Clinical Anatomy and Mgmt of Back Pain [Vol 2 - Thoracic Spine] PDF
Preview Clinical Anatomy and Mgmt of Back Pain [Vol 2 - Thoracic Spine]
Copyrighted Material Copyrighted Material Copyrighted Material Copyrighted Material Butterworth-Heinemann LinacreH OllJsoerd,a nHill ,O xford OX2B OP 225 Wildwood AvenueW,o burn, MA 01801-2041 A divisioofnR eedE ducat.ianodn aJP rofessiPuobnlaJi shingJ.t.d� -& A membero f[ heR eedE Lsevipeircg roup Firs[ ubplished 2000 © ReedE ducarioannaJd P rofessioPnuabll ishinLgr d2 000 Allri ghtsre serveNdo. p arto ft hipsu blicatmiaoynb e reproduceind any materifoanJn ( includipnhgo tocopyionrgs toriinn g; U1ym ediumb y eelctronic means andw hethOefnr o rt ransieonri t.lnyc idye rnotso amlel othelri soef l hipsu blicatiwoint)h outrh ew rittepne nnissioofnt he copyrighhotl deerx cepint accordancewi tJlth e provisioonfst heC opyright, Designasn dPa rentAsc t1 988or u nder( here nns ofJ licenicses uebdy the CopyrigLhitc ensiAngge ncyL td9,0 T onenham( "..ouRrota d,L ondon, EnglanWdI P OLP.A pplicatifoOntfsh ec opyrightho lder's Wf/ITCn permissitoonr eproduacen yp arotf t .hpiusb licats.hioounl bde addressed tot ilt:p ublishers British Ubrary Cataloguing in PubllcationD ata Giles,L .G .F. Clinicaaln aromanyd man agemenr oft horascpiinec pain 1.S pine- Disease2s. B ackache- Trearmen3t .T horacic vertebrae -Diseases I. itleT. H. Singer, (KeKvi.n P.P ) 617.5'64 Ubrary ofC ongressC ataloguining Publication Data Thec liniacnaalt oym andm anagemento ft horaciscp inpea in/[editbeyd] L.G.GEil esa ndK .P.S inger. p. cm. Includbeisb liographirceafle renacnedsin dex. ISBN0 75064 7892 1.Th oracic vertebra-ePa thophysiolog2y..B ackache.3 .S pin-e Disease-sT reatment. I. GilesG,. F L. SingeKr.,P (KeviP.n) [DNLM: 1.T horaciVce rtebra-ep hysiopathologyB. ack2Pa .in -diagnosis.B ack3 . Pain - therapy. 4.Th oraciVce rtebra-ea naromayn dh istoloWEg y7.2 5C 641] RD533.C56 99-056627 617.5'-6d4c 21 ISBN0 75064 7892 Composiotni byG enesis TypesettinLags,e rQ uayR,o chestKeern,t Printeadn db OlUlind GreaB[r ilabiny T heB athP resAsv,o n Copyrighted Material Contents Lisotf c ontributors vii 10 Cervicothoraancdit ch oracolumbar Foreword ix spinalp ains yndromes 157 Preface xi ].-Myai gne Acknowledgement xiii 11 The htoracic psine andt he' tirneedc k SectiIo nI ntroduction syndrome' 171 H.F. Farfan Introducttiheo ne:n igmoaft het horacic spine 3 K.P Singera ndS .] .E dmondston 12 Radioloogfyt h e thoracsipci ne 177 I.WM cCaU Secti/Io n Anatomy,P atholoagyn d Biomechanics 15 SectiIVo n Managemenotf T horacic 2 Anatomy oft he thoracsipci ne 17 SpinPea in 203 K.P Sniger andS .G oh 13 Medicaaln di nvasimvaen agemenotf 3 Ligamenotfst heh umanv ertebral thorcaicsp ina.l pain 205 column 34 R.] .S tolkaenrd G.] .G roen R.V. Putza ndM . Mi.iUer-Gerbl 14S urgictarle atmeonftd iseasaensd 4 