|Patient: 67 year old male|
|History: Patient presents with years of progressively worsening lower back pain, now with pain radiating down posterior right proximal leg and thigh.|
Close approximation and contact of adjacent L4-5 spinous processes (kissing spines)
Resultant enlargement, flattening, and reactive sclerosis of apposing interspinous surfaces
|Diagnosis: Baastrup's disease with lumbar interspinous bursitis with likely bursal extension into posterior epidural space producing moderate central canal stenosis.|
Baastrup's disease is characterized by close approximation and contact of adjacent spinous processes with resultant enlargement, flattening, and reactive sclerosis of apposing interspinous surfaces .
It is often asymptomatic, but may clinically present as midline localized lumbar tenderness and pain on back extension that can be relieved by flexion, local anesthetic injection, and excision of part of the spinous processes .
Interspinous bursography combined with CT confirmed that the interspinous bursitis extended to the intraspinal cystic mass in five of ten patients. 
|References: 1. Resnick D. Degenerative diseases of the vertebral column. Radiology1985; 156:3 –14|
2. Bywaters EG, Evans S. The lumbar interspinous bursae and Baastrup's syndrome: an autopsy study. Rheumatol Int1982; 2:87 –96
3. Chen CK, Yeh L. Intraspinal Posterior Epidural Cysts Associated with Baastrup's Disease: Report of 10 Patients. AJR 2004; 182:191-194
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Case Number: 17686648Last Updated: 2011-03-20 The reader is fully responsible for confirming the accuracy of this content.
The reader is fully responsible for confirming the accuracy of this content.