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Kissing Spines

The term kissing spines is used to describe a condition called over-riding dorsal spinous processes (ODSP). It is when the dorsal spinous processes (bony processes which stick up on top of the vertebrae) are close together, touching or overlapping in the horse’s back. This can happen in the thoracic or lumbar regions or both.

Symptoms

ODSP causes back pain which may present as obvious back pain picked up by an owner or therapist or more subtly as poor performance when ridden. Poor performance due to ODSP can include tension, resentment to work in a contact, inconsistency of contact, reluctance to bend, canter issues, refusing at fences, shooting off after jumping, bucking, rearing or mounting issues.

Diagnosis

ODSP is diagnosed by x-rays of the back. It is important however to have the horse assessed for concurrent issues such as hind limb lameness, neck issues or sacroiliac disease. This is because ODSP is often seen as part of a wider problem and in some cases the ODSP is actually not clinically significant or only a part of the issue.

Treatment

Surgery

There are two main surgical techniques used for treating ODSP which are both performed standing under sedation and local anaesthetic. The ligament snip is the least invasive and involves cutting the ligaments between the dorsal spinous processes to remove the damaged soft tissue and nerves and allow movement between the bones. The ligament snip plus ostectomy is the same plus some shaving of small portions of the bone of the DSPs as well to create a physical gap between them. Surgery is the most permanent solution but is of course more invasive and costly.

Steroid injections

Steroids can be infiltrated around the ODSPs via sterile injection technique. This provides targeted pain relief and anti-inflammatory action to the area to allow effective rehabilitation. This is more temporary but in milder cases where the owner can commit to excellent rehabilitation this can be very successful in helping ODSP horses.

Rehabilitation

Rehab is essential as part of any treatment plan for any horse with ODSP. The aims are to improve the core strength and posture to support the back, increase lift in the back and therefore open the DSPs from each other. This involves physiotherapy, farriery, saddle fitting, acupuncture, water treadmill work, stretches, targeted exercises, long reining, pole work, hill work, careful schooling and hacking.

Systemic pain relief

In some cases the use of systemic pain relief may be sufficient to keep the horse comfortable in combination with careful rehabilitation.

Change of use

In some circumstances it may be decided that the best way forward is a change in use of the horse. This may involve being limited to straight line only work such as hacking and pleasure riding or retirement. Some horses with ODSP only struggle with certain types of work and so adjusting the workload, if possible, may be all that is required.

It is also essential to treat any concurrent issues at the same time as if the horse is compensating for another source of discomfort the back treatment is unlikely to be successful.

Prognosis

The majority of horses with ODSP respond very well to a thorough approach which has been designed for their individual needs making it a rewarding condition to treat in most cases.