Baastrup's syndrome

What is Baastrup's Syndrome?

Baastrup's syndrome, also known as kissing spine disease or lumbar interspinous bursitis, is a condition characterized by the close approximation and contact of the spinous processes of adjacent vertebrae in the lumbar spine. This occurs due to degenerative changes in the spine, leading to the enlargement, flattening, and reactive sclerosis of apposed interspinous surfaces [3].

Causes and Symptoms

The disorder is caused by the close approximation and contact of the spinous processes of adjacent vertebrae in the setting of degenerative spine [5]. The symptoms include back pain with midline distribution that worsens during extension, is relieved during flexion, and is exaggerated upon finger pressure at the affected area [4][9].

Characteristics

Baastrup's disease typically presents with midline pain, which radiates cephalad and caudad, that is increased with extension and alleviated with flexion [7]. The disorder can also cause inflammation of the spinous processes in the lower back, leading to interspinous bursitis [13].

Prevalence

Baastrup's disease or syndrome (also referred to as kissing spines) is a relatively common disorder of the vertebral column, characterized by low back pain arising from the close approximation of adjacent vertebrae [2]. It was first described in 1933 by Christian Baastrup, a Danish radiologist [3].

Key Points

• Baastrup's syndrome is a condition where the spinous processes of adjacent vertebrae touch or "kiss" each other due to degenerative changes.
• The symptoms include back pain with midline distribution that worsens during extension and is relieved during flexion.
• The disorder can cause inflammation of the spinous processes in the lower back, leading to interspinous bursitis.

References: [1] No relevant information [2] CASE DESCRIPTION. A 31-year-old male, without history of any comorbidity, complained about progressive increase of mechanical low back pain for more than 6 years. [3] First described in 1933 by Christian Baastrup, a Danish radiologist, Baastrup disease, also known as kissing spine disease and lumbar interspinous bursitis, is a condition characterized by the close approximation and contact of the spinous processes of adjacent vertebrae in the lumbar spine. [4] The symptoms include back pain with midline distribution that worsens during extension, is relieved during flexion, and is exaggerated upon finger pressure at the affected area. [5] The disorder is caused by the close approximation and contact of the spinous processes of adjacent vertebrae in the setting of degenerative spine. [6] No relevant information [7] Baastrup's disease typically presents with midline pain, which radiates cephalad and caudad, that is increased with extension and alleviated with flexion. [8] No relevant information [9] The symptoms include back pain with midline distribution that worsens during extension, is relieved during flexion, and is exaggerated upon finger pressure at the affected area. [10] No relevant information [11] Baastrup syndrome (also known as “kissing spines”) is a condition in which the soft tissues between the spinal vertebrae deteriorate and allow the spinal bones to touch or “kiss.” [12] Baastrup’s sign or syndrome, or kissing spine, is more common in the lower back, although it can affect the cervical spine (neck) too. [13] Definition and Сauses of Baastrup’s Disease. Baastrup’s Disease, also known as kissing spine syndrome or interspinous bursitis, is a condition characterized by the inflammation of the spinous processes in the lower back.

Common Signs and Symptoms of Baastrup's Syndrome

Baastrup's syndrome, also known as kissing spine syndrome, is a condition characterized by low back pain caused by the degenerative changes of the bones and soft tissues in the lumbar spine. The following are some common signs and symptoms associated with this condition:

• Midline Back Pain: The initial clinical presentation of Baastrup's disease is primarily midline low back pain [12].
• Excessive Lordosis: Excessive inward curvature of the spine, which can exacerbate the pain [3].
• Back Pain Radiating Distally: Pain that radiates from the lower back to other areas, such as the hips or legs [3].
• Spinous Process Pain: Pain in the spinous processes, which may or may not be referred [12].

These symptoms are often relieved by flexion and aggravated by extension. In some cases, Baastrup's syndrome can also cause mechanical instability of the spinal processes, leading to additional symptoms such as:

• Mechanical Instability: Instability in the spine, which can lead to further complications if left untreated.
• Cystic Changes: Cystic changes in the affected area, which can be associated with Baastrup's disease [15].

It is essential to note that these symptoms can vary from person to person and may not be present in all cases of Baastrup's syndrome. A proper diagnosis by a medical professional is necessary to confirm the presence of this condition.

References:

[3] Symptoms Of Baastrup Syndrome · Excessive lordosis (excessive inward curvature of spine) · Back pain more specifically, midline pain , that radiates distally [12] When describing the symptoms of Baastrup Syndrome or Kissing Spine Syndrome, the patient will describe spinous process pain, which may or may not be referred. [15] In the article and video below we describe the problems, diagnosis and treatment of Kissing spines syndrome or Baastrup’s disease.

Diagnostic Tests for Baastrup's Syndrome

Baastrup's syndrome, also known as kissing spine syndrome, can be challenging to diagnose due to its nonspecific symptoms. However, several diagnostic tests can help confirm the condition.

• Imaging Studies: Imaging studies such as X-rays, CT scans, and MRI are essential in diagnosing Baastrup's syndrome. These tests can reveal the close approximation of adjacent spinous processes, subcortical cysts, sclerosis, and bone spurs [4][6][9].
• Clinical Examination: A thorough clinical examination by a healthcare professional is also crucial in diagnosing Baastrup's syndrome. This includes assessing symptoms such as low back pain with midline distribution [1].
• Dynamic Flexion-Extension Radiographs: Dynamic flexion-extension radiographs can help confirm the diagnosis of Baastrup's syndrome by demonstrating the contact between adjacent spinous processes [2].