Biomechaniocfts h et horacsipci naen d traumoaf t het horacsipci ne 223 ribcage 45 G.F. inFdlya and ESi.s enstein IA.. F. Stokes 15C hiropracmtainca gemenotf t horacic 5 Patholoogyf t het horacsipci ne 63 spnie paino fm echanicaolr igin 244 K.P Singer D.] .L awrencaen dB .B akkum 6 Developmenatnaolm alioefst he 16O steopathci managemenotf t horacic thoracriecg ion 83 spinpea in 257 ].S aadaS,.S onga ndW H.B reidahl T. McCluneC,. W alkearn dK .B urton 7 Pathoa.natomcihcaarla cteriosftt ihces 17P hysiothermaanpayg emento ft horacic thoracolumjbunacrt oinalr egino 100 spinpea in 268 K.P Singer andA .M almivaara D.G .L ee 8 Thoracniecu raaln atomy 114 18 Diagnosoifst horacsipci npea inan d G.] .G roena nd ]R.S. t olker contraindicattois poinnasl m obilization andm anipulatoin 283 SectiIoIIn DiagnosoifsT horacSipci ne L.G .F. Giles Pain 143 9 Diagnosiso ft horacipca ins yndromes 145 ].H .B land Index 299 Copyrighted Material Contributors B.B akkum DC,P hD L.G .F .G ilesM Sc,D C(C),P hD NationCaoll leogfeC hiropracLtomicb,ard ,I L DirectSopri,n aPali nU nit,T ownsvilGleen eral 60148U,S A HospitTaolw, nsvi4l8le1 0Q,u eenslaAnuds,t ralia J.H .B landMD ProfesosfoM re dicin-eRh eumatologEym,e ritus S.Go h BSC(Hons)PT, Unievrsityo fV ermonCto Uegoef M edicine, Centrfeo rM usculoskelSettuadli eUsni,v ersity Rheumatologayn dC linicIammlu nologUyn itG,i ven DepartmeonftS urgerTyhe,U niverSoiftyW estern MedicalB uUdingR,o om D-302,B urlingtVoenr,m ont AustralRioay,aP ler ht HospitPaelr,t 6h0 00W,e stern 05405U,S A Austarlai W. H.B reidahl BSc,MB BS,F RACR G.J .G roen MD, PhD ConsultRaandti ologDiespta,r tmeonftI maging ServiceRso,y aPl ertHhos pita,lP erthW,e stern Associate ProCfeenstsrfoeor r,P erioperative Australia MedicinAene,s thesiolaongydP ainC liniUcn,i versity MedicaCle ntrUet rechPtO,. B ox 855003,5 08G A K.B urton PhD,D O, MErgS Utercht,T heN etherlands SpinaRle searUcnh itUn,i versoiftH yu ddersfield, 30Q ueenS treeHtu,d dersfieHlOdI 3DH,U K D.J .La wrence DC NationalC olkge ofC hiropratcCi,L ombard,I L S.E dmondstoPhDn, MT,PT 60148U,S A Centrfeo rM usculoskelSettuadli eUsn,i vresity DepartmeonftS urgery,T heU niversoiftW ye stern AustraRloiyaaP,le rtHho spital,P ert6h0 00W,e stern D. Lee MT,P T Australia DeltOar thopaedPihcys iotherapy Clin.ic, # 302- 84251 20tSht reeDte,l tBaC,, V 4C 6R2, S.E isenstePihnD ,F RCS Canada ConsultantO rthopedaicS urgeoCne,n trfeo rS pinal Studi,eR soberJto neasn dA gnesH untH ospital, GobowenO, swestrShyr,o pshire,U K J.