When interspinous ligamentous inflammation occurs, the adjacent posterior paraspinal musculature and nearby facet capsules may also be inflamed ( Figs. When interspinous bursal formation occurs, both calcium pyrophosphate dihydrate (CPPD) and hydroxyapatite crystal deposition may be present in the bursa. Fractures of the spinous process typically occur at C7 or any of the lower cervical or upper thoracic vertebrae. This process may lead to interspinous adventitial bursal formation and eventually formation of a synovial-lined articulation between the spinous processes. Fracture, Spinous and Transverse Processes Transverse and spinous process fractures are considered minor spine injuries and usually are stable and benign. As this disorder evolves, chronic active or episodic inflammation occurs in the interspinous ligaments, and over time the abutting surfaces of the involved spinous processes contact and eventually become flattened and sclerotic, with small cystic erosions or geodes occurring where the spinous processes contact ( Figs. Normally, the spinous processes are covered by noncartilaginous connective tissue. Interspinous ligamentous inflammation or bursitis (often referred to as Baastrup’s disease or Baastrup’s sign ) most commonly occurs at the L4-5 level but can occur at any lumbar level. These tissues can become inflamed and be a source of back pain. Small, short bilateral paired muscles, the interspinous lumborum muscles, are located on both sides of the interspinous ligament at a given lumbar level.
The space between adjacent lumbar spinous processes contains an interspinous ligament or ligaments and bilateral paraligamentous bursae.
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