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Medical Index
First Posted: August 25, 2010
Aug 29, 2018

Overriding of the Dorsal Spinous Processes (Kissing Spine Syndrome) in Horses

by Debora Johnson


Kissing Spines as a Cause of Lameness in Horses by Tracy A. Turner, DVM, MS
Equine Kissing Spine By Laura Wodzinski, DVM, cVMA

Recently my dear friend, Margie, had her horse diagnosed with "kissing spine." In the case of her horse the upshot is that she can keep working her horse just has she has been, however, he will never be able to be a Grand Prix Champion! Nonetheless, the horse has had pain with certain movements and they are now working on the problem.

So what is kissing spine in horses? Like all things spinal, it sometimes takes time and patience to figure out what the problem might be. Kissing spine, simply, is when the dorsal spines are dangerously close or even touching. Often this is associated with a genetic predisposition. The solution is to figure out the elements that are generating the wrong working attitude and create a functional vertebral column alignment, if possible. Horses will often develop certain behavioral problems due to the pain. Even after the pain has been relieved or even has stopped, horses anticipate pain.

Note: The Veterinary Merck Manual describes it like this: "Impingement of the summits of the dorsal spines beneath the saddle area predisposes to back pain in some horses. Pressure points between adjacent overriding spines are shown by local periosteal reaction, small bone cysts, and false joint formation. Radiographic lesions of this type are sometimes seen in horses that do not suffer from back trouble, although incidence is lower and lesions are less severe. Diagnosis can be aided by injection of local anesthetic into the affected interspinous spaces. Many cases respond to rest and physiotherapy, but treatment in persistent cases is by resection of one or more of the summits to relieve the crowding of the spines." Overriding of the Dorsal Spinous Processes (Kissing Spine Syndrome)


While recently, new surgical techniques are offering a solution to the problem of Kissing Spine, the aftermaths of invasive surgery are raising serious questions by comparison to a non-invasive approach that only take a few months. No two problems are exactly the same. In the case of back muscle imbalance the spine can be in damaging alignment. Physical therapy, in this case, might be used in treatment. Physiotherapy may be used as well as rest. In worst cases resection may be necessary.


A veterinarian or experienced horse owner can palpate the back of a horse to pinpoint sources of pain and from there assess the most likely cause. Radiographs (X-Rays) can be used to diagnose potential problems with cracked vertebrae, some forms of arthritis, impinging dorsal spinous processes (kissing spines), and other skeletal problems, although with large, heavily muscled animals this diagnostic modality is limited. Certain types of soft tissue injury can be assessed with other modern diagnostic imaging techniques, such as ultrasound. In addition, Scintigraphy is often very useful in localizing either bony or soft tissue disorders.

For mild problems, it is sometimes useful to ride the horse in a different saddle or without a saddle to see if the problem goes away, but usually a veterinarian or saddle fitter can determine if an ill-fitting saddle is the problem in fairly short order. Failure to obtain a reliable veterinary opinion can lead to further damage if the horse is worked while in pain.


Like humans, back pain in horses may be treated by acupuncture, massage therapy, chiropractic treatments, ultrasound, simple rest, or a combination of any of the above. Drug treatment may also be advised, particularly the use of NSAIDs, or other anti-inflammatory and analgesic medications. In all cases, the first step is to eliminate the root cause of pain to the horse so that the animal is not reinjured after treatment. Degenerative or arthritic back pain is much harder to treat, so prompt attention is advisable in order to avoid a long-term problem.

If it seems the back pain is caused by an ill-fitting saddle, the saddle should be changed or adjusted, though as an interim measure a horse can be ridden without a saddle or with a saddle pad that is either thicker or thinner, as needed to reduce saddle pressure. To avoid causing back pain caused by lack of athletic fitness, gradually build the horse's athletic agility until it is strong enough to avoid getting sore in the back. Back pain related to stress or injury may require rest and time without being ridden, with a gradual return to work.

For More Information:

All About the Horse's Conformation/Part 1
All About the Horse's Conformation/Part 2
All About the Horse's Conformation/Part 3
Horse Hind End Conformation

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