After the news this week (26 March 2015) that National Hunt star The New One has been diagnosed with kissing spines, we take a look at what it is and how it can be treated

What are kissing spines?

A horse with this condition feels consistent, low-grade pain because the spinous processes, or sections of bone attached to the vertebrae, are too close together and impinge on each other.

Diagnosing kissing spines

“Kissing spines often has very subtle symptoms,” says Dr Kold. “We watch the horse being schooled and look at everything, including the horse’s demeanour, limbs, posture, whether he is accepting the bit, whether he unlocked in his back, and even the expression on his face.

“The trot is often okay, but the horse invariably struggles to maintain a three-beat canter and frequently gets disunited. He may also get irritable when the girth is done up or when you groom his back.”

As well as X-rays and ultra-sonograms, another method of diagnosis is to inject a local anaesthetic between the spinal processes — basically a nerve block — and ask the rider to school the horse and see if it feels different.

What type of horses are affected?

It is predominantly dressage, event and other competition horses who are referred for treatment. This could be because it is more noticeable in performance horses due to the physical demands on them, while in horses just used for hacking and low-level work, the problem may go unnoticed.

Alternatively, it may be that performance horses are more prone to the condition, due to the physical demands placed on them.

Treatment for kissing spines

Surgery is used to rectify the problem. “The operation was developed in the 1980s,” Dr Kold says, “but I have recently modified my technique which, in this case, consists of making two incisions about 8cms long in the back.

“After the incision we cut through the supraspinous ligament. Once all muscular and ligamentous attachments are severed down either side, we cut off around half the spinal processes, removing about three inches of bone. Next, the ligaments and skin are sutured. After the procedure, a void is left, as the bone doesn’t re-grow and a blood clot forms, followed by fibrous tissue.”

But Orthopaedic expert Svend Kold says that deciding whether or not to operate is not always clear-cut. Much depends on the degree of impingement, the individual horse’s tolerance levels and his lifestyle.

“If he’s an athlete and needs to go places, it needs correcting,” he explains.

“The important question is what are people going to do with the horse. Alternatively, can we maintain performance with a twice-a-year steroid injection in combination with physiotherapy and training?”

Equine surgeon Bruce Bladon points out that a colleague in Sweden who has operated on a lot of kissing spines cases has more recently had excellent results — without surgery — with horses sent to a rider experienced in equine rehabilitation and re-schooling.

“This makes sense,” says Bruce. “We’re talking about the normal flexibility of the spine, occasionally resulting in the edges of the bones ‘kissing’. It’s easy to imagine how a different rider or saddle, or increased muscle tone as a result of physiotherapy and a change in work, might prevent this.

“It’s also easy to see how the results of schooling a horse could be so different, depending on the psychology of the rider,” adds Bruce, who believes that kissing spines surgery can, in some cases, have the effect of a placebo.

“The difference in attitude between a rider concerned that their horse is behaving like it is because it has an underlying disease, and a rider who knows that their horse has had surgery for this disease and is now ‘cured’, will be considerable — and quite rightly so.

“But it is major surgery and this has kept a ‘lid’ on the use of the procedure — no-one wants to do it unless they really think it will be beneficial.”