Spondylosis in Horses

As the body and discussion section of this article express, this study suffers from a number of issues. The primary two problems are the low number of cases and the difficulty of assigning the lesions to the presenting problems. Yes, the problems presented are those reported with back pain and yes, significant spinal lesions associated with degenerative joint disease of the spine were present. However, the severity of the lesions did not correlate with the degree of pain nor the treatment outcome. We know that such lesions can be found in horses not exhibiting signs of back pain. So where does that leave us? We are left with a vague constellation of symptoms, clinical findings, treatment palate, and prognosis. Always important in these cases is to rule out other possible causes and do all that is possible to localize the pain to the radiographic lesions. Once you get this far along realize the prognosis for return to function is guarded.
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Spondylosis in Horses: Clinical Features, Diagnostic Imaging Findings, Treatment and Outcome in 13 Horses
Vet Med Sci. 2025 Mar;11(2):e70196. doi: 10.1002/vms3.70196.
Authors
Claudia de Secondi 1 , Federica Cantatore 1 , Marco Marcatili 1 , Marianna Biggi 1 , Jonathan Withers 1 , Donatella de Zani 2 , Davide Zani 2
Affiliations

1 Pool House Equine Hospital, IVC Evidensia, Fradley, UK.
2 Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy.

PMID: 40109022
DOI: 10.1002/vms3.70196

Abstract

Background: 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.

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

Methods: 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.

Results: 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.

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

Keywords: back pain; horses; thoracic spondylosis; vertebral bodies.
© 2025 The Author(s). Veterinary Medicine and Science published by John Wiley & Sons Ltd.