Spondylosis in Horses: Clinical Features, Diagnostic Imaging Findings, Treatment and Outcome in 13 Horses

Back pain is a debilitating condition hampering horses' athletic careers. Thoracic spondylosis (TS), a known cause of back pain, leads to osteophytes formation across intervertebral joints. In horses, TS is poorly reported, with anecdotal signs and response to treatment.

To report clinical presentation, diagnostic imaging findings, treatment and outcome in horses with TS.

The clinical records of horses diagnosed with TS between 2010 and 2023 were reviewed. Signalment, clinical and imaging findings, treatment, and outcome were analysed. Thoracic spondylosis was graded from 1 to 5. Grades, concurrent pathologies, treatment, and outcome were assessed. The median TS grade and number of lesions and outcome were compared using the Mann-Whitney test.

Thirteen horses met inclusion criteria, eight of which performed a discipline involving jumping. All horses exhibited signs consistent with back pain. Thoracic spondylosis sites varied from 1 to 6 (mean 2) with a total of 32 lesions. The most affected site was T13-T14. Five horses had concurrent dorsal spinous processes impingement and three were lame. Treatment included physiotherapy, tiludronate, anti-inflammatory and extracorporeal shockwave therapy. Long-term follow-up (>12 months) was available for 11 horses: the outcome was poor in seven horses, good in one and excellent in three. No statistically significant association was found between TS grade (p = 0.4), number of lesions (p = 0.2) and outcome categories.

Although rare, TS can cause back pain. The outcome is generally poor, but some horses may continue athletic activity despite severe lesions.