Kissing Spine

Overriding dorsal spinous processes or “kissing spine” is an ever increasing diagnosis in performance horses. This blog will discuss what a kissing spine is as well as touch on diagnosis and treatment options.

A kissing spine is an issue that is diagnosed with varying degrees of back discomfort. It is often most severe at thoracic vertebrae 15, or the anticlinal vertebrae. This is the portion of the spine where the vertebrae change orientation and allow more rotation of the spine.

It is also commonly where the back of the saddle lies which puts more pressure on that area. A diagnosis is made by physical exam and radiographs. Radiographs show varying degrees of space narrowing between vertebrae, sclerotic (overly hard) bone or osteoclastic (resorptive) bone.


As modern medicine progresses and we learn more about our performance horses, we know that upwards of 60% of them have a radiographic diagnosis of a kissing spine. How do we know if this is the true cause of discomfort or not? A thorough lameness exam is necessary to rule out other causes of lameness that can cause compensatory back soreness such as hock or stifle osteoarthritis.



Treatment of this condition is often multimodal. Combinations of anti-inflammatories (bute, equioxx), muscle relaxers, injections and acupuncture are aimed at helping patient comfort. However, it is important to remember that this is not correcting the anatomic problem. Osphos is a medication that can be used in patients with bone resorptive lesions. A surgical procedure can be performed call an interspinous ligament desmotomy. The pain from this condition often originates from where the nerves within the interspinous ligament attach to the bone. This procedure is done in the sedated, standing horse where the interspinous ligaments are cut so that the tension and thus pain in this area is relieved.

A mainstay of post operative care as well as maintenance of this condition is appropriate exercise and conditioning. The patient’s topline is targeted to offer strength and stability around the affected area. A Pessoa system is a commercially offered tool that can be used to encourage the horse to use these muscles (Check out our previous blog on developing your horse’s core).

Please do not hesitate to contact Cornerstone Equine for any questions about your horse or this condition!

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