A student has been recommended a procedure called interspinous ligament desmotomy. I understand it involves cutting the ligaments to make more room between the vertebrae.
Anyone had any experience with this?
Hoping to hear success stories before they decide on going ahead.
It really, really depends on what the x-rays look like, and how comfortable the horse is now… and also, what therapeutic approaches have been done already to help mitigate the discomfort… but obviously the vet would know best, I think – and I don’t think vets are quick to jump to lig-snip.
I’ve been involved in the rehab with a few, and also have had a couple of eventer friends do it. I have a horse with kissing spine, and have decided against it after some long talks with people who have had the procedure done on their horses and vets who have done it. I have seen a high failure rate post lig-snip with IMHO an inordinate amount of suspensory issues, but other people report success. My two cents is that the rehabilitation is very hard on the horse, as it involves controlled/confined management and also, daily lunging for weeks… lots of stall time plus lunging is not easy on the horse’s body. I have to wonder what happens to the rest of the horse’s back end when the lig-snip is done, as the lig-snip destabilizes structures in the back that have been presumably compensating for a long, long time. I have seen more failures 2-3 years down the road than immediately following the surgery.
My own vet thinks that the lig-snip is not ideal for most horses and prefers a more conservative approach.
If your student has not tried alternatives, I might opt for the back injection/SWT therapy instead. The rads and the way the horse feels makes all the difference though, and sometimes the lig-snip really is necessary.
It would be a last ditch effort for me, after trying the rehab regime Dr Newton does (sarapin cocktail injection & rehab program). There was a study posted this winter IIRC that was about the management of KS and they found the best (generally) approach was injections, shockwave, and maintaining saddle-fit.
FWIW, my gelding has KS and I have found that shoes all around, full 24/7 turnout has made a remarkable difference. He had his back injected last summer, with a long-slow distance rehabilitation (I did not lunge) and has not looked back (yet).
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My mare had the lig snip two years ago.
After a whole year of trying injections and shock wave with no improvement I decided to give it a go.
I’m really happy I did. She’s back competing and happy!
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I’ve known a few who recovered well and one who it didn’t work (but was considered a bad candidate from the beginning). Rehab wasn’t terribly long. We didn’t/don’t lunge but built up the back muscles long lining and ponying off another horse. You want to strengthen them before riding again. For a horse who is a good candidate…I’d not hesitate to do it.
My gelding had the lig snip 3 years ago. He had 10 processes done, half were overlapping, the rest were touching. They separated immediately during the procedure. The recovery was easy, but the rehab is important and you have to make the long term commitment, to build their back with exercise and stretches. Most KS horses can’t have the winter off and then be expected to be brought back into work quickly in the spring. There are lots of ways to rehab them, as the other posters indicated, that don’t include constant lunging. My guy was turned out after 8 weeks of stall rest, to make sure everything was healed, but hand walked and lunged during that time. We were conservative and it was winter. We did a bone scan 1 1/2 years later to try and pinpoint some other issues he was having and only one process was “hot”. We blocked that process, thinking it was the source of his issue and it turned out not too be. So I would say, his ISLD procedure was a success. However, with many KS horses, they have other issues either directly or indirectly resulting from KS, depending on how long they were compensating for the pain. There is a good FB page, Horses with Kissing Spine, that has lots of good info on rehab techniques, what works for some people and what doesn’t. There’s also a lot information on “related” issues. I agree that if your horse is a good candidate, it’s worth a shot if you don’t want years of injections. The biggest thing to remember is that every horse is different and that the more knowledge you have about how it relates to the whole horse, and specifically, YOUR OWN horse, you can manage it. Don’t get discouraged, sorting it all out is laborious, but, if you’ve made the commitment to do the surgery, it only means you think your horse is worth it.
thank you all so much. this is exactly what we need to know. I appreciate these thoughtful responses.
My mare had this surgery 1.5 years ago and her and I are both very happy with the results 
My vet is against the procedure. My TB has T-14 T-15 KS with bone remodeling. We treated conservatively (but not cheaply) with shock wave, mesotherapy and injections. He returned to full work.
A mom of a friend of mine got the surgery done for her saddlebred after various conservative treatments weren’t responding. Unfortunately, the surgery didn’t work very well for him. Even after surgery, they used some sort of electro blanket to aide in the process of healing. While it did make him more agreeable to work with, within a few months they decided to retire him to pasture because he was just not suitable anymore for what they hoped to achieve.
I have heard of shock wave or laser therapy being very helpful in treating kissing spine though, as mentioned above, it can get costly.
This is an interesting thread! I didn’t even know there was a surgery for kissing spine! This is why I love COTH, I am always learning new things.
There are two options:
Interspinous ligament desmotomy, which is often colloquial referred to as a “lig snip”, is usually recommended in mild/moderate cases with only a few overlapping. The thought is snipping the ligaments relieves the tension (tension and carrying the body hollow is often what contributes to the worsening of the remodeling in between processes, though it is likely congenital) and that the horse, with the back de-stablized, can return to rehabilitative work and establish correct musculature over the back.
There is also the bone-shave, which is exactly what it sounds like – shaving back the processes so they no longer overlap (eliminating the remodeling/cleaning up the area as well). The bone shave seems to be for more moderate/severe cases and is fairly invasive.
