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Baastrup Disease
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Spinous process impingement syndrome
            • "Kissing" spinous process disease
            • Interspinous ligament bursitis (diarthrosis interspinosae)
            • Baastrup sign
          • Definitions

            • Defined by Baastrup in 1933
            • Close approximation and contact of adjacent spinous processes with enlargement, flattening, and sclerosis of apposing interspinous surfaces
            • Putative source of back pain exacerbated by extension, relieved with flexion

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Other Modality Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Clark BM et al: Successful relief of back pain from Baastrup disease (kissing spines) by interspinous radiofrequency lesioning: a case report. A A Pract. 11(3):79-81, 2018
                                          2. Mostofi K et al: Interlaminar lumbar device implantation in treatment of Baastrup disease (kissing spine). J Craniovertebr Junction Spine. 9(2):83-6, 2018
                                          3. Alonso F et al: Baastrup's disease: a comprehensive review of the extant literature. World Neurosurg. 101:331-4, 2017
                                          4. Hatgis J et al: Baastrup's disease, interspinal bursitis, and dorsal epidural cysts: radiologic evaluation and impact on treatment options. Cureus. 9(7):e1449, 2017
                                          5. Gold M et al: Posterior epidural cyst associated with Baastrup disease. Spine J. 16(1):e23-4, 2016
                                          6. Subramanyam P et al: Role of FDG PET/CT in Baastrup's disease. Indian J Nucl Med. 31(3):235-7, 2016
                                          7. Kwong Y et al: MDCT findings in Baastrup disease: disease or normal feature of the aging spine? AJR Am J Roentgenol. 196(5):1156-9, 2011
                                          8. Murthy NS et al: The retrodural space of Okada. AJR Am J Roentgenol. 196(6):W784-9, 2011
                                          9. Jang EC et al: Posterior epidural fibrotic mass associated with Baastrup's disease. Eur Spine J. 19 Suppl 2:S165-8, 2010
                                          10. Barbagallo GM et al: Analysis of complications in patients treated with the X-Stop Interspinous Process Decompression System: proposal for a novel anatomic scoring system for patient selection and review of the literature. Neurosurgery. 65(1):111-9; discussion 119-20, 2009
                                          11. Lamer TJ et al: Fluoroscopically-guided injections to treat "kissing spine" disease. Pain Physician. 11(4):549-54, 2008
                                          12. Lin E: Baastrup's disease (kissing spine) demonstrated by FDG PET/CT. Skeletal Radiol. 37(2):173-5, 2008
                                          13. Maes R et al: Lumbar interspinous bursitis (Baastrup disease) in a symptomatic population: prevalence on magnetic resonance imaging. Spine (Phila Pa 1976). 33(7):E211-5, 2008
                                          14. Hui C et al: Two unusual presentations of Baastrup's disease. Clin Radiol. 62(5):495-7, 2007
                                          15. Mitra R et al: Interspinous ligament steroid injections for the management of Baastrup's disease: a case report. Arch Phys Med Rehabil. 88(10):1353-6, 2007
                                          16. Chen CK et al: Intraspinal posterior epidural cysts associated with Baastrup's disease: report of 10 patients. AJR Am J Roentgenol. 182(1):191-4, 2004
                                          17. Pinto PS et al: Spinous process fractures associated with Baastrup disease. Clin Imaging. 28(3):219-22, 2004
                                          18. Rajasekaran S et al: Baastrup's disease as a cause of neurogenic claudication: a case report. Spine (Phila Pa 1976). 28(14):E273-5, 2003
                                          19. Fardon DF et al: Nomenclature and classification of lumbar disc pathology. Recommendations of the Combined task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology. Spine (Phila Pa 1976). 26(5):E93-E113, 2001
                                          20. Resnick D: Degenerative diseases of the vertebral column. Radiology. 156(1):3-14, 1985
                                          21. Sartoris DJ et al: Age-related alterations in the vertebral spinous processes and intervening soft tissues: radiologic-pathologic correlation. AJR Am J Roentgenol. 145(5):1025-30, 1985
                                          22. Bywaters EG et al: The lumbar interspinous bursae and Baastrup's syndrome. An autopsy study. Rheumatol Int. 2(2):87-96, 1982
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Spinous process impingement syndrome
                                                    • "Kissing" spinous process disease
                                                    • Interspinous ligament bursitis (diarthrosis interspinosae)
                                                    • Baastrup sign
                                                  • Definitions

