–4 segments cranially. Its actions include fine segmental stabilization of the spine, proprioceptive feedback, and extension of individual segments. The cervical portion (multifidus cervicis) performs the same function in the neck. It is innervated by the medial branches of the dorsal rami of the spinal nerves (segmental). Research has shown that multifidus atrophy is closely correlated with back pain and osseous spinal pathology. The atrophy can be ipsilateral to the site of pathology and can persist after the original pain resolves. Targeted rehabilitation (dynamic mobilization exercises, belly lifts, and other core work) can increase multifidus cross-sectional area. Ultrasound is used to assess size and symmetry.
Origin: Articular processes of cervical vertebrae
Insertion: Spinous processes of cervical vertebrae 2-4 segments cranially
Action: Stabilizes individual cervical vertebral segments; fine rotational control
Innervation: Medial branches of dorsal rami of cervical nerves
Multifidus atrophy and asymmetry are common findings in horses with back pain, kissing spines, or chronic lameness. Ultrasound can measure cross-sectional area and compare left and right sides. Rehabilitation focused on core stabilization is often recommended.
## Overview The multifidus muscles are deep segmental stabilizers of the cervical spine. Atrophy or dysfunction of these muscles reduces joint stability, proprioception, and fine motor control of the
Wobbler syndrome, also known as cervical vertebral stenotic myelopathy, is a neurologic condition caused by compression of the spinal cord in the neck. It leads to progressive incoordination (ataxia),
Reluctance to bend, hollow back, or poor engagement under saddle can involve the multifidus and other deep stabilizers. Have persistent back issues evaluated. Core exercises can help restore function.
## Overview The multifidus muscles are deep segmental stabilizers of the cervical spine. Atrophy or dysfunction of these muscles reduces joint stability, proprioception, and fine motor control of the neck. It is commonly associated with facet joint osteoarthritis, chronic pain, or disuse, and can contribute to ongoing stiffness and compensatory issues. ## Causes Facet joint pathology, nerve-root irritation, chronic pain inhibition, and prolonged immobilization or poor posture lead to multifidus atrophy. The muscle attaches directly to the joint capsules, so joint disease and muscle loss reinforce each other. ## Diagnosis Palpation reveals focal concavity or reduced muscle bulk in the deep cervical region. Ultrasound can measure cross-sectional area. Clinical signs of instability or pain support the finding. ## Treatment Targeted rehabilitation with dynamic mobilization exercises (carrot stretches, baited stretches), resistance-band work, and gradual strengthening rebuild the multifidus. Concurrent treatment of underlying joint disease is essential. ## Recovery and Prognosis Muscle size and function can improve with consistent exercise. Underlying osteoarthritis may limit full resolution. ## Prevention Regular neck mobility work and early treatment of cervical pain help maintain multifidus health. Signs include: visible or palpable muscle loss in the deep neck; neck stiffness; reduced stability; compensatory hypertonicity in superficial muscles
Wobbler syndrome, also known as cervical vertebral stenotic myelopathy, is a neurologic condition caused by compression of the spinal cord in the neck. It leads to progressive incoordination (ataxia), primarily in the hind limbs. There are two main forms: Type I (dynamic compression in young horses) and Type II (static compression in older horses due to osteoarthritis). ## What it is In Type I wobbler syndrome, developmental abnormalities of the cervical vertebrae cause narrowing of the vertebral canal and dynamic compression of the spinal cord during neck movement. It typically affects horses between 1 and 4 years of age, most commonly at C3 to C5. Type II wobbler involves static compression from osteoarthritic enlargement of the articular facets, usually affecting older horses at C5 to C7. Both forms result in damage to the spinal cord, leading to proprioceptive deficits and ataxia that is usually worse in the hind limbs. ## Signs and symptoms - Progressive hindlimb incoordination and ataxia - Wide-based stance and stumbling, especially when turning or going downhill - Toe dragging and difficulty backing - Neck stiffness or pain in some cases - In severe cases, weakness or falling - Symmetric or slightly asymmetric ataxia that is worse in the hind limbs than forelimbs - Positive cervical flexion test in many cases ## Causes and risk factors Type I wobbler is developmental and linked to rapid growth, genetic factors, and nutritional imbalances (especially copper deficiency or excess protein/calcium in young horses). Type II is associated with chronic wear and osteoarthritis of the cervical facet joints. Risk factors include large body size, rapid growth rates in young horses, and conformational issues that place abnormal stress on the neck. ## How it is diagnosed Diagnosis is based on clinical neurologic examination and confirmed with radiographs and myelography or MRI. Standing or recumbent radiographs can show vertebral canal narrowing or facet joint changes. Myelography or MRI provides the most accurate assessment of spinal cord compression. A neurologic grading system helps quantify the severity of ataxia. ## Treatment and management Treatment depends on the type, severity, and age of the horse. Conservative management includes stall rest, anti-inflammatory medication, and controlled exercise. For young horses with Type I, dietary management and restricted growth may help. Surgical options (ventral interbody fusion or dorsal laminectomy) are available for selected cases and can improve neurologic function in many horses. Prognosis varies widely depending on the severity and duration of compression before treatment. ## When to call the vet Contact your veterinarian promptly if your horse shows incoordination, stumbling, or difficulty backing or turning. Early diagnosis improves the chance of successful management or surgical intervention. ## Prevention For Type I wobbler in young horses, prevention focuses on balanced nutrition (avoiding excessive protein and calcium while ensuring adequate copper and other minerals) and avoiding overly rapid growth rates. Regular monitoring of at-risk young horses can help with early detection. ## Frequently asked questions **Can a horse with wobbler syndrome be ridden?** Many horses with mild to moderate signs can be ridden carefully after treatment, but those with severe ataxia are usually retired for safety reasons. **Is surgery always successful for wobbler syndrome?** Surgical success rates are good in appropriately selected cases, but results vary depending on the severity and chronicity of spinal cord damage. **Is wobbler syndrome hereditary?** There is a genetic component, especially in Type I. Breeding horses with wobbler syndrome or from lines with high incidence is generally discouraged. This information is for educational purposes only. Always consult with a licensed veterinarian for diagnosis and treatment of your horse. Signs include: Progressive hindlimb incoordination and ataxia; wide-based stance and stumbling, especially when turning or going downhill; toe dragging and difficulty backing; neck stiffness or pain in some cases; in severe cases, weakness or falling; symmetric or slightly asymmetric ataxia worse in hind limbs; positive cervical flexion test in many cases
Multifidus atrophy and asymmetry are common findings in horses with back pain, kissing spines, or chronic lameness. Ultrasound can measure cross-sectional area and compare left and right sides. Rehabilitation focused on core stabilization is often recommended.
Reluctance to bend, hollow back, or poor engagement under saddle can involve the multifidus and other deep stabilizers. Have persistent back issues evaluated. Core exercises can help restore function.
See the Multifidus Cervicis on our interactive 3D horse model. Open 3D Model