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

## TL;DR

This study reports on 13 horses with thoracic spondylosis, a condition causing back pain, and finds that most have poor outcomes despite treatment.

## Contribution

This is the first study to describe clinical signs, treatment, and long-term outcomes of thoracic spondylosis in horses.

## Key findings

- Most horses with thoracic spondylosis had poor long-term outcomes despite treatment.
- Four out of 13 horses were able to continue athletic activity after treatment and rehabilitation.
- The most commonly affected site was the T13–T14 intervertebral joint.

## Abstract

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.

The aim of this study is to describe for the first time clinical signs, treatment and long‐term outcomes of horses diagnosed with thoracic spondylosis. Of the 13 horses that met the inclusion criteria, four were able to continue their athletic careers with good results, after treatment and rehabilitation.