Therefore, treatment of each individual must address all of the reactions in the body. It is this pattern that we see in kissing spine. Without proper function of these structures, joints may subluxate, cause damage to the capsule, cartilage, tendons, nerves, blood vessels and discs and of course to themselves. The ligaments and muscles surrounding a joint are responsible for joint stability. Pain occurs and eventually changes in the widespread function of the whole body occurs (Chaitow, Modern Neuromuscular Techniques). These reactions include increased tonicity, edema, distortions in the tissue, joint distortions, inflammation, and changes in the nerves, blood and fibers. When the musculoskeletal system becomes strained either from poor confirmation, overuse, asymmetry, trauma, posture imbalances, pathology or negative emotional states, the body responds with a long list of reactions. In order to be diagnosed, anesthetics, radiographs, ultrasound, nuclear scintigraphy and/or thermography are used. Obviously, these symptoms could describe numerous lamenesses or problems and a veterinary diagnosis is needed to be sure. Symptoms include back pain, tight back, being “cold backed”, girthy or agitated when saddling, bucking, bolting, exploding when mounted, refusing to jump or do certain movements, grouchiness, unwillingness to perform, hollowing of the back, unwillingness to go forward, or not accepting the bit. For instance, injuries to the supraspinous ligament are best identified with ultrasound and can cause local thickening and pain. Other contributing factors and lesions will play a part in diagnosis.
Extensive evaluation of all involved structures should be performed even after kissing spine has been found. Kissing spine is also seen in horses that exhibit no back pain. Regardless of the radiographs, confirmation and bio-mechanical limitations may contribute to back stiffness. Horses with obtrusive back pain may have only mild impingement and mild uptake on the nuclear scan. Increased uptake in nuclear scan does not appear to be well correlated with the severity of the clinical signs or the radiographic abnormalities” (Ross & Dyson, Lameness in the Horse). However, “active bone remodeling is not synonymous with pain. Ultrasound is used to view the condition of the ligament whereas x-ray and nuclear scintigraphy (bone scan) are used for viewing the bone remodeling. Lesions are most commonly seen at thoracic vertebra 10 through 18 but have also been seen in lumbar vertebra 1 through 6. Lesions may not be limited just to the summits. Grade 4 being severe sclerosis of the spinous processes, osteolysis and a change in shape of the spinous processes. Grade 3 is severe sclerosis and thickening. Grade 2 is loss of interspinous space with moderate sclerosis. Grade 1 being narrowing of the interspinous space. Dyson as “Impingements of the summits of the spinous processes causing remodeling of the dorsal aspect or an avulsion fracture reflects an insertional lesion of the supraspinous ligaments.” Pressure points between adjacent overriding spines are shown by local inflammation of the bone covering, small bone cysts, and false joint formation. Kissing spine, otherwise known as the Overriding of the Dorsal Spinous Processes is defined in Diagnosis and Management of the Lameness in the Horse by Mike Ross and Sue J. It is estimated that as many as 80% of all horses have some touching of the dorsal spinous processes at some point in their life.
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