Subtotal ostectomy of impinging dorsal spinous processes in 23 standing horses.
Authors: Brink Palle
Journal: Veterinary surgery : VS
Summary
Kissing spines—where the dorsal spinous processes of the caudal thoracic vertebrae become abnormally close or contact each other—causes performance loss in affected horses, yet surgical options remain limited. Palle's 2014 case series evaluated standing subtotal ostectomy in 23 horses, performing the procedure through a dorsal median incision under sedation and local anaesthesia, with intraoperative radiography confirming adequate bone removal before closure. Within the first year, 86% of horses (19/22) achieved full athletic function, with a further 9% showing meaningful improvement, and critically, no serious surgical complications occurred. Longer-term follow-up revealed some deterioration in performance, with one horse initially successful losing full capacity at follow-up beyond 12 months, though most gains persisted. For practitioners managing performance horses with confirmed kissing spines, this work demonstrates that standing subtotal ostectomy offers a viable surgical alternative to general anaesthesia, delivering strong early outcomes and good safety, though realistic owner expectations about potential late-term performance plateaus remain important.
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Practical Takeaways
- •Standing surgical technique for dorsal spinous process removal eliminates general anesthesia risks and recovery complications in horses with withers/back pain affecting performance
- •Realistic owner expectations: while 86% achieve full function short-term, durability is variable—plan for reassessment at 6-12 months post-op
- •Intraoperative radiographic confirmation of bone removal is essential for procedural success and should be standard protocol
Key Findings
- •Subtotal ostectomy of impinging dorsal spinous processes can be safely performed in standing horses with no serious intraoperative complications
- •At <1 year post-surgery, 86% (19/23) of horses returned to full athletic function
- •Long-term follow-up showed variable durability, with some horses maintaining improvement while others declined or showed no sustained benefit