46TH
ANNUAL
CONGRESS
OF
THE
SAEVA
SKUKUZA
16-‐20
FEBRUARY
2014
129
often obliquely arranged, cranial left to caudal right or cranial right to caudal left.
The bone of the dorsal spinous processes is remarkably soft and it is quite possible
to split the spinous processes with stout scissors. We have done this, and treated it
by removal of the affected bone using rongeurs. Again, this is quite possible to do
through a relatively small incision. Intraoperative radiography is recommended and
is used far more frequently than when doing the traditional more open procedure.
Skin closure alone is sufficient and we usually use two or three simple interrupted
sutures of monofilament nylon.
Post operatively; horses have made very good progress. It is normal for horses to
show significant postoperative pain following conventional open surgery of the dorsal
spinous process. Following the minimally invasive procedure post-operative pain is
unusual. Horses generally are discharged the following day with oral antibiotics and
analgesics. We usually recommend three weeks of box rest, followed by three
weeks of light lunging exercise, prior to reassessment and reintroduction of ridden
exercise.
We have observed one case of sub optimal wound healing. One-horse developed
swelling and focal pain possibly associated with infection of adjacent bone. This
resolved satisfactorily with antibiotic treatment and rest but did take some time.
The procedure was unpopular with the client, as they had anticipated a very limited
convalescence.
We have performed this procedure on 18 horses. The results are comparable to
conventional open surgery. One horse has been put down, as the clinical signs of
backing severely were not altered by surgery. Two horses have been put down after
developing other lameness. One horse represented for conventional open surgery,
which was performed, despite radiographically much improved appearance. Of 11
horses with appropriate follow up, 6 have excellent results, based on telephone
follow up. It is quite frequent to be told how the horse’s personality has been
transformed, and a miserable horse has now become a delight to own. Exactly as
with conventional “open” surgery, conducting follow up on Kissing Spines cases is
enormously satisfying, due to the enthusiasm of owners for the procedure. My
personal favourite was a client who described the surgery as “the most successful
operation they had ever had done”, which considering they had also had a horse
with a colon torsion which was still alive three years later seemed a little surprising.
References
1.
Coomer RPC, McKane SA, Smith N, VANDEWEERD J-ME. A Controlled Study Evaluating a
Novel Surgical Treatment for Kissing Spines in Standing Sedated Horses. Vet Surg 2012:n/a–
n/a.
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