Kissing Spine: Coming Back From a Terrifying Diagnosis

When Richelle Tracht’s mare Bristol started exhibiting signs of anxiety and stress at the higher levels she ruled out saddle fit and lameness only to discover her mare had Kissing Spine. Faced with little information about the procedure, she proceeded with an unnerving surgery. This article was submitted by Richelle so that her experience might help others through a stressful decsion as it relates to diagnosis, surgery, and recovery. 

Richelle and Bristol post-surgery. | Photo by Cortney Drake

Kissing Spine: Is it fiction or fad, or is it time we start digging deeper and listening to what our horses might be telling us?

Bristol is a 15 year old 16.3h Hungarian/TB. I started her as a three year old and focused on dressage which she seemed to enjoy. By the time I retired my eventing mare, I decided to start jumping Bristol for cross-training reasons and for the fact that I just loved it! She was an eight year old late bloomer in her jumping debut, but we had fun training and competing up to Training level for the next few years. I also kept competing in dressage, working toward my medals. 

Diagnosis 

My mare was never nasty about work. She never tried to buck, rear, or kick out. But there were small signs that I knew something was bothering her and affecting her performance. While jumping, her topline slowly started changing in a negative way. Even when I ruled out tack fitting and possible lameness issues, she would choose to surge the last three strides while inverting; causing a harder landing than necessary. It really bothered me since I pride myself on having correct carriage and throughness. Her performance continued down that road, so I finally put a hold on jumping to not further escalate the situation. Although she was never lame, I decided she was better off training strictly in dressage. 

I’m very in tune with my horses and their reactions. Bristol was a trier with a lot of heart, but she is also sensitive and can get very anxious through the body, which shows itself via tension. As the movements became more challenging, I could feel her anxiety build and the work seemingly became more taxing, specifically when I asked her to sit and load her hind for more self-carriage. I especially noticed when I would raise her poll for more collection and a more advanced frame, there was a definite change in her body and mind. Then the grinding started. The tongue started slipping out the side of her mouth. I feared I had met the peak of her skill level. 

January 2018

I contemplated selling Bristol through a local sales barn due to the lack of time while focusing on raising my two very young daughters. The sales barn required a pre-purchase exam in order to start the listing process, so we took 17 radiographs, four with images of her spine. The results blew my mind at the very obvious Kissing Spines in multiple spots of her thoracic, lumbar, and whithers! It’s uncommon to see impingement in the withers according to the vet. I decided to keep Bristol and continue riding her while managing her properly based on what we learned from the radiographs.

Spring 2018

Under my vet Dr. Schneider’s guidance, we continued diagnostics and attempted several treatments including various injections to verify the degree the kissing spines were making her uncomfortable and to see the extent she could continue with work. She seemed fine, but not great, and this trend continued throughout the year.

January 2019

I took her to Dr. Schneider’s clinic at Emerald Downs racetrack and he looked me straight in the eyes and told me: “You either get the surgery or you get a new horse.” That was a lot to hear, but when you trust your vet, you listen. He highly recommended Dr. Cliff Honnas from Texas Equine Hospital in Bryan, Texas. Initially when we injected Bristol to verify if surgery was going to make a big difference for her, I felt relief under saddle. There was an obvious comfort level not normally there and a new swing in her back that was exciting to say the least. As we all know too well, injections won’t be as effective long-term in most cases. This was my answer…surgery. 

Method 

Kissing Spine surgery cuts the bone and ligament between the spinous processes to generate room from the impingement. Even with insurance, it is an expensive endeavor. Before committing I asked a lot of questions to Dr. Honnas, the surgeon. 

Q: What causes Kissing Spine? 

Kissing spine appears to be developmental as no specific cause has been determined. I have xrayed the back of yearling horses and found kissing spine, which would definitely suggest developmental origin. Anecdotally, there are those who suggest it possibly could be caused by riding skeletally immature horses at a young age and causing kissing spine. No one knows for sure. 

Q: What are your thoughts on the Coomer Technique? 

