Interspinous bursae are adventitial bursae that develop between adjacent spinous processes, most commonly in the lumbar spine (L4-L5 and L3-L4), in response to chronic contact between converging spinous processes during lumbar extension. They are not universally present in younger individuals but become increasingly common with age and degenerative lumbar hyperlordosis.
Kissing spine syndrome (Baastrup disease) describes the pain produced by contact between adjacent lumbar spinous processes, with or without interspinous bursa formation. On MRI, signal change within and around the interspinous space, including T2 hyperintensity and enhancement of an interspinous bursa, confirms the diagnosis. Treatment includes lumbar flexion-based physiotherapy, extension restriction, corticosteroid injection into the interspinous space, and interspinous process spacer implantation for refractory cases.
Contact and bursitis between adjacent lumbar spinous processes, worsened by standing and lumbar extension and relieved by flexion, producing midline back pain with a characteristic tender point directly over the interspinous space, managed with injection, physiotherapy, or interspinous spacer device.
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