New Minimally Invasive Approach to Treating Kissing Spines

New Minimally Invasive Approach to Treating Kissing Spines

One commonly diagnosed conditions that could cause a horse's poor performance is impingement of the dorsal spinous processes—more commonly known as kissing spines.

Photo: Tracy A. Turner, DVM, MS, Dipl. ACVS

A buck from a seasoned schoolmaster, a refusal from an experienced jumper, or a hollow frame in an upper-level dressage horse could all be signs of a sore back. One commonly diagnosed conditions that could cause a horse's poor performance is impingement of the dorsal spinous processes—more commonly known as kissing spines. In many cases this condition is treatable, and veterinarians frequently perform a subtotal ostectomy (surgically removing part of the offending bone) to make affected horses more comfortable. But a team of veterinarians recently evaluated a different technique's efficacy in alleviating kissing spines pain, with positive results.

Ian Wright, MA, VetMB, DEO, Dipl. ECVS, MRCVS, and his colleagues at Newmarket Equine Hospital, in Suffolk, England, reviewed a new minimally invasive surgical technique for treating kissing spines called a subtotal cranial wedge ostectomy. In the study they evaluated patients' long-term functional and cosmetic outcome post-surgery.

The ostectomy technique involves resecting the upper segment of the affected spinous processes (the most common site on the vertebrae for kissing spines to occur) under general anesthesia by making two angled cuts, creating a pointed apex that is rounded off during surgery. Wright and colleagues believe that by only removing affected bone and preserving normal tissue, they can maintain the horse's normal spinal architecture and thereby reduce the risk of changing the back's cosmetic appearance. Additionally, the team believes that performing the surgery under general anesthesia allows surgeons better access to the affected spinal region, reducing tissue trauma and surgical time.

Wright and his colleagues were able to obtain long-term follow-up information on 19 of 25 horses that underwent the procedure between 2009 and 2011 at Newmarket. Of those, 15 horses showed complete resolution of clinical signs and returned to full work; three horses' clinical signs had improved, but the animals were not in full work; and one horse showed no improvement post-surgery. These results are similar to other published studies, the team said, and support the use of this technique in treating kissing spines.

Wright and colleagues concluded that this technique is an effective method of treating kissing spines, and the reduced surgical time, low complication rate, and favorable cosmetic results offer many advantages to the surgeon, owner, and patient.

The study, “A new technique for subtotal (cranial wedge) ostectomy in the treatment of impinging/overriding spinous processes: Description of technique and outcome of 25 cases,” was published in the Equine Veterinary Journal.

About the Author

Thomas O'Keeffe, MVB, MRCVS

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