Full-endoscopic interspinous cleaning surgery for chronic low back pain associated with Baastrup's disease:a technical note and case series.

Chronic low back pain due to impingement of two adjacent spinous processes has been called Baastrup's disease. The diagnosis can be confirmed by interspinous infiltration of local anesthetic. However, little evidence regarding its pathology and treatment exists. Considering previous reports and our cases, three pathologies including impingement caused by contact between two adjacent spinous processes, inflammation and synovitis at the interspinous ligament, and inflammation and synovitis in the tissue surrounding the interspinous area are needed to be addressed. Conservative treatment with an interspinous steroid injection has been reported, as has surgery consisting of partial resection of the spinous processes or installation of an interspinous spacer. Thus, surgical strategy should include partial resection of the spinous processes causing impingement, removal of the interspinous inflammatory bursitis, and radiofrequency ablation of the surrounding tissue. Another surgical option that can achieve these strategies is a minimally invasive full-endoscopic procedure, which we refer to as "full-endoscopic interspinous cleaning surgery." Briefly, the bony surface on the spinous processes is removed by the drill and the surrounding tissues are ablated using a bipolar radiofrequency device. This report describes the surgical technical presentation and the clinical outcomes for 3 cases based on the pathologies.