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Some horses that show signs of back pain are diagnosed with a condition known as kissing spines. The horse’s thoracic spine (area between the withers and last rib) is made up of a number of individual vertebrae, each of which has a thin flange of bone protruding from its upper surface. These dorsal spinal processes can rub against each other as the spine flexes, causing pain and inflammation. Kissing spines can sometimes be successfully treated with pain medications, anti-inflammatory drugs, and various types of physiotherapy. If the pain is not resolved, another option is surgical removal of bone spurs or other vertebral surfaces that impinge on each other. This surgery is often performed with the horse under general anesthesia.

Standing surgery can reduce risk to the horse, length of surgery and hospitalization time, and owner cost. A study in Sweden evaluated surgery performed on standing horses rather than using general anesthesia. Veterinarians at the Jagersro Equine Clinic sedated horses and supported them in stocks that could be lowered so that the surgeon could access the horse’s back. The technique was used on 23 horses (10 mares and 13 geldings) ages 3 to 12 years old, and of Thoroughbred or Warmblood breeding. The horses had been used for dressage, jumping, or racing.

The kissing spines were located between the 12th and 17th thoracic vertebrae. Affected bone was removed through small incisions. After the surgery, horses were kept in stalls for two weeks and then progressed through periods of increased turnout and exercise. Of the 22 horses whose cases were followed for a year, 17 had returned to full athletic function. No horses were in worse condition than before the surgery. In this study, results were comparable to those for horses undergoing the same procedure with general anesthesia.

Another treatment for kissing spines is interspinous ligament desmotomy. This technique can also be used in standing horses. In one group of horses diagnosed radiographically with kissing spines, some of the horses had methylprednisolone acetate injected into the irritated areas. The rest of the horses were treated by cutting the interspinous ligament in 3 to 8 places between the impinging spinal processes. All horses were returned to work three to six weeks after treatment.

Among the 38 horses treated with methylprednisolone acetate, 34 (89%) had resolution of back pain initially, but pain recurred in 19 (50%) of horses treated this way. For the 35 horses treated surgically, all but one had initial relief of back pain with no recurrence of pain. Radiographs in 19 of the horses showed that the spaces between the spinous processes had widened significantly after the surgery.

Standing surgery can reduce risk to the horse, length of surgery and hospitalization time, and owner cost.

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