Baastrup Syndrome or Kissing Spine Syndrome in Humans: Causes, Symptoms, Treatment

Back Pain- This is one of the most common pain conditions that people have. There are many medical conditions that cause back pain like degenerative disc disease, spinal stenosis, lumbar spondylosis etc. Apart from these medical conditions, there is one condition, which also causes significant back pain in which the spinous processes of two adjacent vertebrae come in contact with each other resulting in severe back pain. This condition was first described by Baastrup in 1933 and known as Baastrup Syndrome or the Kissing Spine Syndrome. In this article, we will go in detail about Baastrup Syndrome or Kissing Spine Syndrome.

Baastrup Syndrome or Kissing Spine Syndrome is a common medical condition of the vertebral column where the spinous processes of the two adjacent vertebrae come in contact with each other resulting in acute back pain. This contact between the spinous processes can lead to a new joint forming between them. The spinous processes that are in actual contact with each other may undergo resultant degeneration. This is most common in the lumbar spine but in rare cases this is known to occur in the cervical spine also.

The exact cause of Baastrup Syndrome or Kissing Spine Syndrome is not known. The most common theory is that it is caused due to loss of disc space leading to degeneration of the disc resulting in contact between the spinous processes. Some of the other potential causes of Baastrup Syndrome or Kissing Spine Syndrome may be lordosis as a result of scoliosis, spondylolisthesis, incorrect posture, traumatic injuries to the spine, and obesity.

The cause of the back pain resulting from Baastrup Syndrome or Kissing Spine Syndrome is mainly mechanical as a result of the adjacent spinous processes coming in contact with each other. It is worse with hyperextension, limited hip movements; also it is quite common in swimmers.

When describing the symptoms of Baastrup Syndrome or Kissing Spine Syndrome, the patient will describe spinous process pain, which may or may not be referred. Since Baastrup Syndrome or Kissing Spine Syndrome is usually an age related disorder, the instances of it occurring in the elderly population is more. The L4-L5 level is generally the area which is mostly affected. Lumbar extension causes maximum amount of pain. Rotation and lateral flexion of the spine is also very painful. Flexion is the only movement, which causes least amount of pain.

The physician will order the following tests/procedures to look at the lumbar spine and to confirm the diagnosis of Baastrup Syndrome or Kissing Spine Syndrome.

• Plain Films and CT Scan¹: The study will show close proximity or contact of adjacent spinous processes. There may be enlargement, flattening, and sclerosis of the contacting interspinous surfaces.
• MRI Scan of the Lumbar Spine: This study may demonstrate interspinous bursal fluid, posterior-central epidural cyst formation. MRI is very helpful in delineating as to whether there is compression of the posterior thecal sac as a result of this contact of the interspinous processes.

Both conservative and surgical approaches are available to treat Baastrup Syndrome or Kissing Spine Syndrome, which are described below:

• Analgesics- NSAIDs or Opioids.
• Muscle Relaxants- Baclofen, flexeril or Skelaxin.

• Physical therapy is also useful to ease up the symptoms.
• The PT exercises are aimed at stretching the hip flexor muscles, strengthening the core muscles with a flexion bias.

Pilates is also found to be helpful for reducing symptoms of Baastrup Syndrome or Kissing Spine Syndrome.

• Local corticosteroid injections into the interspinous processes help calm down the pain.
• If the condition gets chronic then at least two to four treatments with injections may be required.

The following surgical procedures can be done for Baastrup Syndrome or Kissing Spine Syndrome.

• Excision of spine
• Spinal fusion
• Implant position between the spine.

The outcome of surgical treatment is often questioned.²

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