Standing Resection of Impinging and Overriding Dorsal Spinous Processes

Introduction
Although significant advances in imaging techniques have been made over the last 2 decades, notably the improved quality of digital radiographs and nuclear scintigraphic images, the accurate investigation and diagnosis of ‘back pain’ in the horse remains a problem. This should be no surprise given the sheer size and complexity of anatomy. It is important to realise from the outset the limitations of our knowledge, and therefore of our treatment for back disease. If we had magnetic resonance imaging (MRI) available for the horse’s back, there is no doubt it would unlock many diagnoses not currently available, in the same way that MRI of the horse’s foot unlocked problems that were historically often grouped together as ‘navicular disease’.

Despite the frustrations of our current situation there is no doubt that many horses suffer back pain, and that impinging dorsal spinous processes (iDSPs) are one potential cause. Accurate diagnosis depends upon thorough history taking, detailed clinical examination and palpation; where appropriate seeing a ridden assessment of the problem; certainly obtaining good quality radiographs; and in an ideal world supplementary evidence such as response to local anaesthesia and nuclear scintigraphic examination. Ultrasound scan of the soft tissues (including supraspinous ligament, interspinous ligament and epaxial muscles) may also provide useful information. [...]