Recent surgeries

Standing kissing spines operation

Think your horse has kissing spines? Read our new Kissing Spines FAQ

Back pain is a very common complaint in equines of all shapes and sizes and at Cotts we seem to see out fair share of them. One of our most commonly encountered conditions is kissing spines, a.k.a. impingement of the dorsal spinous processes (DSPs). The impingement can be passive in the more severe cases, in which case the DSPs are actually touching on the x-rays. Equally commonly in our experience, spines can be close and only touch each other when under saddle. This is called dynamic impingement. Pictured below is a typical case of kissing spines seen in a Thoroughbred riding horse: the DSPs are the battlement-shaped bones which stick up along the midline of the back. Only their tops can ever be felt through the skin. In this case they are touching at 3 sites and very close at the other.

First line of treatment is normally anti-inflammatory medication to temporarily remove pain, coupled with a period of physiotherapy exercise in a side rein device (Pessoa or Chambon) to stretch the back and open up the spaces. The injection is carried out under x-ray guidance, as is shown in this picture of the same horse as above.

Surgical removal of every other kissing spine is the traditional approach used for repeat offenders for whom repeat injections are ineffective. More recently it is carried out standing with good success, although the wounds have always had difficulty healing because of the amount of surgical manipulation needed to filet out these bones. At Cotts we have been carrying out a minimally invasive technique with excellent success and significantly reduced cost compared to the traditional approach. This is shown below, during and immediately after surgery.

Horses are discharged the same day, start hand walking the day after surgery and are back in full work at 6 weeks. The major advantage of the procedure is the rapid return to work, lack of complications and without months of tedious box rest and controlled exercise. The x-rays below were taken before surgery (left) and 2 months later (right), at which time the horse was back in full ridden work. They show enlargement of all the spaces between the DSPs, indicating the technique is effective at removing the pain and hence the muscular spasm which, in our opinion, is largely to blame for causing the kissing spines.

It should be noted that there are a number of other causes of back pain which need to be ruled out. A thorough examination and x-rays need to be taken to make sure that kissing spines are the important element in the back pain, something we are developing considerable expertise with at Cotts.