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This course module provides the foundation needed to evaluate horses with back pain and dysfunction.  Detailed anatomic descriptions of the soft tissue, muscular, articular, and osseous features of the thoracolumbar vertebrae and rib cage are presented. A review of thoracolumbar spinal biomechanics includes material on wither asymmetries, the role of the rib cage in weight bearing, and paired muscle function. Spinal pathology content includes the role of osteoarthritis and impinged spinous processes in the development of thoracolumbar pain and dysfunction. A structured outline for detailed evaluation of active and passive joint thoracolumbar and rib cage motion is provided. Treatment options focus on conservative methods for reducing pain and improving core stability in horses with back pain.