Atypical variant of Baastrup’s disease with lumbar stenosis and cauda equina syndrome

Background: Classical Baastrup’s disease is a degenerative disorder of the lumbar spine characterized by the approximation of adjacent spinous processes due to excessive lordosis. This results in edema, sclerosis, cyst, bursitis, and midline epidural fibrosis and is often overlooked as a cause of low back pain. Here, we report a patient with atypical Baastrup’s disease and lumbar spinal stenosis who presented with a cauda equina syndrome. Case Description: A 67-year-old male presented with low back pain of 1 year’s duration. This exacerbated over the past 3 weeks, becoming associated with the left lower limb numbness/weakness and bladder dysfunction. The lumbar magnetic resonance (MR) showed atypical Baastrup’s disease characterized by multiple ill-defined areas of contrast enhancement in the paraspinal region in conjunction with lumbar canal stenosis. The patient underwent lumbar decompression and exhibited improvement in his neurological deficits postoperatively. Conclusion: This case highlights the atypical MR features of lumbar Baastrup’s disease in conjunction with stenosis. Atypical Baastrup’s disease should be differentiated from classical Baastrup’s disease or other infectious pathologies (e.g., Pott’s disease of the spine) and appropriately treated with timely spinal decompression.

The steps until surgery in the management of Baastrup’s Disease (kissing spine syndrome)

Baastrup’s disease is a rare condition of the vertebral column often misdiagnosed and wrongly treated due to poor knowledge, characterized by low back pain arising from the close approximation of adjacent posterior spinous processes and resultant degenerative changes. Diagnosis rests on clinical examination and detailed imaging studies. Proposed therapies include conservative treatment, percutaneous infiltrations or surgical therapies. We present the case of a 31-year-old man with persistent chronic lumbago for several years. In whom, the diagnosis of Baastrup’s disease was high suspected clinically, with a final surgical treatment despite the absence of inflammation on imaging studies, which allowed the diagnostic confirmation and the return to a normal social and professional life. We wish through this case, to expose the different steps of interventional diagnostic/therapeutical procedures until the surgical management in a clinical suspicion of Baastrup’s diseases with unclear radiological findings.