Disorders of the thoracic spine: Non-disc lesions

Disorders of the thoracic spine

Non-disc lesions

Chapter contents

Introduction

Warning symptoms and signs

Pathology: see the online content

Introduction

Non-disc lesions of the thoracic spine comprise the following disorders:

• Extradural haematoma

• Spinal cord herniation

• Spinal canal stenosis

• Vertebral fracture

• Chest deformities

• Fracture of a transverse process

• Spinal infections

• Lateral recess stenosis

• Localized lesion of costovertebral and costotransverse joints

• Localized lesion of a facet joint

• Paget’s disease.

Very often, the signs and symptoms of the non-discal lesions of the thoracic spine resemble those of discodural disorders.

Some of the lesions mentioned are serious and even life-threatening. Therefore examiners must be on their guard and should immediately request further investigation whenever there is doubt about the exact diagnosis.

Warning symptoms and signs that warrant the examiner’s attention are listed here and are summarized in Box 28.1.

Box 28.1 Summary of warning signs

• Progressive increasing pain

• Expanding pain

• Continuous pain, not changed by posture or activity

• Increasing postoperative thoracic backache

• First symptoms and signs in people over 50 years of age

• Central pain radiating bilaterally and spreading anteriorly

• Gross limitation of both side flexions and rotations

• Gross limitation of extension

• Pain and limitation of side flexion away from the painful side as the only positive finding

• Flexion with a rigid thoracic segment

• Presence of one of following neurological signs:

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Tags: A System of Orthopaedic Medicine

Jun 5, 2016 | Posted by admin in ORTHOPEDIC | Comments Off

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