Surgical interspinous ligament desmotomy for equine kissing spines provides welfare benefits for horses with severe disease where conservative management is insufficient.
Kissing spines surgical welfare requires careful patient selection to ensure the welfare benefit of surgery outweighs the procedural welfare cost of anesthesia, surgery, and extended rehabilitation. The 70-80% success rate in appropriately selected horses represents genuine welfare improvement — resolution of chronic back pain that limits performance and quality of life. However, inappropriate selection — surgery in horses with concurrent pathology or without adequate conservative management trial — produces poor outcomes that add surgical trauma to existing welfare problems. Pre-operative investigation including sacroiliac assessment and thorough diagnostic workup is the welfare-protective standard.