A controlled study evaluating a novel surgical treatment for kissing spines in standing sedated horses.

This research article compares the effectiveness of a new minor surgical technique with traditional corticosteroid medication for treating horses with kissing spines. Based on the authors’ findings, the surgical technique had a higher success rate, and horses treated with this method were more likely to be free of back pain in the long term.

Research Methodology

• The researchers used a retrospective controlled clinical case series to conduct the study.
• The study involved 68 horses diagnosed with overriding dorsal spinous processes, or ‘kissing spines’, based on medical history, clinical, and radiographic examination.
• All horses had narrowed spaces between the spinous processes treated. The treatment given to each horse depended on the group they were assigned to – one group received corticosteroid injection, while the other had a minimally invasive surgery carried out.
• Those receiving medication had methylprednisolone acetate injected directly into the affected space under radiographic control.
• The surgical cases underwent interspinous ligament desmotomy (ISLD), where the ligament between the dorsal spinous processes was cut using a type of surgical scissors known as Mayo scissors. The supraspinous ligaments were left intact.
• Following treatment, all the horses followed the same controlled exercise plan and resumed work 3-6 weeks after treatment.

Research Findings

• The methylprednisolone was administered in between 1 and 7 spaces in 38 cases, compared with ISLD performed in between 3 and 8 spaces in 37 cases.
• Initial signs of back pain resolved in 34 horses (89%) that were treated with medication, compared to 35 horses (95%) that were treated surgically.
• However, back pain recurred in 19 of the medically treated horses, while none of the surgical horses had a recurrence.
• Horses that had undergone ISLD were found to be 24 times more likely to experience long-term resolution of back pain.
• Interspinous spaces in 19 surgical cases were found to have significantly widened following surgery, based on repeat radiographs.

Research Conclusion

• The novel surgical technique for treating ‘kissing spines’ in horses was found to be effective, as the horses were able to return to work without any further clinical signs of back pain.
• The surgery appeared to make significant improvements to the condition, as shown by radiographic evidence.