Impinging dorsal spinal processes (IDSP) can significantly impact horses’ performance. Various treatment modalities are available, ranging from conservative management to anti-inflammatory injections to surgery. Researchers in the U.K. surveyed horse owners from December 2019-February 2020 on their treatment and management approaches to IDSP; 265 owners completed the questionnaire.
This owner-answered survey is helpful to compare against a 2024 survey of orthopedic specialists on diagnostic and treatment modalities for equine back pain.
Owner-Answered Survey Results
The results from the owner-answered survey are as follows:
- Age of diagnosis of IDSP: 41% age 7-10 years; 93% age 3-14 years.
- Breed: Thoroughbreds 35%; warmbloods 27.3%; other sport horses 16.2%; miscellaneous other breeds 21.5%.
- Location of affected vertebrae: 8.1% cranial thoracic; 58.8% caudal thoracic; 7.3% lumbar; 25.8% in more than one location.
- Nearly half the horses returned to their previous level of performance following treatment.
- Treatment modalities: 35.4% received one type of treatment; 36.2% two types; 20.8% three types; and 4.6% four or more different treatments. 3.1% received no treatment.
- Secondary diagnoses occurred in 60.8%, including tarsal joints in 36.2%; sacroiliac pain in 29.3%; suspensory desmitis/desmopathy in 12.3%; stifle pathology in 6.5%; cervical vertebrae pathology in 3.1%; thoracic vertebral arthritis in 1.9%; navicular disease in 1.2%; fetlock arthritis in 1.2%; coffin joint arthritis in 0.8%; and lumbar spondylosis in 0.8%.
Relevance of Number of Affected Vertebrae
Horses with more than one affected vertebra had a lower chance of being treated with corticosteroids. However, the area of spine affected did not correlate with corticosteroid use. There was no association between the number of affected vertebrae or spinal location and use of physiotherapy. Horses with other musculoskeletal problems were more likely to receive physiotherapy.
Horses with more problem vertebrae were more likely to receive surgical treatment. Spinal lesion location also correlated with surgical treatment: Horses with caudal thoracic lesions (T10-18, beneath the saddle) were five times more likely to have surgery compared to horses with lumbar-only pathology.
The affected region and/or the number of vertebrae involved did not correlated with a horse’s return to previous work levels. Horses with additional pathology had a worse prognosis for returning to work: 47.3% with an additional pathology returned to work compared to 58.8% without additional pathologies.
Surgical Intervention
In this survey, surgical intervention was associated with a greater chance of the horse returning to its previous performance level. Other treatment types were not associated with return to work. Other treatment combinations (surgery, corticosteroids, and physiotherapy) improved horses’ chances of returning to work. Surgical intervention doubled the odds of a horse returning to its previous level of activity.
Alternative Treatments and Exercise
Corticosteroids, while commonly used, did not associate with a return to work; further, one study showed 56% of those treated with corticosteroids developed recurrent back pain compared to none of those with surgery. Physiotherapy (electrotherapy, thermotherapy, and manual therapy) also did not associate with return to previous performance demands. The likelihood of returning to work increased tenfold in horses that underwent a tailored exercise plan compared to horses without a modified exercise program that mitigates the adverse effects of ridden exercise. Developing a horse’s core musculature—accomplished by non-mounted exercise, use of raised poles, and treadmill or aqua treadmill work—is important for supporting the spine.
Final Thoughts
Because information for this survey was owner-generated, not all the specific medical details were forthcoming. However, these generalities provide useful perspectives on how to help horses with IDSP continue to perform. Surgical intervention greatly improved outcomes for the horses in this survey.
Reference
Brassington R, Hardy R, Bye T. Long-term effects of treatment and management approaches for impinging dorsal spinous processes. Equine Veterinary Education Sept 2024; DOI: 10.1111/eve.14057
Related Reading
- Diagnostic and Treatment Modalities for Overriding Spinous Processes in Horses
- Equine Lumbosacral Pathology and Back Pain
- Developing Horses’ Core Fitness
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