From the Research
Baastrup disease, also known as "kissing spine syndrome," is a condition affecting the lower lumbar spine where adjacent spinous processes come into close contact and eventually rub against each other, causing inflammation and pain, with the etiology primarily stemming from degenerative changes in the spine associated with aging, particularly excessive lordosis (curvature) of the lumbar spine, as supported by the most recent study 1.
Etiology and Risk Factors
The condition develops when the normal space between spinous processes diminishes, leading to contact, friction, and subsequent inflammation. Contributing factors include:
- Age-related disc degeneration causing loss of disc height
- Osteoarthritis of the facet joints
- Hyperlordosis which can be exacerbated by obesity, poor posture, or weakened core muscles
- Advanced age, severe intervertebral disc degeneration, and facet joint degeneration are independent risk factors for the occurrence of Baastrup's disease in patients with lumbar degenerative diseases, as indicated by the study 1
Diagnosis and Treatment
Diagnosis rests on clinical examination and detailed imaging studies, including standard and dynamic flexion-extension radiographs of the lumbar spine, MRI, CT scan, and FDG PET/CT, as mentioned in the studies 2, 3, 4. Treatment typically begins with conservative measures, including:
- Physical therapy to strengthen core muscles
- Postural correction
- Weight management
- Pain management with NSAIDs or corticosteroid injections In severe cases that don't respond to conservative treatment, surgical interventions such as spinous process resection or interspinous spacer placement may be considered to relieve symptoms and prevent further progression, as suggested by the studies 2, 5.
Key Considerations
It is essential to note that Baastrup's disease is often underdiagnosed and mistreated due to a lack of knowledge and/or improper diagnostic techniques, leading to frequent mistreatment, as highlighted in the study 5. Proper diagnosis and treatment are crucial to alleviate symptoms and improve the quality of life for patients with Baastrup's disease, as emphasized by the study 4.