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Spinal Processes and Associated Ligaments in Horses

By

Peter Clegg

, MA, Vet MB, DipECVS, PhD, MRCVS, Veterinary Teaching Hospital, School of Veterinary Sciences, University of Liverpool

Last full review/revision Sep 2015 | Content last modified Oct 2015

Kissing Spines

The most common location of kissing spines is the vertebral segment between T10 and T18, although these lesions are also identified between L1 and L6. Abnormal findings can be seen in the dorsal part of the spinous processes where their identification is easy; they include kissing and overriding lesions. Different grades can be identified (grade 1: narrowing of the interspinal space; grade 2: densification of the margins; grade 3: bone lysis adjacent to the margins; grade 4: severe remodeling). Abnormal findings can also be seen in the ventral part of the spinous processes and may involve the interspinal ligaments or be associated with osteoarthrosis of the articular processes. Their severity can be established using the same grading system; their clinical incidence seems higher.

The incidence of kissing spines seems to vary according to the discipline/use of the horse and biomechanical effects of specific gaits and exercises on the back. In general, these lesions are commonly found in racing Thoroughbreds and seem to be tolerated in many of them. They are quite rare in Standardbreds, but when present, their likelihood of causing pain seems higher. Intermediate frequency and signs are seen in sport horses. Kissing spines can be found in performance race and sport horses without back pain and even with normal thoracolumbar active and passive mobilization. Thus, in each case, the clinical significance of these lesions must be carefully assessed. Diagnosis can be aided by injection of local anesthetic into the affected interspinous spaces. Medical management includes local injections of steroids and/or shockwave therapy, as well as rehabilitation using tolerated exercises after progressive warm-up at a slow canter. Surgical treatment has been advocated for this condition, with surgical resection of the affected spinous processes being most commonly performed and being described as efficacious in managing this condition. A number of differing techniques have been described for this surgical management.

Fractures

Multiple fractures of the spinous processes of T4–T10 are sometimes seen in horses that have reared and fallen over backward. The summits and centers of ossification are fractured and displaced laterally. After the initial pain and local reaction have subsided, recovery is often satisfactory, with usually no permanent effect on performance, although a persistent deformation of the withers may require some adaptation of the saddle.

Desmopathies

Acute or subacute desmopathies can be identified ultrasonographically, because they demonstrate dorsoventral or transverse thickening of the ligament, altered echogenicity, and obvious alteration of the linear longitudinal pattern. They can be seen both in the median plane or asymmetrically. In old or chronic injuries, the ligament often remains thicker, with a reduced echogenicity and an irregular architectural pattern. Hyperechogenic images with or without acoustic shadows are compatible with mineralization or calcification of the supraspinous ligament. Alteration of the bone surface of the top of the spinous processes indicates insertional desmopathy (enthesopathy) of the supraspinous ligament. The significance of findings can be difficult to definitively prove, because ultrasonographic abnormalities can be seen in healthy as well as injured horses.

