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Home / Equine Research Bank / Vet Rec / International survey of equine orthopaedic specialists revea...
The Veterinary record2024; 194(10); e3899; doi: 10.1002/vetr.3899

International survey of equine orthopaedic specialists reveals diverse treatment strategies for horses with overriding spinous processes.

Abstract: Overriding spinous processes, also known as 'kissing spines', are one of the most common causes of back pain in horses. The aim of this study was to investigate which options for diagnosis and treatment are preferred by equine orthopaedic specialists and assess which techniques are used for local injection. An online survey was distributed among members of the European/American College of Veterinary Surgeons, the European/American College of Veterinary Sports Medicine and Rehabilitation, the International Society of Equine Locomotor Pathology and nationally recognised advanced equine orthopaedic practitioners. The survey was completed by 353 respondents. The injection techniques most commonly used involve placing two needles abaxial to the interspinous space (42%) under ultrasonographic guidance (32%) or one needle in the midline (35%) between two spinous processes. The most popular combination for overriding dorsal spinous process therapy was local injection (26.7%) combined with controlled exercise (25.5%). Manual therapy was considered by 42% of European and 25% of American specialists (p = 0.01). Surgical intervention as a first-line treatment was recommended mainly by specialists working in the United States, the UK or Ireland (p = 0.001). Overall, most equine orthopaedic veterinarians (71%; n = 201) preferred conservative management and recommended surgery only for horses that did not respond to conservative therapy. Respondents' personal bias may have skewed the findings. Despite a growing body of evidence, the therapeutic approach to 'kissing spines' in horses is influenced by professional specialisation and regional preferences. Variations in injection techniques and differing criteria for surgical intervention warrant further investigation.
© 2024 The Authors. Veterinary Record published by John Wiley & Sons Ltd on behalf of British Veterinary Association.
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Publication Date: 2024-02-20 PubMed ID: 38379241DOI: 10.1002/vetr.3899Google 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.

The research article surveyed international equine orthopaedic specialists about their preferred diagnosis and treatment strategies for horses with ‘kissing spines’, a condition causing horse back pain. The majority of respondents preferred conservative management techniques, however, regional and professional specialisation influenced treatment preferences.

Research Methodology

  • The primary research method was an online survey. This survey was distributed to key professional groups operating within the equine orthopedic field. These groups included the European/American College of Veterinary Surgeons, the European/American College of Veterinary Sports Medicine and Rehabilitation, the International Society of Equine Locomotor Pathology and nationally recognised advanced equine orthopaedic practitioners.
  • In total, 353 professionals in the field responded to the survey. This robust sample allowed a greater understanding of regional and disciplinary differences in treatment strategies.

Results and Findings

  • Survey data indicated variation in the method of local injection. The majority of specialists placed two needles abaxial to the interspinous space (42%), often under ultrasonographic guidance (32%). Alternatively, 35% of respondents opted to use one needle in the midline situated between two spinous processes.
  • The dominant treatment strategy for ‘kissing spines’ involved a combination of local injection (26.7%) and controlled exercise (25.5%).
  • Manual therapy was a treatment option considered by many European specialists (42% of respondents), however, only 25% of American specialists indicated they would opt for this approach.
  • First-line surgical intervention was a preferred strategy for specialists located in the United States, the UK or Ireland.
  • Overarching, the majority of equine orthopaedic veterinarians (71%; n = 201) recommended conservative treatment methods. Surgery was viewed as the last resort, applicable only in cases where horses did not respond to conservative therapy.

Conclusions

  • The study concluded that diverse approaches are used in the treatment of ‘kissing spines’ in horses, influenced by regional preferences and professional specialisation.’
  • The variations in injection techniques and differing criteria for surgical intervention warrant further investigation. This indicates that the field lacks a universally accepted treatment guideline for this common condition in horses, possibly affecting the quality and outcomes of treatment.

