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Bo A Brock,1 Hunter R Greer,1 Clifford M Honnas,2 Brad E Gilleland,3 Myra F Barrett,4 James N Moore,3 Noah D Cohen5 1Brock Veterinary Clinic, Lamesa, TX, USA; 2Texas Equine Hospital, Bryan, TX, USA; 3Department of Large Animal Medicine, College of Veterinary Medicine, Athens, GA, USA; 4Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; 5Department of Large Animal Clinical Sciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USACorrespondence: Noah D Cohen, Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, 77843-4475, USA, Tel +1 979 845 0741, Fax +1 979-847-8863, Email ncohen@cvm.tamu.edu Bo A Brock, Brock Veterinary Clinic, 1204 S Dallas Avenue, Lamesa, TX, 79331, USA, Tel +1 806 872 3183, Email brockvets@gmail.comIntroduction: Podotrochlear syndrome is a common cause of lameness in Quarter Horses involving both soft tissue and bony structures within the heel region. Current surgical treatment of podotrochlear syndrome addresses pathological changes affecting the soft tissue structures of the navicular region but does not address either edema or cyst-like lesions of the navicular bone.Objective: The objective of this randomized, self-controlled case series was to determine whether core osteostixis improved lameness in Quarter Horses with podotrochlear syndrome characterized by bilateral magnetic resonance imaging (MRI) findings of osseous cyst-like lesions of the navicular bone.Methods: Seven Quarter Horses that had not responded to standard medical management were included. Each horse had an affected forefoot randomly assigned to surgical treatment with navicular bursoscopy and core osteostixis; the contralateral limb was assigned to navicular bursoscopy only. Video recordings were used to assign lameness scores and make comparisons of each limb