Equine back problems are considered to be a significant cause of poor performance in today's equine athlete, with impinging spinous processes (ISP; ‘kissing spines’) being the most common diagnosis. The aetiology of pain caused by ISP is poorly understood and requires further research. A robust diagnostic workup including exclusion of lameness, diagnostic anaesthesia and radiography will assist the veterinary surgeon in arriving at a secure diagnosis of clinically significant impinging spinous processes. Nuclear scintigraphy can also be utilised. Medication with corticosteroids is frequently used both therapeutically and diagnostically. Surgical options include subtotal ostectomy of the affected spinous processes or interspinous ligament desmotomy. Good success rates are seen with both and the option chosen will depend on the case and surgeon preference.

Andy Fiske-Jackson - Senior Lecturer, RCVS and European Specialist in Equine Surgery, Equine Referral Hospital, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire AL9 7TA