OTHER TOPICS IN THIS CHAPTER

Lameness in Horses
Overview of Lameness in Horses
The Lameness Examination in Horses
Imaging Techniques in Equine Lameness
Arthroscopy in Equine Lameness
Regional Anesthesia in Equine Lameness
Disorders of the Foot in Horses
Osseous Cyst-like Lesions in the Distal Phalanx in Horses
Bruised Sole and Corns in Horses
Canker in Horses
Fracture of Navicular Bone in Horses
Fracture of Distal Phalanx in Horses
Keratoma in Horses
Laminitis in Horses
Navicular Disease in Horses
Pedal Osteitis in Horses
Puncture Wounds of the Foot in Horses
Pyramidal Disease in Horses
Quittor in Horses
Quarter Crack in Horses
Scratches in Horses
White Line Disease in Horses
Sheared Heels in Horses
Sidebone in Horses
Thrush in Horses
Disorders of the Pastern and Fetlock
Fractures of the First and Second Phalanx in Horses
Fractures of the Proximal Sesamoid Bones in Horses
Osteoarthritis of the Proximal Interphalangeal Joint in Horses
Palmar/Plantar Metacarpal/Metatarsal Nonadaptive Bone Remodeling in Horses
Sesamoiditis in Horses
Chronic Proliferative Synovitis in Horses
Digital Sheath Tenosynovitis in Horses
Disorders of the Metacarpus in Horses
Tendinitis in Horses
Suspensory Desmitis in Horses
Inferior Check Desmitis in Horses
Bucked Shins in Horses
Exostoses of the Second and Fourth Metacarpal Bones in Horses
Fractures of the Small Metacarpal (Splint) Bones in Horses
Fracture of the Third Metacarpal (Cannon) Bone in Horses
Disorders of the Carpus in Horses
Fracture of the Carpal Bones in Horses
Subchondral Bone Disease of the Third Carpal Bone in Horses
Tearing of the Medial Palmar Intercarpal Ligament in Horses
Osteoarthritis of the Carpus in Horses
Distal Radial Exostosis and Osteochondroma of the Distal Radius in Horses
Carpal Hygroma in Horses
Rupture of the Common Digital Extensor Tendon in Horses
Disorders of the Shoulder in Horses
Developmental Diseases of the Shoulder in Horses
Fractures of the Shoulder in Horses
Bicipital Bursitis in Horses
Infection of the Shoulder in Horses
Suprascapular Neuropathy in Horses
Osteoarthritis of the Shoulder in Horses
Disorders of the Elbow in Horses
Developmental Orthopedic Disease in the Elbow of Horses
Fractures of the Elbow in Horses
Osteoarthritis of the Elbow in Horses
Collateral Ligament Injury in the Elbow of Horses
Disorders of the Metatarsus in Horses
Bucked Shins/Dorsal Cortical Fractures of the Third Metatarsal Bone in Horses
Exostoses of the Metatarsal Bones in Horses
Diaphyseal Fracture of the Third Metatarsal Bone in Horses
Incomplete Longitudinal Fractures of the Plantar Aspect of the Third Metatarsal Bone in Horses
Focal Bone Reaction and Avulsion Fractures of the Third Metatarsal Bone in Horses
Fractures of the Second and Fourth Metatarsal Bones in Horses
Enostosis-like Lesions of the Third Metatarsal Bone in Horses
Disorders of the Tarsus in Horses
Failure of Ossification of the Distal Tarsal Bones in Horses
Osteoarthritis of the Distal Tarsal Joints in Horses
Osteoarthritis of the Talocalcaneal Joint in Horses
Osteoarthritis of the Tarsocrural Joint in Horses
Synovitis/Capsulitis of the Tarsocrural Joint in Horses
Osteochondrosis of the Tarsocrural Joint in Horses
Osteitis of the Calcaneus in Horses
Fractures of the Distal Tarsal Bones in Horses
Fracture of the Talus in Horses
Fracture of the Fibular Tarsal Bone (Calcaneus) in Horses
Fracture of the Lateral Malleolus of the Tibia in Horses
Tarsal Joint Luxation in Horses
Desmitis of the Collateral Ligaments of the Tarsus in Horses
Rupture of the Fibularis (Peroneus) Tertius in Horses
Stringhalt
Curb in Horses
Disorders of the Tarsal Sheath in Horses
False Thoroughpin in Horses
Luxation of the Superficial Digital Flexor Tendon from the Tuber Calcanei in Horses
Gastrocnemius Tendinitis in Horses
Calcaneal Bursitis in Horses
Capped Hock
Disorders of the Stifle in Horses
Osteochondrosis of the Stifle in Horses
Subchondral Cystic Lesions in Horses
Meniscus and Meniscal Ligament Injuries in Horses
Cranial and Caudal Cruciate Ligament Injuries in Horses
Collateral Ligament Injuries in Horses
Intermittent Upward Fixation of the Patella and Delayed Patella Release in Horses
Fragmentation of the Patella in Horses
Patellar Luxation in Horses
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