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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thoracic percutaneous facet denervation has been employed for the treatment of thoracic zygapophysial joint pain. But the surgical anatomy of this procedure has been assumed to be the same as for lumbar medial branch neurotomy. To establish the anatomical basis for thoracic medial branch neurotomy, an anatomical study was undertaken. Using an X40 dissecting microscope, a total of 84 medial branches from 7 sides of 4 embalmed human adult cadavers were studied. The medial branches of the thoracic dorsal rami were found to assume a reasonably constant course. Upon leaving the intertransverse space, they typically crossed the superolateral corners of the transverse processes and then passed medially and inferiorly across the posterior surfaces of the transverse processes before ramifying into the multifidus muscles. Exceptions to this pattern occurred at mid-thoracic levels (T5-T8). Although the curved course remained essentially the same, the inflection occurred at a point superior to the superolateral corner of the transverse process. At no time during the dissection were nerves encountered crossing the junctions between the superior articular processes and transverse processes which have been the target points advocated for thoracic facet denervation. Rather, the results of this study indicate that the superolateral corners of the transverse processes are more accurate target points.
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PMID:The surgical anatomy of thoracic facet denervation. 874 44

Thoracic discography is performed much less frequently than either cervical or lumbar discography due to the relative infrequency of symptomatic thoracic disc pathology. Clinicians are less likely to ascribe thoracic pain to discogenic disease of the thoracic spine than to other more common etiologies, such as facet joint pain, muscle pain, skeletal pain or visceral pain. A comprehensive evaluation for pain includes having an index of suspicion that includes the thoracic disc as the cause of these symptoms. The purpose of thoracic discography is to identify or confirm a thoracic disc as a pain generator. The procedure itself has many similarities to the one used in the lumbar region; there are also similarities with the lumbar procedure with respect to patient selection and indications. Unintentional or inadvertent pleural puncture is a major risk of this procedure. It is a safe procedure when performed by an expert. Thoracic discography identifies the particular painful disc and provides a more complete description of thoracic disc pathology, correlated with MRI or CT findings.
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PMID:Thoracic discography. 1685 87