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Aims

To demonstrate that subtotal (cranial wedge) ostectomy represents an effective treatment for overriding spinous processes (SPs), with short surgery time, fewer complications, maintains the contour of the spine, and produces a functionally and cosmetically better outcome than previously reported techniques.

Methods

A new technique is described and records were retrieved for 25 cases which had undergone the procedure at Newmarket Equine Hospital between 2009 and 2011. Case records were evaluated for anamnesis, clinical findings, and details of surgical and post operative management. Outcome of surgery was assessed by telephone questionnaire with owners, relating to both functional and cosmetic outcome of surgery.

Results

A total of 78.9% of cases treated using the described technique had resolution of clinical signs and returned to full work, and a further 18.2% were improved. Outcome was unrelated to number of SPs resected or mean radiographic grade of impingement. Cosmetic outcome was described as excellent in 81.8% and good in the remainder. Surgery time ranged from 20 to 70 (median 30) min and there were no intraoperative or post operative complications.

Conclusions

Previous descriptions of overriding SPs have failed to consider the shape of the SPs, and common site of impingement. As a result, previously reported techniques have been excessively destructive. Additionally, the changing relationships of SPs between standing and recumbent positions complicates surgical procedures when the previously reported technique is employed.

Practical significance

Based on the above and the presented follow-up data, subtotal (cranial wedge) ostectomy represents a logical and effective treatment for overriding SPs. If performed under general anaesthesia it results in short surgery time, maintains the contour of the spine, has few complications, and produces a functionally and cosmetically better outcome than previously reported nondefined amputation of the dorsal portion of implicated SPs.

Ethical animal research

Not required by this Congress: retrospective clinical study. Sources of funding: None. Competing interests: None.