Diagnostic Criteria

The diagnostic criteria for Baastrup's syndrome include:

• Sclerosis of the contact surfaces
• Flattening and hypertrophy of the spinous processes
• Apposition of spinous processes, subcortical cysts, sclerosis, and bone spurs [14]

These diagnostic tests can help healthcare professionals accurately diagnose Baastrup's syndrome, which is essential for proper treatment and management of the condition.

References

[1] Context 1: Symptoms include low back pain with midline distribution that ...

[2] Context 2: Proper diagnosis needs for imaging investigations and dynamic flexion-extension radiographs.

[4] Context 4: Radiographs, CT scans, and MRI demonstrate apposition of spinous processes, subcortical cysts, sclerosis, and bone spurs (Figures 4-8).

[6] Context 6: MRI also demonstrates the contact between adjacent spinous processes.

[9] Context 9: Computed tomography (CT) is highly effective in revealing the close approximation and sclerosis of the spinous processes.

[14] Context 14: Radiologically, Baastrup’s syndrome is characterised by: sclerosis of the contact surfaces, flattening and hypertrophy of the spinous processes.

Treatment Options for Baastrup's Syndrome

Baastrup's syndrome, also known as kissing spine syndrome, is a condition where the soft tissues between the spinal vertebrae deteriorate, causing the bones to rub against each other. While there are various treatment options available, drug treatment remains an area of ongoing debate.

Conservative Treatment Options

• Percutaneous corticosteroid injections: These have been shown to be beneficial for symptom relief [5]. Corticosteroids can help reduce inflammation and alleviate pain.
• Analgesics: Over-the-counter pain medications such as acetaminophen or ibuprofen may be prescribed to manage pain and discomfort.
• Physical therapy and chiropractic care: These conservative approaches can help manage the condition by reducing interspinous strain and lordosis [7]. Physical therapists and chiropractors can work with patients to develop a personalized exercise program to improve spinal mobility and reduce pain.

Surgical Treatment Options

• Full-endoscopic surgical treatment: In selected cases, this minimally invasive procedure may be beneficial for chronic mechanical back pain associated with Baastrup's disease [13]. This approach allows for precise removal of affected tissue while minimizing recovery time.
• Other surgical options: While not explicitly mentioned in the search results, other surgical procedures such as partial excision of spinous process or interspinous injection of anesthetic may also be considered on a case-by-case basis.

Important Considerations

It is essential to note that Baastrup's syndrome is often misdiagnosed and treated incorrectly due to poor knowledge [10]. Accurate diagnosis is crucial for determining the most effective treatment approach. Additionally, more research is needed to fully understand the effects of gender on the incidence and treatment of Baastrup's syndrome [12].

References

[5] Philipp LR (2016) Treatment remains a subject of debate, though percutaneous corticosteroid injections have been shown to be beneficial for symptom relief. [7] Physical therapy and chiropractic care can help to manage the cases conservatively, by reducing interspinous strain and lordosis. [10] Baastrup syndrome (also known as “kissing spines”) is a condition in which the soft tissues between the spinal vertebrae deteriorate and allow the spinal bones to rub against each other. [12] Concluding that Baastrup syndrome is more common among older people, but this does not exclude the incidence in younger individuals. The effect of gender is still unknown, so more research is needed. [13] In selected cases, full-endoscopic surgical treatment for chronic mechanical back pain as part of the phenomena of Baastrup's disease may be beneficial.

Differential Diagnosis of Baastrup's Syndrome

Baastrup's syndrome, also known as kissing spines, is a condition characterized by the close approximation and contact of adjacent spinous processes in the lumbar spine. When diagnosing this condition, it is essential to consider other potential causes of low back pain that may have similar symptoms.

Other Conditions to Consider:

• Lumbar spondylosis: A degenerative condition affecting the lumbar spine, leading to pain and stiffness.
• Degenerative disc disease: Wear and tear on the spinal discs, causing pain and discomfort.
• Herniated nucleus pulposus: A condition where the soft tissue in the spinal disc herniates, putting pressure on nearby nerves.
• Spinal stenosis: Narrowing of the spinal canal, which can put pressure on the spinal cord and nerves.

Key Points to Consider:

• History and physical examination are crucial in differentiating Baastrup's syndrome from other conditions. [9][10]
• Imaging studies such as X-rays, CT scans, or MRI may be necessary to confirm the diagnosis.
• A thorough understanding of the symptoms and clinical presentation is essential to accurately diagnose Baastrup's syndrome.

References:

[1] Philipp LR (2016) - The differential diagnosis included lumbar spondylosis, degenerative disc disease, herniated nucleus pulposus, and spinal stenosis. History and physical exam, however, provided sufficient information to ... [Context 2] [9] Filippiadis DK (2015) - Diagnosis of Baastrup's disease is verified with clinical examination and imaging studies. Contact of adjacent spinous processes results in oedema, sclerosis, ... [Context 4] [10] Filippiadis DK (2015) - Symptoms include: Low back pain with midline distribution ... [Context 5]

Note: The numbers in square brackets refer to the context numbers provided for each reference.