Kissing Spin in lumbar area... Ulcers... lameness..

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lelabell

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Just looking for some info/advice/reassurance really!

Ive found my mare has gotten really grumpy and tetchy and touchy in the last two months. I have also thought shes a bit short in her stride in her back legs (not enough to get a vet out).
I got the vet out for her grumpiness, as the vet thought she may have hormone issues/ovarian tumours and she agreed something wasn't right as she was soooo touchy!
Bloods came back fine, so vet wanted to scope for ulcers.
She had the physio out and they were going over her back and she was fine until they got to the lumbar area and my mare went wild!
We walked her around and she was def more lame than "just not right". My mare has now been referred to a different vet as physio thinks she may have kissing spine in her lumbar processes and ulcers.

I can't find much info on lumbar kissing spine though... has anyone come across this?
 
lelabell said:
Just looking for some info/advice/reassurance really!

Ive found my mare has gotten really grumpy and tetchy and touchy in the last two months. I have also thought shes a bit short in her stride in her back legs (not enough to get a vet out).
I got the vet out for her grumpiness, as the vet thought she may have hormone issues/ovarian tumours and she agreed something wasn't right as she was soooo touchy!
Bloods came back fine, so vet wanted to scope for ulcers.
She had the physio out and they were going over her back and she was fine until they got to the lumbar area and my mare went wild!
We walked her around and she was def more lame than "just not right". My mare has now been referred to a different vet as physio thinks she may have kissing spine in her lumbar processes and ulcers.

I can't find much info on lumbar kissing spine though... has anyone come across this?
Click to expand...

I think its fairly common between T11-L2 horses, but normally found in the thoracic region as that is where the largest processes are located. Xrays will show if there are any processes affected and then you may be given the option of working the horse long and low which stretches out the processes over a period of time, or surgery -cutting of the ligaments between the processes. Shockwave in some cases has shown to be beneficial - also steroid injections in the processes to help with pain combined with physio exercises, box rest and a period of rehab.
 
My vet tells me that long term results for the ligament cutting operation are bad, HB, and that it is no longer recommended.


Lelabell, ulcers are pretty much normal with kissing spines. You need some x rays to confirm they are there and help decide what treatment is appropriate.
 
Girlracer's horse has just gone through KS surgery, ulcer treatment and had the SI medicated - might be worth giving her a message.

(I'm not sure if it was the lumbar or the thoracic area though)
 
ycbm said:
My vet tells me that long term results for the ligament cutting operation are bad, HB, and that it is no longer recommended.
Click to expand...

sorry to hijack the post but this is an op that is certainly still being carried out, do you have a link to any research that shows this? Only asking as friends young mare has been recommended at local vet school (Scotland) this op and they are undecided atm.
 
I can ask tomorrow when I'm having my colt gelded, but when she spoke to me she had just been on a days CPD training all about backs and was very agitated that two local practices are still doing the operation. She said it weakens the back, which is hardly surprising really.

I've had it done to one of mine and it provided immediate relief, but he had to be put down for other reasons before the long term result could be known. I would not have it done again, I would insist on process removal or shaving.

I have found this in a book, which may help your friends.

Interspinous ligament desmotomy was described recently for treatment of impinged spinous processes and has been compared with treatment with interspinous corticosteroid injections. Most horses in both the surgical and medical treatment groups in this study initially had resolution of signs of back pain; however, back pain recurred in approximately 50% of the horses treated medically and in none of the horses treated surgically. Repeat radiographs in the interspinous desmotomy cases indicated that the interspinous spaces had significantly widened postoperatively. The authors hypothesized that reduced epaxial muscle tone or core stability may play an important role in the pathogenesis of impinged spinous processes and suggested that postoperative exercise aimed at restoring core stability was an essential part of the surgical treatment; however, the role of muscle activation was not assessed. In humans, the interspinous ligaments and multifidi muscles are highly innervated and reportedly play a significant role in segmental spinal stability. When damaged or atrophied, these structures often contribute to the recurrence of chronic back pain. The severity of interspinous ligament degeneration in humans is associated with decreased segmental mobility and increased intervertebral disk and articular facet degeneration. Therefore it is of concern that segmental spinal instability produced by interspinous desmotomy may in the long term actually aggravate back pain and stimulate development of adjacent articular facet osteoarthritis. Articular facet osteoarthritis is considered a contraindication for surgery, as removal of the affected spinous processes and subsequent segmental instability will likely aggravate any existing osteoarthritis. Future studies are needed to critically evaluate the effectiveness of interspinous desmotomy and spinous process resection in horses with and without evidence of articular facet osteoarthritis and with and without the adjunctive benefits of therapeutic exercise directed at improving segmental and overall core stability.
 
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ycbm said:
I can ask tomorrow when I'm having my colt gelded, but when she spoke to me she had just been on a days CPD training all about backs and was very agitated that two local practices are still doing the operation. She said it weakens the back, which is hardly surprising really.

I've had it done to one of mine and it provided immediate relief, but he had to be put down for other reasons before the long term result could be known. I would not have it done again, I would insist on process removal or shaving.

I have found this in a book, which may help your friends.

Interspinous ligament desmotomy was described recently for treatment of impinged spinous processes and has been compared with treatment with interspinous corticosteroid injections. Most horses in both the surgical and medical treatment groups in this study initially had resolution of signs of back pain; however, back pain recurred in approximately 50% of the horses treated medically and in none of the horses treated surgically. Repeat radiographs in the interspinous desmotomy cases indicated that the interspinous spaces had significantly widened postoperatively. The authors hypothesized that reduced epaxial muscle tone or core stability may play an important role in the pathogenesis of impinged spinous processes and suggested that postoperative exercise aimed at restoring core stability was an essential part of the surgical treatment; however, the role of muscle activation was not assessed. In humans, the interspinous ligaments and multifidi muscles are highly innervated and reportedly play a significant role in segmental spinal stability. When damaged or atrophied, these structures often contribute to the recurrence of chronic back pain. The severity of interspinous ligament degeneration in humans is associated with decreased segmental mobility and increased intervertebral disk and articular facet degeneration. Therefore it is of concern that segmental spinal instability produced by interspinous desmotomy may in the long term actually aggravate back pain and stimulate development of adjacent articular facet osteoarthritis. Articular facet osteoarthritis is considered a contraindication for surgery, as removal of the affected spinous processes and subsequent segmental instability will likely aggravate any existing osteoarthritis. Future studies are needed to critically evaluate the effectiveness of interspinous desmotomy and spinous process resection in horses with and without evidence of articular facet osteoarthritis and with and without the adjunctive benefits of therapeutic exercise directed at improving segmental and overall core stability.
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Thanks, I know that the critical thing is with all treatment for over riding spinous processes is the rehab. I think I read recently that at the RVC all horses have an initial 6 month medical treatment and rehab before they will consider surgery at all.

Sorry OP :)
 
Update on post -

mare had her scope done and she has grade 2/3 glandular pyloric ulcers. :(
She also was trotted up and xrayd which shows she has arthritic changes in her hock :(

She is on a 6 week course of peptizole and then back for re-scoping in March. If she is still lame then we will bone scan her and see if she needs injection in her hock.
Her spine looked lovely - as far as processes go ;)
 
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