Cite This Article

APA
Treß D, Lischer C, Merle R, Ehrle A. (2024). International survey of equine orthopaedic specialists reveals diverse treatment strategies for horses with overriding spinous processes. Vet Rec, 194(10), e3899. https://doi.org/10.1002/vetr.3899

Publication

The Veterinary record
ISSN: 2042-7670
NlmUniqueID: 0031164
Country: England
Language: English
Volume: 194
Issue: 10
Pages: e3899

Researcher Affiliations

Treß, Dorothea
  • Equine Clinic, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
Lischer, Christoph
  • Equine Clinic, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
Merle, Roswitha
  • Institute for Veterinary Epidemiology and Biostatistics, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
Ehrle, Anna
  • Equine Clinic, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.

MeSH Terms

  • Animals
  • Horses
  • Horse Diseases / therapy
  • Surveys and Questionnaires
  • Veterinarians / psychology
  • Veterinarians / statistics & numerical data
  • Orthopedics / veterinary
  • Humans
  • Internationality
  • Europe

References

This article includes 35 references
  1. Jeffcott LB. Disorders of the thoracolumbar spine of the horse—a survey of 443 cases.. Equine Vet J 1980;12(4):197–210.
  2. Mayaki AM, Intan‐Shameha AR, Noraniza MA, Mazlina M, Adamu L, Abdullah R. Clinical investigation of back disorders in horses: a retrospective study (2002–2017).. Vet World 2019;12(3):377–381.
  3. Denoix J‐M, Dyson SJ. Thoracolumbar Spine.. In: Diagnosis and Management of Lameness in the Horse. 2011. p. 592–605.
  4. Coomer RP, McKane SA, Smith N, Vandeweerd JM. A controlled study evaluating a novel surgical treatment for kissing spines in standing sedated horses.. Vet Surg 2012;41(7):890–897.
  5. Cousty M, Retureau C, Tricaud C, Geffroy O, Caure S. Location of radiological lesions of the thoracolumbar column in French trotters with and without signs of back pain.. Vet Rec 2010;166(2):41–45.
  6. Walmsley JP, Pettersson H, Winberg F, McEvoy F. Impingement of the dorsal spinous processes in two hundred and fifteen horses: case selection, surgical technique and results.. Equine Vet J 2002;34(1):23–28.
  7. Zimmerman M, Dyson S, Murray R. Close, impinging and overriding spinous processes in the thoracolumbar spine: the relationship between radiological and scintigraphic findings and clinical signs.. Equine Vet J 2012;44(2):178–184.
  8. Brown KA, Davidson EJ, Ortved K, Ross MW, Stefanovski D, Wulster KB. Long‐term outcome and effect of diagnostic analgesia in horses undergoing interspinous ligament desmotomy for overriding dorsal spinous processes.. Vet Surg 2020;49(3):590–599.
  9. Ehrle A, Ressel L, Ricci E, Merle R, Singer ER. Histological examination of the interspinous ligament in horses with overriding spinous processes.. Vet J 2019;244:69–74.
  10. van Zadelhoff C, Ehrle A, Merle R, Jahn W, Lischer C. Thoracic processi spinosi findings agree among subjective, semiquantitative, and modified semiquantitative scintigraphic image evaluation methods and partially agree with clinical findings in horses with and without thoracolumbar pain.. Vet Radiol Ultrasound 2019;60(2):210–218.
  11. Clayton HM, Stubbs NC. Enthesophytosis and impingement of the dorsal spinous processes in the equine thoracolumbar spine.. J Equine Vet Sci 2016;47:9–15.
  12. Erichsen C, Eksell P, Holm KR, Lord P, Johnston C. Relationship between scintigraphic and radiographic evaluations of spinous processes in the thoracolumbar spine in riding horses without clinical signs of back problems.. Equine Vet J 2004;36(6):458–465.
  13. Jeffcott LB. Radiographic features of the normal equine thoracolumbar spine.. Vet Radiol 1979;20(3‐6):140–147.
  14. Townsend HG, Leach DH, Doige CE, Kirkaldy‐Willis WH. Relationship between spinal biomechanics and pathological changes in the equine thoracolumbar spine.. Equine Vet J 1986;18(2):107–112.