                                                    • Defined by Baastrup in 1933
                                                    • Close approximation and contact of adjacent spinous processes with enlargement, flattening, and sclerosis of apposing interspinous surfaces
                                                    • Putative source of back pain exacerbated by extension, relieved with flexion

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Nuclear Medicine Findings

                                                            • Other Modality Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • Staging, Grading, & Classification

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Clark BM et al: Successful relief of back pain from Baastrup disease (kissing spines) by interspinous radiofrequency lesioning: a case report. A A Pract. 11(3):79-81, 2018
                                                                                  2. Mostofi K et al: Interlaminar lumbar device implantation in treatment of Baastrup disease (kissing spine). J Craniovertebr Junction Spine. 9(2):83-6, 2018
                                                                                  3. Alonso F et al: Baastrup's disease: a comprehensive review of the extant literature. World Neurosurg. 101:331-4, 2017
                                                                                  4. Hatgis J et al: Baastrup's disease, interspinal bursitis, and dorsal epidural cysts: radiologic evaluation and impact on treatment options. Cureus. 9(7):e1449, 2017
                                                                                  5. Gold M et al: Posterior epidural cyst associated with Baastrup disease. Spine J. 16(1):e23-4, 2016
                                                                                  6. Subramanyam P et al: Role of FDG PET/CT in Baastrup's disease. Indian J Nucl Med. 31(3):235-7, 2016
                                                                                  7. Kwong Y et al: MDCT findings in Baastrup disease: disease or normal feature of the aging spine? AJR Am J Roentgenol. 196(5):1156-9, 2011
                                                                                  8. Murthy NS et al: The retrodural space of Okada. AJR Am J Roentgenol. 196(6):W784-9, 2011
                                                                                  9. Jang EC et al: Posterior epidural fibrotic mass associated with Baastrup's disease. Eur Spine J. 19 Suppl 2:S165-8, 2010
                                                                                  10. Barbagallo GM et al: Analysis of complications in patients treated with the X-Stop Interspinous Process Decompression System: proposal for a novel anatomic scoring system for patient selection and review of the literature. Neurosurgery. 65(1):111-9; discussion 119-20, 2009
                                                                                  11. Lamer TJ et al: Fluoroscopically-guided injections to treat "kissing spine" disease. Pain Physician. 11(4):549-54, 2008
                                                                                  12. Lin E: Baastrup's disease (kissing spine) demonstrated by FDG PET/CT. Skeletal Radiol. 37(2):173-5, 2008
                                                                                  13. Maes R et al: Lumbar interspinous bursitis (Baastrup disease) in a symptomatic population: prevalence on magnetic resonance imaging. Spine (Phila Pa 1976). 33(7):E211-5, 2008
                                                                                  14. Hui C et al: Two unusual presentations of Baastrup's disease. Clin Radiol. 62(5):495-7, 2007
                                                                                  15. Mitra R et al: Interspinous ligament steroid injections for the management of Baastrup's disease: a case report. Arch Phys Med Rehabil. 88(10):1353-6, 2007
                                                                                  16. Chen CK et al: Intraspinal posterior epidural cysts associated with Baastrup's disease: report of 10 patients. AJR Am J Roentgenol. 182(1):191-4, 2004
                                                                                  17. Pinto PS et al: Spinous process fractures associated with Baastrup disease. Clin Imaging. 28(3):219-22, 2004
                                                                                  18. Rajasekaran S et al: Baastrup's disease as a cause of neurogenic claudication: a case report. Spine (Phila Pa 1976). 28(14):E273-5, 2003
                                                                                  19. Fardon DF et al: Nomenclature and classification of lumbar disc pathology. Recommendations of the Combined task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology. Spine (Phila Pa 1976). 26(5):E93-E113, 2001
                                                                                  20. Resnick D: Degenerative diseases of the vertebral column. Radiology. 156(1):3-14, 1985
                                                                                  21. Sartoris DJ et al: Age-related alterations in the vertebral spinous processes and intervening soft tissues: radiologic-pathologic correlation. AJR Am J Roentgenol. 145(5):1025-30, 1985
                                                                                  22. Bywaters EG et al: The lumbar interspinous bursae and Baastrup's syndrome. An autopsy study. Rheumatol Int. 2(2):87-96, 1982