case_images: PMC9944191_01
case_images: Imaging modalities for diagnostic workup in Baastrup's disease.. (A) Sagittal CT of the lumbosacral junction. The arrow indicates the close relationship of the spinous process L5 and S1 with reactive sclerosis of the opposing interspinous surfaces. A reduced interspinous space of spinous processes L4-L5 is observed. (B) Corresponding coronal CT. The arrow indicates the approximation and contact of the adjacent spinous processes of L5 and S1. (C) T2-weighted sagittal MRI of the lumbosacral junction. Minor degenerative changes and postoperative changes at the L5-S1 segment (long arrow) are evident. (D) The contact of the L4 and L5 spinous processes is visible (arrow). (E) SPECT data do not demonstrate any relevant tracer uptake.. CT = computed tomography; MRI = magnetic resonance imaging; SPECT = single-photon emission computed tomography
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case_images: FIG1
case_images: Single-photon emission computed tomography (SPECT) data were available from previous examinations (see Figure 1).
case_images: Graphic illustration of the partial surgical resection of the one-third superior and inferior portions of the spinous processes L4-L5.. (A) Close approximation and contact of spinous processes leading to irritation (red circle). (B) Segmental spinous processes have adequate distance following partial resection. The identical procedure was performed for the adjacent segment L5-S1.. Permission has been granted from Miles Rothoerl.
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case_images: FIG2
case_images: Surgical decompression of both spinous processes was performed by wedge excision of the one-third superior and inferior portions using a piezoelectric cutting instrument, with additional high-speed drilling of the spinous process margins (see Figure 2).