equine spine initiative

Position Statements

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ESI Position Statement Development Protocol (2026)

The Equine Spine Initiative (ESI) recognizes that it serves as an important source of scientific expertise and professional guidance regarding equine axial skeleton-related pain and dysfunction clinical decision-making, and welfare. ESI position statements are intended to support evidence-based, ethical, and humane care of horses, and to assist veterinarians, owners, and industry professionals in navigating complex and evolving clinical issues.

Accordingly, the following protocol will govern the development, review, and adoption of ESI position statements:

  • Initiation of Issues: Issues or areas of concern must be submitted in writing for consideration by the ESI Board. Submissions should include a concise and complete background outlining context, current state of knowledge, areas of uncertainty, and anticipated impact. A length of no more than one page is preferred.
    Data Review and Investigation: If it is determined that additional data collection is necessary to adequately inform a position statement, ESI may undertake such efforts through its members and resources.
  • Scope and Limitations: No ESI position statement may be construed as an endorsement or approval of any specific breed, sport, discipline, training methodology, commercial product, pharmaceutical, diagnostic modality, treatment technique or device. Statements focus on principles of clinical evaluation, interpretation of findings, welfare considerations, and responsible decision-making rather than prescriptive or promotional guidance.
  • Scientific Review and Approval: All position statements must first undergo review by the ESI board and then are voted on for approval by ESI Core Members, committees, or designated subject-matter experts with relevant clinical or research expertise. Final approval requires review and adoption by the ESI Board.

Revised and adopted by the Equine Spine Initiative Board of Directors, 2026.

Equine Spine Initiative Position Statement on the Use of Radiographic Findings Alone to Justify Euthanasia in Horses with Congenital Caudal Cervical and Cranial Thoracic Anatomical Variations

The Equine Spine Initiative (ESI) recognizes the importance of and is actively engaged in ongoing research into the congenital anomalies of the caudal cervical and cranial thoracic region, colloquially referred to by some as “Equine Complex Vertebral Malformation” or “ECVM”.

Based on the current veterinary and anatomic literature, as well as the collective clinical experience and expertise within ESI, the organization does not support making irreversible clinical decisions, including euthanasia, based solely on radiographic screening findings suggestive of “ECVM”.

The term “ECVM” represents a variety of congenital anomalies, both the short-term and long-term biomechanical and physiologic consequences of which are not fully understood. Available evidence supports a wide spectrum of anatomic findings and clinical presentations, including cases in which radiographic features consistent with “ECVM” are identified as incidental findings in high-performance horses. In addition, growing evidence indicates that radiographic screening alone is insufficient to comprehensively characterize these anatomic variations or to reliably predict clinical significance.

Accordingly, ESI emphasizes that clinical decision-making for horses with congenital anomalies of the caudal cervical and cranial thoracic region should be grounded in a broader diagnostic and clinical context. As research efforts continue to expand the available knowledge base, ESI remains committed to advancing evidence-based guidance to support informed, appropriate, and humane decision-making. As such, we welcome any referring veterinarian feedback or requests for clarification by writing us at info@equine-spine-initiative.org or use the contact form.

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