From the Research
Baastrup's disease, also known as kissing spine syndrome, should be managed with a stepped approach, starting with conservative measures such as physical therapy and anti-inflammatory medications, and progressing to steroid injections or surgical intervention if necessary, as supported by the most recent and highest quality study 1. The condition is characterized by the close approximation of adjacent spinous processes, leading to degenerative changes, inflammation, and pain. Diagnosis is based on clinical examination and imaging studies, including standard and dynamic flexion-extension radiographs, MRI, and CT scans 1. Key points to consider in the management of Baastrup's disease include:
- Conservative treatment, including physical therapy to strengthen core muscles, postural correction exercises, and anti-inflammatory medications like NSAIDs to manage pain and inflammation 1
- Percutaneous infiltrations, such as steroid injections between the affected spinous processes, to reduce inflammation and pain 2
- Surgical decompression, such as partial resection of the spinous processes, in persistent cases unresponsive to conservative treatment 1 It is essential to appreciate the existence of Baastrup's disease and identify it on imaging to improve diagnosis and appropriate treatment of associated back pain, as it may be associated with other degenerative disease processes of the spine 3. The most recent and highest quality study 1 provides the best evidence for the management of Baastrup's disease, and its findings should be prioritized in clinical decision-making.