A male, 70 years of age experiences serious episodes of low back pain for the previous 10 years. The pain is accompanied with tenderness on palpation, in the mid-lumbar region. The patient explained that the pain becomes worse during extension movements while eliminates during forward flexion. A CT scan and MRI was performed which showed that the L3 and L4 spinal column were facing each other, with the interspinous space filled with fluid, causing inflammation around the tissues. It turned out to be Baastrup’s disease or kissing spinal column syndrome.
What Is It?
Baastrup’s disease is named after a radiologist, Christian Ingerslev Baastrup. This disease is likewise called back pain syndrome. This condition is defined by the changes in soft tissues in between the adjacent spines. Baastrup’s disease also has other names such as interspinous bursitis (ISB) on the interspinous area, which is an adventitious bursa appears since of the development of a synovial articulation. This is why both of the terms, ISB and Baastrup’s disease, are used interchangeably.
Back pain is among the characteristic symptoms of Baastrup’s disease since of the close contact of spinous processes. The condition is most typically found in lumbar and cervical region, and often leads to degeneration of spine.
Symptoms of Baastrup’s Disease in Humans
Baastrup’s disease or kissing spinal column syndrome is an acute condition of cervical or spinal area, leading to severe back pain as discussed previously. This mechanical instability of spinal processes may produce other symptoms. Some of the characteristic symptoms of Baastrup’s disease are:
- Patient feels pain in spinous procedures.
- Patient will sometimes feel numbness due to participation of nerves.
- Rotation movement is jeopardized because L4-L5 is most frequently affected.
- Hyperextension caused by swimming may get worse the condition.
The precise cause of this disease is still unknown. However the most frequently thought theory is that the area in between discs is removed, causing disc degeneration and contact of surrounding spinous procedures. Some prospective triggers that may initiate the disease consist of:
- Incorrect or unusual posture
- Mishap spine injuries or trauma
- Weight problems and over-weight
Diagnosis of Baastrup’s disease is done by different methods. The following is the most typically used diagnostic procedures.
1. Plain film and computed tomography (CT scan)
The outcomes of plain film and CT scan can reveal close approximation of adjacent processes. Flattening, enlargement of spinal column can likewise be observed.
2. Magnetic resonance imaging (MRI)
Intespinous bursal fluid accumulation that causes bursitis is observed. Postero-central epidural cysts will show in MRI.
3. FDG-PET/CT Scan
PET scan and CT scan give more appropriate results when inflammatory condition such as bursitis exists. MPR (multi planar restoration) is performed in case of a possible malignancy.
How to Treat Baastrup’s Disease
Baastrup’s disease can affect your daily life, bringing enormous pain. It must be treated and handled by the following methods.
Injections of corticosteroids are usually administered for relieving the pain.2 to 4 seepages are indicated in case of micro-trauma. The physician will ask you to avoid any back spine movements during the treatment protocols.
If the patient do not responds to corticosteroid injections, then surgery is carried out for partial or total excision of spine.
The surgery does not constantly provide satisfying results. Inning accordance with a latest research study carried out on various patients of Baastrup’s disease, private investigators revealed that just 11 patients from 64 were totally pleased with the surgery, the remaining 53 had established the pain again after some time. This might be because that the fundamental cause of this condition might differ from patient to patient. For example, Baastrup’s disease pain triggered by back spondylosis is not eliminated by surgery.
3. Physical Therapy Management
Physical therapy is considered as an important treatment protocol for Baastrup’s disease as it assists in restoring the muscle versatility and strength. Physical therapy likewise enhances the neuromuscular damage brought on by the disease.
Trough abdominal muscles enhancing, it helps in dealing with pain triggered by lordosis. Muscle activity (such as gluteal muscle and abdominal muscle) can be increased in case of hyperlordosis. It also supports in regaining the back position by moving hip flexor muscles. Pilate workout, a type of workout, can enhance the condition of hyperlodosis.
What People with Baastrup’s Disease Say About Their Conditions
Just been dx ‘d with this with an x-ray. Serious DDD from L1-S1. All of them “demineralized”. I assume that means Osteoporosis. At any rate, now waiting for MRI approval. Work comp and they’re being very uncooperative (another story), so I am paying out of my own pocket.
Excruciating pain when attempting to arise from lying down and even after sitting or reclining. My spine appears to secure and can take minutes to relax, thus “Kissing”. Well, at least I have a partial answer describing this pain which seems to be escalating at an alarming rate.