Desmotomy of the Interspinous Ligament in Standing Sedated Horses to Treat Kissing Spines: 142 Horses

Introduction
Overriding dorsal spinous processes (ORDSP), also known as ‘kissing spines’, is one of the commonest findings in horses suffering from back pain. Current surgical treatments carry a favourable prognosis but are invasive, costly and have prolonged rehabilitation times. Many favour regular medical treatment as a result. This paper reviews the results of minimally invasive interspinous ligament desmotomy (ISLD), as an alternative treatment for ORDSP.

Technique
All narrowed spaces were treated using the technique described by Coomer et al (2012). Under standing sedation, each surgical site was infiltrated with local anaesthetic. A 1 cm skin incision was made 2.5 cm left of midline and Mayo scissors then used to penetrate the dorsal fascia and then cut between adjacent dorsal spinous processes, transecting the dorsal part of the interspinous ligament. The skin was sutured. Horses followed a controlled non- ridden exercise plan focussed on remobilising the back and re-building core strength, including use of professional physiotherapists where possible. The standard time to riding was 6 weeks post-surgery.

Results

1.  Inclusion criteria

Horses were selected by having historical and clinical signs of back pain and poor performance, coupled with a radiographic finding of a minimum 2 or more subjectively narrowed interspinous spaces, graded 1 to 4 (Dyson & Denoix 2011). The presenting signs and diagnostic methods used before surgery are shown.

Eighty-eight (88) geldings, 52 mares and 2 stallions were treated. Median age was 7 years, mean 7.8, range 3 – 17. Breed and use are summarised.  [...]