Minimally invasive cranial ostectomy for the treatment of impinging dorsal spinous processes in 102 standing horses.
Authors: de Souza Therese C, Crowe Oliver M, Bowles Danielle, Poore Luke A, Suthers Joanna M
Journal: Veterinary surgery : VS
Summary
# Minimally Invasive Cranial Ostectomy for Impinging Dorsal Spinous Processes Impingement of the dorsal spinous processes (DSPs) remains a challenging diagnosis in equine back pain, and surgical intervention is often necessary when conservative management fails. De Souza and colleagues retrospectively evaluated 102 horses treated with a minimally invasive cranial ostectomy technique performed under standing sedation between 2011 and 2019, using bone rongeurs through multiple small incisions to remove the caudal aspect of the impinging process. Of 66 horses available for long-term follow-up (median 18 months post-operatively), 53 (80%) showed complete resolution of clinical signs and returned to their intended work, with notably higher success rates in horses without concurrent orthopaedic pathology (93% versus 69%). The procedure carried no recorded surgical complications, positioning it as a reliable low-risk alternative to other DSP treatments. For practitioners managing cases of DSP impingement refractory to conservative therapy, this standing technique offers a viable option with strong success rates, particularly where concurrent musculoskeletal issues can be ruled out or managed independently.
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Practical Takeaways
- •Minimally invasive cranial ostectomy performed standing under local anesthesia is a low-risk, effective surgical option for horses with impinging DSPs, with an 80% success rate for return to work
- •Horses with concurrent orthopedic issues have lower success rates (69%) compared to those without other problems (93%), so manage expectations accordingly when additional lameness issues are present
- •This standing procedure avoids general anesthesia risks and may be a practical alternative to other DSP treatment techniques for your practice
Key Findings
- •80% of 66 horses available for long-term follow-up (median 18 months) had complete resolution of clinical signs and returned to intended work
- •93% of horses with no concurrent orthopedic issues presurgery returned to the same level of work, compared to 69% with concurrent orthopedic issues
- •No surgical complications were recorded in any of the 102 horses treated with minimally invasive cranial ostectomy under standing sedation and local anesthesia