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Iatrogenic Baastrup's Syndrome: A Potential Complication Following Anterior Interbody Lumbar Spinal Surgery

James J. Yue, MD, Glenn S. Russo, MD, MS, Carlos A. Castro, MD

Department of Orthopaedic Surgery, Yale School of Medicine, New Haven, CT

Abstract

Background

Baastrup's Syndrome is a condition that occurs when there is abnormal contact between two adjacent spinous processes resulting in back pain. An alteration in lumbar spinal alignment and/or adjacent segment compensatory motion is thought to be potential causative factors. The objective of this study was to present a case series of what appears to be iatrogenic Baastrup's Syndrome as a mid-to-late term complication following anterior lumbar interbody surgery.

Methods

A retrospective chart review was performed of all patients undergoing anterior lumbar surgery for either fusion or disc replacement to determine the prevalence of Baastrup's Syndrome.

Results

Over a 12-year period, 855 patients who had undergone an anterior approach for lumbar spine surgery were identified. Of them 8 patients with evidence of Baastrup's Syndrome were found; this demonstrated a prevalence of 0.9%. Diagnostic injection was a helpful clinical tool in confirming the diagnosis of iatrogenic Baastrup's Syndrome. The partial removal of the impinging spinous processes resulted in excellent clinical relief.

Conclusions

Iatrogenic Baastrup's Syndrome may be an iatrogenic result of anterior lumbar surgery in small group of patients. Spinous process excision is a suggested treatment option. Further studies are necessary to explore the above phenomenon. This study is a Level 3 retrospective case series.

keywords: 
anterior lumbar surgery, spinous process impingement, Kissing Spine Disease, Baastrup's Syndrome
Volume 9 Article 66
doi: 
10.14444/2066