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Home / Equine Research Bank / Animals (Basel) / Impinging and Overriding Spinous Processes in Horses: A Narr...
Animals : an open access journal from MDPI2025; 15(18); 2679; doi: 10.3390/ani15182679

Impinging and Overriding Spinous Processes in Horses: A Narrative Review.

Abstract: The term overriding spinous processes (ORSPs), commonly known as "kissing spine syndrome," refers to a skeletal abnormality in horses that is characterized by the narrowing (<4 mm) of the interspinous space and touching or overlapping of the spinous processes (SPs). This condition primarily affects the mid- and caudal thoracic vertebrae; however, ORSP can also affect the lumbar SPs. In the veterinary community, kissing spine is widely recognized as a common condition in sport horses, as it is often associated with chronic back pain and contributes to poor performance. Despite its significant clinical implications, the true incidence of pain arising from ORSPs in the equine population remains speculative and the demonstrated lack of correlation between diagnostic imaging findings and clinical signs complicates the clinical scenario. Over the years, several treatment approaches, both conservative and surgical, have been suggested to manage ORSP in horses. Although the development of these therapeutic strategies reflects ongoing efforts to address the complex nature of ORSP, the pathogenesis of the condition remains poorly understood. The aim of this review is to examine the literature to evaluate the current approaches to ORSPs and to highlight gaps in knowledge and directions for future research to improve the understanding, diagnosis, and treatment of this condition.
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Publication Date: 2025-09-13 PubMed ID: 41007924PubMed Central: PMC12466526DOI: 10.3390/ani15182679Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Impinging and Overriding Spinous Processes in Horses: A Narrative Review

Overview

  • This research article reviews the condition of overriding spinous processes (ORSPs), also known as “kissing spine syndrome,” in horses, focusing on its clinical implications, diagnosis challenges, and treatment methods.
  • The study aims to evaluate current knowledge, identify gaps, and suggest directions for future research to enhance understanding and management of ORSPs in equine medicine.

What are Overriding Spinous Processes (ORSPs)?

  • ORSPs are a skeletal abnormality characterized by a narrowing (less than 4mm) of interspinous spaces—the gaps between spinous processes (SPs) of vertebrae in horses.
  • This condition causes the spinous processes to touch or overlap, hence the term “kissing spine syndrome.”
  • It most commonly affects the mid- and caudal thoracic vertebrae, but can also involve lumbar spinous processes.

Clinical Significance in Horses

  • ORSP is widely recognized in sport horses and is often linked to chronic back pain and reduced performance.
  • Despite recognition, the actual incidence of pain caused by ORSPs in the horse population is not well-established.
  • A significant challenge exists due to the lack of clear correlation between diagnostic imaging results and the clinical signs exhibited by horses with ORSPs.

Diagnosis Challenges

  • Diagnostic imaging techniques (such as radiography, ultrasound, or advanced imaging) might show ORSPs without corresponding clinical symptoms, complicating diagnosis.
  • This discrepancy results in difficulty determining if ORSP is truly the cause of a horse’s back pain or poor performance.
  • Further research is needed to develop diagnostic criteria that better predict clinical relevance of imaging findings.

Treatment Approaches

  • Both conservative and surgical treatment options have been developed to manage ORSPs in horses.
  • Conservative treatments may include rest, physical therapy, anti-inflammatory medications, and corrective shoeing or saddle fitting.
  • Surgical options might involve procedures like spinous process resection or interspinous ligament desmotomy aimed at reducing pain and improving spinal function.
  • Despite these options, no consensus exists on the most effective treatment, partly due to incomplete understanding of the condition’s pathogenesis.

Knowledge Gaps and Future Directions

  • The pathogenesis or underlying cause and development of ORSP remains poorly understood.
  • There is a need for more rigorous studies correlating clinical signs with imaging findings to improve diagnostic precision.
  • Further evaluation of treatment outcomes is necessary to establish evidence-based protocols for managing ORSP in horses.
  • Future research may explore molecular, biomechanical, and genetic factors contributing to ORSP development and progression.
  • Improved understanding will aid in developing preventive strategies, better diagnostic tools, and optimized therapeutic interventions.

Summary

  • This review highlights that while ORSP is commonly recognized as a cause of back pain in horses, significant uncertainty remains about its diagnosis and treatment.
  • Clinicians should be cautious interpreting imaging findings in isolation and consider a comprehensive clinical assessment.
  • Advancing research in this field will be crucial to improve welfare and performance of sport horses affected by this condition.

Cite This Article

APA
Pilati N, Pressanto MC, Palumbo Piccionello A, De Angelis Corvi F, Beccati F. (2025). Impinging and Overriding Spinous Processes in Horses: A Narrative Review. Animals (Basel), 15(18), 2679. https://doi.org/10.3390/ani15182679

Publication

Animals : an open access journal from MDPI
ISSN: 2076-2615
NlmUniqueID: 101635614
Country: Switzerland
Language: English
Volume: 15
Issue: 18
PII: 2679

Researcher Affiliations

Pilati, Nicola
  • School of Bioscience and Veterinary Medicine, University of Camerino, via Circonvallazione 93/95, 62024 Matelica, Italy.
Pressanto, Maria Chiara
  • Sports Horse Research Center, Department of Veterinary Medicine, University of Perugia, via San Costanzo 4, 06126 Perugia, Italy.
Palumbo Piccionello, Angela
  • School of Bioscience and Veterinary Medicine, University of Camerino, via Circonvallazione 93/95, 62024 Matelica, Italy.
De Angelis Corvi, Francesco
  • Sports Horse Research Center, Department of Veterinary Medicine, University of Perugia, via San Costanzo 4, 06126 Perugia, Italy.
Beccati, Francesca
  • Sports Horse Research Center, Department of Veterinary Medicine, University of Perugia, via San Costanzo 4, 06126 Perugia, Italy.

Conflict of Interest Statement

The authors declare no conflicts of interest.

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