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Baastrup’s Disease: A Comparison of Imaging Modalities and Literature Review 2012

General Spine

Austin, C, Bourgeois, B.S., M.D.
Ted, T, Chang, B.A., M.D., Non ASSR Member
Geoffrey, G, Laing, B.A., M.D., Non ASSR Member
Paul, D, Campbell, Jr., B.S., M.D., Non ASSR Member
James, W, Boyd, B.S., M.D., Non ASSR Member

Paper/Mentor

Purpose

In 1933 Baastrup described a clinical syndrome of low back pain associated with radiographic evidence of contact between adjacent lumbar spinous processes. Baastrup's disease remains a nociceptor of controversial clinical prevalence and pathologic mechanism. Current literature suggests "kissing" spinous processes can be found on computed tomography (CT) in up to 41% of the general population. However, the relationship between closely approximated spinous processes and magnetic resonance (MR) evidence of associated interspinous bursitis remains unexplored. The purpose of this retrospective study is to examine the prevalence of interspinous bursitis in patients that have CT evidence of kissing spine in order to better understand and treat Baastrup's-related low back pain.

Methods & Materials

A retrospective medical record review was performed of 140 patients who had undergone a CT and MR of the lumbar spine between January 1, 2006 and November 1, 2011. Two board certified neuroradiologists independently evaluated these images. Inclusion criteria were determined as closely approximated lumbar spinous processes with sclerosis of the apposing ends. MR short T1 inversion recovery (STIR), T2, and post-contrasted T1 sequences were evaluated for evidence of interspinous bursitis. Discordant opinions between the reviewing radiologists were excluded from the study results.

Results

Preliminary results demonstrate a low incidence of interspinous bursitis in patients with CT evidence of Baastrup's Disease (9.1%).

Conclusion

A small proportion of patients with CT evidence of Baastrup's disease possess MR evidence of interspinous bursitis. Recent literature suggests that this subset of patients is more likely to have symptomatic Baastrup's disease and to benefit from interventional analgesia.

References/Financial Disclosures

1. Beks, J.W.F. "Kissing Spines: Fact or Fancy?" Acta Neurochir (1989) 100:134-135. 2. Chen, K. H. Clement. "Intraspinous Posterior Epidural Cysts Associated with Baastrup's Disease." AJR (2004) 182:191-194. 3. Kwong, Yune, Nitin Rao, and Khalid Latief. "MDCT Findings in Baastrup Disease: Disease or Normal Feature of the Aging Spine?" AJR (2011) 196:1156-1159. 4. Lin, Eugene. "Baastrup's disease (kissing spine) demonstrated by FDG PET/CT." Skeletal Radiology (2008) 37:173-175. 5. Maes, Robbert et al. "Lumbar Interspinous Bursitis (Baastrup Disease) in a Symptomatic Population." Spine Vol 33, Num 7, (2008) 211-215. 6. Mitra, Raj et al. "Interspinous Ligament Injections for the Management of Baastrup's Disease: A Case Report." Arch Phys Med Rehabil (2007) 88(10):1353-6. 7. Prescher, Andreas. "Anatomy and pathology of the aging spine." European Journal of Radiology Vol 27, Issue 3, (1998) 181-195. No financial disclosures.

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