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Pain and Therapy

, Volume 8, Issue 2, pp 285–287 | Cite as

Extensive Degeneration of Vertebral Body Leading to Baastrup’s Disease: A Radiographic Review of an Image

  • Ruben H. SchwartzEmail author
  • Ivan Urits
  • Omar Viswanath
Open Access
Images in Practice
Part of the following topical collections:
  1. Images in Practice

Abstract

Baastrup’s disease, known colloquially as “kissing spine disease”, is a degenerative process, most commonly occurring in the lumbar spine, in which adjacent spinous processes closely approximate or even touch (Filippiadis et al. in Insights Imaging.  https://doi.org/10.1007/s13244-014-0376-7, 2015). We present the case of an 86-year-old woman presenting with left low back, hip, and anterolateral thigh pain. Magnetic resonance imaging noted an approximation of the L2/3 spinous processes, with degeneration of the vertebral processes. This article is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors. Informed consent for publication was obtained from the participant.

Keywords

Baastrup’s disease Degenerative spine disease Spondylosis 

Key Summary Points

Baastrup’s disease occurs in the lumbar spine when adjacent spinous processes closely approximate or even touch, most often seen in elderly women, with symptomatology mimicking spinal stenosis, with localized back pain at the vertebral segment worsened with extension and improved with flexion.

Imaging will possibly show loss of disk height, spondylolisthesis, spondylosis, and osteophyte formation.

Although less common in presentation, Baastrup’s disease must be on the interventional pain medicine physician’s differential diagnosis when an elderly patient is presenting with symptoms similar to spinal stenosis.

Case

Baastrup’s disease, known colloquially as “kissing spine disease”, is a degenerative process, most commonly occurring in the lumbar spine, in which adjacent spinous processes closely approximate or even touch [1]. Most often seen in elderly females, symptomatology mimics spinal stenosis with localized back pain at the vertebral segment worsened with extension and improved with flexion [2]. Lordosis of the lumbar spine with mechanical pressure over time produces repeated strain on the interspinous ligament, thinning it, with resultant collapse of the spinous process. Baastrup’s disease is commonly associated with loss of disk height, spondylolisthesis, spondylosis, and osteophyte formation [3]. Magnetic resonance imaging (MRI) of the lumbar spine can sometimes illustrate interspinous ligament bursitis characterized as a fluid-like intensity between the affected spinous processes [1].

Our case involved an 86-year-old woman with a history of chronic osteoarthritis and left low back, hip, and anterolateral thigh pain. She had undergone previous intra-articular hip injections with no relief of symptomatology. MRI radiographic findings (Fig. 1) demonstrated the vertebral spinous processes of the L2 and L3 levels approximating, almost touching. The treatment course of Baastrup’s disease includes conservative management, with non-steroidal anti-inflammatory drugs and percutaneous intervention. Although controversial, surgical removal of the inflicted spinous processes may be indicated in medically refractory cases.
Fig. 1

T2-weighted sagittal magnetic resonance image (MRI) of the lumbar spine displaying collapse of L2/3 spinous processes. Degeneration and extreme lordosis of the vertebral column can also be seen throughout

Notes

Acknowledgements

Funding

No funding or sponsorship was received for this study or publication of this article.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Compliance with Ethics Guidelines

This article is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors. Informed consent for publication was obtained from the participant.

Disclosures

Ruben H. Schwartz, Ivan Urits, and Omar Viswanath have nothing to disclose.

Open Access

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

References

  1. 1.
    Filippiadis DK, Mazioti A, Argentos S, Anselmetti G, Papakonstantinou O, Kelekis N, Kelekis A. Baastrup’s disease (kissing spines syndrome): a pictorial review. Insights Imaging. 2015.  https://doi.org/10.1007/s13244-014-0376-7.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Kuramoto A, Chang L, Graham J, Holmes S. Lumbar spinal stenosis with exacerbation of back pain with extension: a potential contraindication for supine MRI with sedation. J Neuroimaging. 2011;21(1):92–4.  https://doi.org/10.1111/j.1552-6569.2009.00382.x.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Beks JWF. Kissing spines: fact or fancy? Acta Neurochir. 1989;100(3–4):134–5.  https://doi.org/10.1007/BF01403600.CrossRefPubMedGoogle Scholar

Copyright information

© The Author(s) 2019

Authors and Affiliations

  1. 1.Department of AnesthesiologyMount Sinai Medical CenterMiami BeachUSA
  2. 2.Department of Anesthesia, Critical Care, and Pain Medicine Harvard Medical SchoolBeth Israel Deaconess Medical CenterBostonUSA
  3. 3.Valley Anesthesiology and Pain ConsultantsPhoenixUSA
  4. 4.Department of AnesthesiologyUniversity of Arizona College of Medicine-PhoenixPhoenixUSA
  5. 5.Department of AnesthesiologyCreighton University School of MedicineOmahaUSA

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