An MRI found intraspinous processes bursitis in 8.2% of individuals which could be causing segmental back pain.
Spine: 1 April 2008. 33(7), E211-E215.
Lumbar Interspinous Bursitis (Baastrup Disease) in a Symptomatic Population: Prevalence on Magnetic Resonance Imaging
Maes, Robbert MD; Morrison, Willam B. MD; Parker, Laurence PhD; Schweitzer, Mark E. MD; Carrino, John A. MD, MPH abstract here
Associations:
- age
- centreal spinal stenosis
- bulging discs
- anterolithesis (anterior slipping of one level on another)
- epidural cysts if big enough can even cause spinal claudication!
No associations with:
- gender
- disc degeeration or protusions
- scoliosis (curvature)
- lordosis (sway back)
- endplate disease
- retrolithesis (posterior slipping)
Should have localized spinal pain on extension and relief with flexion.
There should be midline tenderness but it could present with segmental dysfunction.
Plain Xrays may show kissing of spinous processes (may need extension views)
article here
MRI show bursal changes abstract here
Bone scan should show it up but it might be confusing what it was.
PET - CT showed it beautifully abstract here
Injection of steroid into interspace has shown benefit:
Interspinous Ligament Steroid Injections for the Management of Baastrup’s Disease: A Case Report
Archives of Physical Medicine and Rehabilitation, 2007, 88(10), 1353-1356
Raj Mitra, Usama Ghazi DOd, Dhiruj Kirpalani abstract here
"Interspinous process injection of 20mg of triamcinolone acetate with local anesthetic. The patient remained pain free for 3 months."
Removal of spinous process is an option.
Comment - this may occur more often than one thinks and got un-noticed as just being a segmental dysfunction that won't go away. It appears in bad situations with bylging discs and spinal stenosis where in actuality a simple shot might benefit. I will have to be more suspicious...
Any comments?
- Called "kissing-spine" disease the impingement of 2 spinoud process vertebra can cause problems.