Impinged spinous processes are commonly noted on radiographs of the thoracolumbar region in horses. However, the clinical relevance of narrowed interspinous spaces and bony changes is difficult to assess, as 50% of horses judged to be normal have evidence of impinged spinous processes. In this webinar, Dr. Haussler reviews the anatomy, biomechanics, and pathologic changes associated with impinged spinous processes in horses. The clinical assessment of affected horses is discussed to help identify bone, soft tissue, and neurologic causes of back pain. Treatment options focus on conservative management with a review of surgical techniques and post-surgical rehabilitation approaches.