Fluoroscopy-guided infiltration for pain reduction in patients with Baastrup's disease: clinical experience and results.
OBJECTIVE
Baastrup disease refers to degenerative changes of adjacent spinous processes with resultant back pain. The purpose of this study is to assess the safety and efficacy of percutaneous, fluoroscopy-guided infiltrations in a consecutive series of patients suffering from Baastrup disease.


METHODS
From January 2009 until December 2013, 55 patients suffering from Baastrup disease (diagnosed clinically and by imaging findings) underwent percutaneous, fluoroscopy-guided infiltration. The position of the needle (22-gauge spinal needle) was fluoroscopically verified at the level of interspinous ligament. Then a mixture of long-acting corticosteroid with local anesthetic (1.5/1 cc) was injected. A questionnaire with NVS scale helped in assessing pain relief degree, life quality, and mobility improvement.


RESULTS
In the patients of our study, a total of 67 sessions was performed. In 12/55 patients (22%), a second infiltration was performed within 7-10 days apart from the first one. The end point was 1 year post-treatment. Patients were followed 1 week after the first injection for a subsequent treatment and then if asymptomatic re-controlled in 3-6 and 12 months. Comparing the pain scores prior (mean value, 8.18 ± 1.44 NVS units) and after (mean value, 0.62 ± 0.93 NVS units) there was a mean decrease of 7.56 ± 1.68 NVS units (p < 0.001) on terms of pain reduction, effect upon mobility and life quality. There were no clinically significant complications noted in our study.


CONCLUSIONS
Fluoroscopy-guided infiltrations seem to be a feasible, efficacious, and safe approach for pain reduction and mobility improvement in patients with Baastrup disease.
2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini str, 12462, Athens, Greece, dfilippiadis@yahoo.gr.
Dimitrios K
DK
Filippiadis
Georgios
G
Velonakis
Aikaterini
A
Malagari
Efthymia
E
Alexopoulou
Elias
E
Brountzos
Nikolaos
N
Kelekis
Alexios
A
Kelekis
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001416:Back Pain / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects; D015641:Radiography, Interventional / Q000379:methods*; D013122:Spinal Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000779:Anesthetics, Local