Impingement of the dorsal spinous processes in two hundred and fifteen horses: case selection, surgical technique and results.
Authors: Walmsley J P, Pettersson H, Winberg F, McEvoy F
Journal: Equine veterinary journal
Summary
# Editorial Summary Dorsal spinous process (DSP) impingement remains a challenging diagnosis in equine practice, and this 2002 multicentre study of 215 cases provides valuable guidance on case selection and surgical outcomes. Diagnosis was established through clinical examination combined with radiography and diagnostic analgesia, with scintigraphy used selectively; importantly, surgery was reserved for horses that had failed conservative management (comprising 3–9 months rest, intralesional corticosteroid injection and physiotherapy), reflecting a pragmatic approach to case selection. Using an oscillating saw via midline approach, surgeons resected between one and six DSPs per horse, most commonly affecting T15, 16 and 17, with a structured postoperative rehabilitation protocol involving lungeing at 2 weeks and ridden work from 3 months onward. Long-term follow-up of 209 horses showed that 72% returned to full athletic work, with a further 9% sufficiently improved for limited use—a meaningful success rate that justifies the surgical intervention when conservative methods fail. These findings suggest that appropriate case selection through multimodal diagnostics, combined with a graded rehabilitation programme, offers a reliable pathway for managing this painful condition in performance horses.
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Practical Takeaways
- •Surgery for dorsal spinous process impingement has an 81% success rate for returning horses to work, but conservative treatment (3-9 months rest, intralesional corticosteroids, physiotherapy) should be attempted first
- •Post-surgical rehabilitation is protracted—plan for 3-6 months recovery with controlled lungeing before returning to riding
- •Clinical examination combined with radiography and diagnostic analgesia is sufficient for case selection; scintigraphy may aid diagnosis but is not essential
Key Findings
- •72% of 209 horses with long-term follow-up returned to full work after surgical resection of impinged dorsal spinous processes
- •9% of cases improved sufficiently for some athletic use, bringing total success rate to 81%
- •Thoracic vertebrae 15, 16, and 17 were the most commonly affected sites requiring resection
- •Horses required 3 months to return to riding and 6 months for full recovery in most successful cases