title: Baastrup's Disease Is Associated with Recurrent of Sciatica after Posterior Lumbar Spinal Decompressions Utilizing Floating Spinous Process Procedures.
abstract: METHODS
  Retrospective case-control study.
  
  
  OBJECTIVE
  To determine whether kissing spine is a risk factor for recurrence of sciatica after lumbar posterior decompression using a spinous process floating approach.
  
  
  BACKGROUND
  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.
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.; Department of Orthopedic Surgery, Chiba Aoba Municipal Hospital, Chiba, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Koda
authors.affiliation: Department of Orthopedic Surgery, Chiba Aoba Municipal Hospital, Chiba, Japan.
authors.forename: Chikato
authors.initials: C
authors.lastname: Mannoji
authors.affiliation: Department of Orthopedic Surgery, Chiba Aoba Municipal Hospital, Chiba, Japan.
authors.forename: Masazumi
authors.initials: M
authors.lastname: Murakami
authors.affiliation: Department of Orthopedic Surgery, Narashino Dai-ichi Hospital, Narashino, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kinoshita
authors.affiliation: Department of Orthopedic Surgery, Chiba Medical Center, Chiba, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Hirayama
authors.affiliation: Department of Orthopedic Surgery, Matsudo City Hospital, Matsudo, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Miyashita
authors.affiliation: Department of Orthopedic Surgery, Matsudo City Hospital, Matsudo, Japan.
authors.forename: Yawara
authors.initials: Y
authors.lastname: Eguchi
authors.affiliation: Department of Orthopedic Surgery, University of Tsukuba, Tsukuba, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamazaki
authors.affiliation: Department of Bioenvironmental Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Takane
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Aramomi
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Ota
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Maki
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Furuya
keywords: Lumbar stenosis; Postoperative complications; Sciatica