I like my approach because I cut away the bone so that it can’t touch the other dorsal spinous process and never touch again. When I remove the bone, I also remove the ligament that they cut with the Coomer Technique. The Coomer Technique cuts the ligament only, but in my opinion is only potentially useful if the bones are not crushed together or overriding. In these instances, you are unable to get an instrument between the touching or overriding bones to cut the ligament. It’s not physically possible. 

Q: What is your success rate? 

I would say my success rate is 95% or better. If kissing spine is the horse’s actual clinical problem, surgery will fix the horse. 

Q: Have you ever seen a bad outcome from the surgery? 

The only bad outcome I have seen is 4 horses that grew more bone at the cut edge and reimpinged. I have operated over 800 horses and only seen this in 4 horses. Incisional drainage post op is not terribly uncommon but suturing a small surgical towel over the incision has markedly lessened this complication. 

Q: What is the recovery time? 

Recovery time is typically 60 days for 3-5 spaces and up to 90-120 days for 6-9 spaces. 

Q: When would she be back into full work? 

Typically, most are back to full work by 30 days after riding commences. 

Day of Surgery 

Amazingly, Dr. Honnas was able to perform surgery at the Emerald Downs Racetrack Clinic’s surgical room with the help of Dr Schneider, Dr Stenslie, and their team along side him. He flew in on a Thursday night, performed surgery Friday, and then flew back home Saturday. Thankfully with word he was coming, he was able to tack on two additional horses who also needed the surgery. I’m so thankful for that little blessing, because that split the cost of his trip three ways! 

I live about 45 minutes from the track (better than the distance to TX!), which made it an easy morning of loading her up and hauling to the clinic. Once we got there, we signed some papers and they took her back to prep her for the surgery. They began by clipping her and inserting the IV to administer the drugs. I had to get out of there with my nerves. My mom and I went down the road for coffee and food waiting for his text. Once the surgery was in action, it only took about 1.5 hours. I finally got the text (after what seemed like forever), which read, “She’s up, went good!” 

One of my concerns with having the surgery at the track was that once she was up and alert, we would need to load her into the trailer and take her home within 15 minutes. The reason being, there was only one post-surgery recovery stall and no stabling or monitoring overnight on site. That freaked me out a bit (okay a lot!), but both doctors assured me she would be fine trailering home. In fact, Dr. Honnas had done it that way before, although typically when the surgery is done at his clinic he keeps them preferably 7-10 days before shipping them out. Since I wasn’t far, they were positive it was fine. Bristol did amazing, but the bandages were definitely a sight to see! He had stitched towels onto her back over the staples in both areas of withers and thoracic. He said it was the best way to keep the area clean and held together. The ride home was quiet for the most part. 

Post Surgery Fears 

COLIC. I said the most dreaded word in a horse owner’s vocabulary! I quickly unloaded her once we got home and she looked crazed! She was pawing intensely and trying to throw herself down on the grass while being led, and even tried on the asphalt which was scary. I immediately got Dr. Honnas on the phone, and he said to get the vet out fast. We called a local vet, and went through the whole treatment protocol for colic. And, it worked! Like cutting through her spine wasn’t enough on my nervous system, but then throwing colic on top — well that about did me in. Thank the Lord for good vets! 

Post Surgical Care Instructions 

I asked Dr. Honnas on a scale of 1-10, 10 being the worst he’d ever seen, what would he rate her Kissing Spine. He gave the two spots in her withers a 9!! The four spots in the thoracic a 5. It felt great knowing I did the right thing for my horse. 

Rehab 

After talking with both Pegasus Rehabilitation Center and Dr. Honnas, I decided to rehab her myself to save on costs and to have my eye on her the whole time. What can I say? I’m a control freak. Dr. Honnas’ advice was to bring her back like I would any horse coming out of the field from rest: slow with long and low work to strengthen her topline. There were no major restrictions to my surprise. 

