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Journal of Neurosurgical Sciences 2021 Aug 03

DOI: 10.23736/S0390-5616.21.05428-X

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Epidemiology, diagnosis and management of Baastrup’s diseases: a systematic review

Maria C. MELUZIO 1, Amarildo SMAKAJ 1, Andrea PERNA 1 , Calogero VELLUTO 1, Giovanni GRILLO 1, Luca PROIETTI 1, 2, Ivan DE MARTINO 1, Francesco C. TAMBURRELLI 1, 2

1 Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; 2 Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy


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INTRODUCTION: Baastrup disease (BD) is a common cause of low back pain which is often underdiagnosed. It is characterized by adjacent interspinous processes contact and it can be associated with cystic lesions. The aim of this review is to evaluate the epidemiology, diagnosis, and treatment options of patients with BD.
EVIDENCE ACQUISITION: The present study is performed according to PRISMA statement. MEDLINE via PubMed and Embase, Scopus, Cochrane Library database were searched using the keywords: “Baastrup”, “Kissing Spines”, “Syndrome”, “Disease”. A total of 35 papers met our inclusion criteria. Full text were reviewed for demographic, clinical data and treatment.
EVIDENCE SYNTHESIS: 1308 patients were included in the studies. The mean age of the enrolled patients was 59.6 years. The M:F ratio was 1.3:1. Population-based studies demonstrated a decade on decade increase in the incidence. Standard and dynamic flexion-extension radiographs of the lumbar spine were performed in 213 (16.2%) of cases. MRI was performed in 735 patients (56,2%) whereas FDG PET/CT was used to demonstrate BD in 77 included cases (5.9%). CT scan was performed in 574 cases (43.9%). 26 studies reported the treatment choice for a total of 277 patients. Anti-inflammatory drugs and physical therapy were chosen in 99 cases (35.7%). Percutaneous infiltrations and surgical decompression in 80 (28.9%) and 196 (70.7%) patients respectively.
CONCLUSIONS: Baastrup disease is a common cause of low back pain. Proper diagnosis needs for imaging investigations and dynamic flexion-extension radiographs. Conservative and surgical therapies are available but there is a need for randomized clinical trials.


KEY WORDS: Baastrup's disease; Interspinous bursal cyst; Posterior epidural cyst; Kissing spines syndrome; Low Back Pain

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