  15. Pressanto MC, Pepe M, Coomer RPC, Pilati N, Beccati F. Radiographic abnormalities of the thoracolumbar spinous processes do not differ between yearling and trained Thoroughbred horses without perceived back pain.. J Am Vet Med Assoc 2023;261(6):844–851.
  16. Garcia‐Lopez JM. Neck, back, and pelvic pain in sport horses.. Vet Clin North Am Equine Pract 2018;34(2):235–251.
  17. Riccio B, Fraschetto C, Villanueva J, Cantatore F, Bertuglia A. Two multicenter surveys on equine back pain 10 years apart.. Front Vet Sci 2018;5:195.
  18. Jeffcott LB. Symposium on back problems in the horse. (2) The diagnosis of diseases of the horse's back.. Equine Vet J 1975;7(2):69–78.
  19. Zimmerman M, Dyson S, Murray R. Comparison of radiographic and scintigraphic findings of the spinous processes in the equine thoracolumbar region.. Vet Radiol Ultrasound 2011;52(6):661–671.
  20. Haussler KK. Equine manual therapies in sport horse practice.. Vet Clin North Am Equine Pract 2018;34(2):375–389.
  21. Paulekas R, Haussler KK. Principles and practice of therapeutic exercise for horses.. J Equine Vet Sci 2009;29(12):870–893.
  22. Wilson JM, McKenzie E, Duesterdieck‐Zellmer K. International survey regarding the use of rehabilitation modalities in horses.. Front Vet Sci 2018;5:120.
  23. Brink P. Subtotal ostectomy of impinging dorsal spinous processes in 23 standing horses.. Vet Surg 2014;43(1):95–98.
  24. Derham AM, O'Leary JM, Connolly SE, Schumacher J, Kelly G. Performance comparison of 159 Thoroughbred racehorses and matched cohorts before and after desmotomy of the interspinous ligament.. Vet J 2019;249:16–23.
  25. Desbrosse FG, Perrin R, Launois T, Vandeweerd JM, Clegg PD. Endoscopic resection of dorsal spinous processes and interspinous ligament in ten horses.. Vet Surg 2007;36(2):149–155.
  26. Jacklin BD, Minshall GJ, Wright IM. A new technique for subtotal (cranial wedge) ostectomy in the treatment of impinging/overriding spinous processes: description of technique and outcome of 25 cases.. Equine Vet J 2014;46(3):339–344.
  27. Perkins JD, Schumacher J, Kelly G, Pollock P, Harty M. Subtotal ostectomy of dorsal spinous processes performed in nine standing horses.. Vet Surg 2005;34(6):625–629.
  28. Marshall‐Gibson ME, Durham MG, Seabaugh KA, Moorman VJ, Ferris DJ. Survey of equine veterinarians regarding primary equine back pain in the United States.. Front Vet Sci 2023;10:1224605.
  29. Henson FM, Lamas L, Knezevic S, Jeffcott LB. Ultrasonographic evaluation of the supraspinous ligament in a series of ridden and unridden horses and horses with unrelated back pathology.. BMC Vet Res 2007;3:3.
  30. Ramey DW, Daft B. An investigation into the feasibility of interspinous injections in the horse.. J Equine Vet Sci 2003;23(10):440–442.
  31. Chiavaccini L, Cavalcanti M, De Gasperi D, Portela DA. Clinical efficacy of ultrasound‐guided bilateral erector spinae plane block for standing lumbar spinous osteotomy in a horse.. Vet Anaesth Analg 2022;49(5):517–519.
  32. Delgado OBD, Louro LF, Rocchigiani G, Verin R, Humphreys W, Senior M. Ultrasound‐guided erector spinae plane block in horses: a cadaver study.. Vet Anaesth Analg 2021;48(4):577–584.
  33. Dutton H. The corticosteroid laminitis story: 1. Duty of care.. Equine Vet J 2007;39(1):5–6.
  34. Haussler KK, Stover SM, Willits NH. Pathologic changes in the lumbosacral vertebrae and pelvis in Thoroughbred racehorses.. Am J Vet Res 1999;60(2):143–153.
  35. Prisk AJ, Garcia‐Lopez JM. Long‐term prognosis for return to athletic function after interspinous ligament desmotomy for treatment of impinging and overriding dorsal spinous processes in horses: 71 cases (2012–2017).. Vet Surg 2019;48(7):1278–1286.
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