Once I got the okay, I started with short lunging work with no guidance, such as side reins or weight on her back for three weeks. I did about four sessions a week with 15-20 minute durations. Then I added the surcingle and side reins for about another two weeks to slowly add in the connection without weight, but also setting them lower to encourage stretching through her neck and back. I insisted on going very SLOW. Then I added the saddle with the side reins slowly shortening them up for the next two weeks or so before I had my FIRST RIDE in December, just shy of 3.5 months post-surgery date. Cue the band! It was the most exciting session of strictly walking on a long rein that I’d ever had! I knew I had a long way to go, but it was seemingly successful in my eyes. 

From there, I slowly added in trot work for a couple of weeks. I was very attentive to her reactions. I wanted to watch for any signs of pain. There were none. What I did feel was an overall weakness as I would encourage connection and lifting of carriage. I would base all my actions on how she felt and would add to her workload as she got stronger. It got to the place I was cantering and then bringing her up into contact for longer periods of time. I slowly added some lateral work to stretch her muscles in a positive, strengthening way. I had to really keep in mind that it could potentially take a while to really feel the effects of the surgery based off of muscle memory and traveling patterns. I knew she could easily hold on to these things mentally as well. I would have to patiently retrain the way she moved and carried herself from all the years of protecting and reacting; rewinding time and theoretically starting over. I’ve recently heard of and started using the Eagle Pro Six body band for rehabbing and strengthening. I managed the healing process with chiropractic work to break down any scar tissue once she was back at work. I’m a huge believer in chiropractic work for alignment. Shout out to Julie Page DVM from Peninsula Equine Services for being so great at what she does! I also had my kinesiology therapist out to administer low level laser treatment to speed up healing and recovery to the tissue involved. 

I can’t stress enough the importance of taking it slowly. She had been through a lot; bones chiseled, muscle and nerves severed, and being locked up in prison for months…her stall. She was used to having ten acres to freely roam every day of her life. 

Training In Full Swing 

In March 2020 Bristol had been back into her normal pre-surgery workload for about a month and a half. I’m so happy to say she’s feeling great! Her back is slowly, but surely regaining strength, and I’m just taking it one day at a time. The only main weakness I feel is her right hind leg; but that had always been a shorter side for her due to a spur in her hock. It’s also getting stronger by our training post-surgery. I still will be injecting her hocks soon to make her all sorts of comfortable for the upcoming show season. I’m going to go out on a limb (no pun intended), and say this will be our best year yet! I’m so glad I chose to listen to her. Once I knew the facts, I could be her voice. 

Richelle and Bristol, post-surgery. Richelle and Bristol recently earned their PSG silver medal and are schooling I1 Photo by Cortney Drake

I wish I had something like this for reference before I went into this journey for Bristol. If only to give me a peace of mind about all of the unknowns. I’m hoping this gives confidence to someone who’s deciding on this route, or enlightens someone on the fence about whether or not this is the right answer for them and their four-legged, beautiful creature. Is kissing spine fiction or fad? Ask your horse and go with what you know! 

We continue training and are competing PSG, where we received our last score for our silver medal post surgery. Currently we are schooling I1 in hopes to achieve our next goal of future gold medals. 


Expense Breakdown 

Minus the injections, my insurance covered 80%. 

Pre-surgery costs: 

$889.50: pre-purchase exam, X-rays, and sedation 

$150.00: pre-purchase radiograph reading 

$420.00: lameness evaluation, fetlock injection, and sedation 

$752.50: hock X-rays, hock injections, sedation, and Equioxx 

$726.25: recheck, X-rays of back (4), back injections (6), and sedation 

$105.00: blood draw/equine screening 

Total: $3043.25 

Surgery: 

$2340.00: general anesthetic procedure 

$4400.00: Kissing Spine surgery (It can range from $4k-$6k depending on the amount of areas the horse needs correction.) 

Total: $6740.00 
Post-surgery colic treatment: $679.20 
Total cost: $10,462.45 

Follow Richelle @richtracht on Instagram for updates on her progress and more!
Richelle is the Owner and Trainer at Baydo Equestrian Farm

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