New Surgical Treatment for Kissing Spines Evaluated

Here's some good news for owners of horses with kissing spines: A British research team recently developed a new, minimally invasive treatment method that boasted a 95% success rate in a recent study.

Kissing spines, technically termed overriding dorsal spinous processes (ORDSP), causes mild to severe back pain and can have a negative effect on a horse's ability to work. Several treatment options currently exist, including corticosteroid injections, physical therapy, and surgical resection of the affected vertebra. The latter has the highest success rate; however it can be a risky procedure for the horse and costly for the owner.

Richard Coomer, MA, VetMB, CertES, Dipl. ECVS, MRCVS, an associate practitioner at Cotts Farm Equine Hospital in Pembrokeshire, England, recently developed and evaluated a minimally invasive surgical technique to treat ORDSP in horses. Coomer and colleagues performed a study comparing this new technique with a traditional veterinary treatment for ORDSP, and found that the surgical technique had a higher long-term success rate.

Coomer performed the surgical technique on 37 horses diagnosed with ORDSP, and 38 control horses received a traditional treatment of corticosteroid injections into affected vertebral spaces.

The team found that Coomer's technique, which involves making a 1-centimeter incision near the spine and cutting the interspinous ligament (ISL), appeared to releive back pain: When the ISL is cut, "the horse appears to experience pain relief, which in many cases results in muscle relaxation and the spines to move apart," Commer said.

Further, "rehabilitation (was) critical for success," he said. For the surgical group, rehabilitation included two weeks of stall rest, daily hand walking for three weeks, and lunging for three more weeks. Horses in the medical group had 48 hours paddock turnout and then three weeks of lunging. All horses were evaluated six weeks post-treatment before resuming work.

Long-term follow-up (performed after an average of 379 days) revealed that a 42% success rate for the medical group and a 95% success rate for the surgical group. Radiographs performed on 25 horses showed no changes in horses treated medically, but significant space enlargement in horses treated surgically.

Additionally, Coomer noted, the "surgical technique allowed (affected horses) to return to work without further clinical signs of back pain."

The team believes further study of surgical technique is warranted but also noted that the procedure "proved superior to medical treatment despite being applied to a group of more severely affected horses."

The study, "A Controlled Study Evaluating a Novel Surgical Treatment for Kissing Spines in Standing Sedated Horses," appeared in Veterinary Surgery in June 2012. The abstract is available online.

Disclaimer: Seek the advice of a qualified veterinarian before proceeding with any diagnosis, treatment, or therapy.

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