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Iatrogenic Baastrup's Syndrome: A Potential Complication Following Anterior Interbody Lumbar Spinal Surgery
James J Yue1, Glenn S Russo1, Carlos A Castro1
1Department of Orthopaedic Surgery, Yale School of Medicine, New Haven, CT.
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.
