Horse Kissing Spines: Advanced Diagnosis and Surgical Outcomes

Overriding dorsal spinous processes (kissing spines) cause significant pain in horses — advances in diagnosis and surgical treatment are improving outcomes.

Key Facts

Kissing spines affect an estimated 39% of riding horses when radiographically screened
Many horses with radiographic kissing spines show no clinical signs, complicating diagnosis
Pain assessment using grimace scales and ridden horse pain ethograms improves detection accuracy
Conservative treatment (physiotherapy, corticosteroid injections) helps mild to moderate cases
Surgical interspinous ligament desmotomy success rates of 70-80% are reported for refractory cases
Post-surgical rehabilitation requires 4-6 months of structured exercise before return to work
Saddle fit assessment is essential — poor fitting saddles exacerbate kissing spine discomfort

Welfare Considerations

Kissing spines represent one of the most prevalent and underdiagnosed sources of chronic back pain in sport and leisure horses. The disconnect between radiographic findings and clinical signs creates welfare risks: horses with pain-related behavioral changes are sometimes labeled difficult or disobedient rather than receiving appropriate diagnostic workup. Modern ridden horse pain ethograms provide standardized behavioral indicators that improve pain recognition without relying solely on imaging. Treatment selection should prioritize welfare outcomes — freedom from pain and ability to perform without discomfort — over return-to-competition speed.

What You Can Do

Have any horse with back pain or behavioral changes under saddle assessed by a veterinarian for spinal issues
Ensure regular saddle fit checks by a qualified saddle fitter to prevent mechanical pain contribution
Learn the ridden horse pain ethogram signs to recognize potential back pain during riding
Support research into non-surgical treatment protocols that maintain pain-free working lives for horses