Baastrup’s Disease, more formally known as Spondylolisthesis, is a rare condition that affects the soft tissue of the lumbar spine, affecting predominantly middle-aged men. The diagnosis has been made on the basis of symptoms, which are broadly classified as either radiographic axial patterns or signs and symptoms of restricted movement. Radiographic techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) are used to obtain detailed images of the affected areas. Once the diagnosis is established, management includes physical therapy and pharmacological therapy.
Symptoms of Baastrup’s Disease
Baastrup’s disease is widely recognized by its commonly reported symptoms of back pain associated with limited extension activity, with an absence of muscle tone along the lumbar spine, weakness in the legs and feet, inability to climb stairs, walking with an arch, and a flattening of the thoracic region. In addition, a patient may experience neck pain, headaches, nerve pain, and/or headache. The exact cause is not known, but there is a strong suspicion that it is related to a disorder of the nervous system, specifically the nervous system’s motor control centers. This disorder is known as central nervous system hypotonia and is characterized by a reduction in the ability of the brain to control cranial movement. This process is believed to result in an imbalance of muscle forces, resulting in pain in the back.
Diagnosis and Treatment of Baastrup’s Disease
Baastrup’s disease can be either primary, meaning it is a disease that has no previous history of coronary artery disease, or secondary, meaning it is a disease that develops after a previous history of heart disease or hypertrophy of the lumbar spine. A history of heart disease can be diagnosed by means of cardiac catheterization, magnetic resonance imaging, and angiography. Treatment is aimed at controlling hypotonia (loss of muscle tone in the lower limbs) and reducing the loss of cranial blood flow to the spinal cord. Initial treatment for this condition will focus on reducing the burden of physical activity and reducing daily activity, with therapy being administered to address problems relating to the lumbar spine and spinal cord. In some cases, particularly those where the disease is primary, exercise may be required to increase the range of motion of affected limbs. Rest and immobilization are also recommended to reduce the risk of spreading the disease.
MRI scan of the lumbar spine, cervical spine, thoracic spine, and cervical hip joint can be conducted to detect problems with the lumbar spine. Interspinous bursitis may also be detected through an ultrasound. MRI scanning and magnetic resonance imaging will normally show no abnormalities in the major organs, although in a small number of patients, ultrasound may reveal abnormal calcifications in the interspinous bursa. Other than that, the imaging methods used in the diagnosis of Baastrup’s disease are very specific, which makes it difficult to treat patients using standard procedures. It is therefore often necessary to resort to more specific techniques such as interspinous bursitis arthroscopy or sclerotherapy.