Surgical management of equine kissing spines through interspinous ligament desmotomy and bone resection offers significant welfare improvement when conservative management has failed.
Surgical intervention for kissing spines represents a significant welfare investment that is justified when conservative management has failed to provide adequate pain relief. The welfare benefit of successful surgery is substantial: horses that return to comfortable ridden work after years of pain represent a meaningful quality of life improvement. The decision to pursue surgery requires honest assessment of the horse's current welfare status, realistic expectations about surgical outcomes, and commitment to the rehabilitation period that is essential for success. Horses that return to work too quickly following surgery are at high risk of recurrence, and the physiotherapy component of rehabilitation that builds supporting musculature is as important as the surgery itself.