Asian Spine J.  2016 Dec;10(6):1085-1090. 10.4184/asj.2016.10.6.1085.

Baastrup's Disease Is Associated with Recurrent of Sciatica after Posterior Lumbar Spinal Decompressions Utilizing Floating Spinous Process Procedures

• Koda M
• Mannoji C
• Murakami M
• Kinoshita
• Hirayama J
• Miyashita
• Eguchi Y
• Yamazaki M
• Suzuki T
• Aramomi M
• Ota M
• Maki S
• Takahashi
• Furuya T

• KMID: 2362187
• DOI: http://doi.org/10.4184/asj.2016.10.6.1085

Abstract

STUDY DESIGN: Retrospective case-control study. PURPOSE: To determine whether kissing spine is a risk factor for recurrence of sciatica after lumbar posterior decompression using a spinous process floating approach. OVERVIEW OF LITERATURE: Kissing spine is defined by apposition and sclerotic change of the facing spinous processes as shown in X-ray images, and is often accompanied by marked disc degeneration and decrement of disc height. If kissing spine significantly contributes to weight bearing and the stability of the lumbar spine, trauma to the spinous process might induce a breakdown of lumbar spine stability after posterior decompression surgery in cases of kissing spine.
METHODS
The present study included 161 patients who had undergone posterior decompression surgery for lumbar canal stenosis using a spinous process floating approaches. We defined recurrence of sciatica as that resolved after initial surgery and then recurred. Kissing spine was defined as sclerotic change and the apposition of the spinous process in a plain radiogram. Preoperative foraminal stenosis was determined by the decrease of perineural fat intensity detected by parasagittal T1-weighted magnetic resonance imaging. Preoperative percentage slip, segmental range of motion, and segmental scoliosis were analyzed in preoperative radiographs. Univariate analysis followed by stepwise logistic regression analysis determined factors independently associated with recurrence of sciatica.
RESULTS
Stepwise logistic regression revealed kissing spine (p=0.024; odds ratio, 3.80) and foraminal stenosis (p<0.01; odds ratio, 17.89) as independent risk factors for the recurrence of sciatica after posterior lumbar spinal decompression with spinous process floating procedures for lumbar spinal canal stenosis.
CONCLUSIONS
When a patient shows kissing spine and concomitant subclinical foraminal stenosis at the affected level, we should sufficiently discuss the selection of an appropriate surgical procedure.

Keyword

Lumbar stenosis; Postoperative complications; Sciatica

MeSH Terms

Case-Control Studies
Constriction, Pathologic
Decompression
Humans
Intervertebral Disc Degeneration
Logistic Models
Magnetic Resonance Imaging
Odds Ratio
Postoperative Complications
Range of Motion, Articular
Recurrence
Retrospective Studies
Risk Factors
Sciatica*
Scoliosis
Spinal Canal
Spine
Weight-Bearing