-MYa.i gneM D Hotel-Dieu oHspita,lR ehabilitDaetpiaornt ment, H.F .F arfaMDn PlacNeot re Dame,7 5004Pa ris,F rance (deceased) G.F .F indlBaScy,M B,C hB,F RCS A.M almivaaMrDa, PhD Consultant NeuroWsaulrtgoeCno enn,t rfeo r FinniIsnhs titouftO ec cupatoinalH ealth, Neuroloagyn dN eurosurgNHerSy T,r usLto,w er Departmetno fO ccupatioMneadli cine, LaneF,a zakerJey, LiUvKe rpool, Topeliuksen4k1aA t,u0 0250H elsink,iF inland Copyrighted Material viiCio ntbruit ors I.M cCalFl RCR K.P .S ingerP hD, PT ConsultaRnatd iologDiespta,r tmeonftR adiology, Centrfeo rM usculoskelSettuadli eUsn,i versity TheR oberJto neasn dA gnesH untO rthopaedic Dep:u1:meonft TheU niversoift\Vye ,stern InstitUOlscw,e stry, AustralRioay,a l HospitPaelr,t 6h0 00\'Vc,,t ern Australia T.M cCluneD O S.S ongB Sc( Hons)M,B BS,F RACR SpinaRle searcUhn itU.n iversoiftyH lIddersfit"'lrl, 30Q ueenS treeHtu,d dersfiHeDl1d3 DH,U K MHI DepartmeonftI magi.nSge rvicHeosv,a l PertHho spital, WesterAnu stra6l0i0a 0 M. Miiller-GerPblhD Ludwig-Maximmilians-UMniiivnecrhseint,a t I.A .F .S tokePshD AnatomiscAnhset al!P,e ttenkofe1r1s,0t -r 80336 DepartmeonftO rthopaedaincrlsR ehabilit:uion. MiincliGeenr,m any UniversoiftVye rmomB,u rlingVtTo n0,5 405I,S A R.Pu tz MD, PhD R.J .S tolkeMrD , PhD Ludwig-MaximrniIians-Universitat Miinchen,D epartmeonftA nesthesiolCoagtyh,ar iHnoas pital, Anatom.isA<nhset aiPle,t tenkofer,s 0t-r 80356 5602 EindhoveTnh,e Nethe:rbncls Miinchen(,; ermany C.Wa lker nsc( Hons)B,S c( Ost) J.S aadaF RCR SpinalR esearcUhn itU,n iversoiftH yu ddersfield, ConsultaRnatd iologNiosrtf,o Hloks pitNaolr,w ichUK, 30Q ueenS treeHtu,d dersfieHlOdt 3 DH,U K Copyrighted Material Foreword Havingb een personalalnyd heaviliyn volvefdo r assembleadn excelleinntte rnationtaela m from nearl2y5 y earins clinicaanldl aboratosryt udioefs diverbsuet r elevadnits ciplitnoa edsd resnso rmaaln d thes pineh,a vinagt tendendu merousc onferencesp athologisctarlu ctuarnedf unctiino na ddititoont he andm eetingcso ncernewdi thb ackp ain,a ndh aving diagnosainsd managemenotf pain involvitnhge reada multitude of publicatidoenasl inwgi tht he thoracriecg ioTnh.e t eama ndt heierd itoarrse t ob e vertebcraoll umnt,h ep erceptitohna tI g aineeda rly congratulatefdo rh avinags semblae dc omprehensive after takinugp my intereisntt hes pinew,a s that but readablaec counto f existiknnogw ledge,f or comparewdi tht hel umbara ndc ervicaslp inet he havinagc hievesdu bstantuinaiflo rmitoyf s tylea,n d thoracsipci nhea sr eceivmeudc h lesast tentiMoyn . forh aving raiseda range of new conceptTsh.e perceptihoans c ontinuteodb e sustainoevde rt hat resultbinogo kp resenat vsa luabsloeur ceo fi nforma manyy earMs.y own explanatfioortn h er easonwsh y tionf orp rofessionals iinnvt ohlevin evde stigation thet horacsipci nhea sn ota ttracttheeds amel eveolf andc linicmaanla gemento f backp aina,s wella s clinicaanldl aboratory investaisgt ahteic oenrv ical providinbga sics cientiwsittsh a richs ourceo f andl umbarre gioinsst hatth et horaCrieCg ioinsl ess existiknnogw ledgea sw ella sp rovidinag s ubstantial oftent hes ourceo fc omplainotfsb ackp aint,h atth e stimluusf orn ew lineosf i nvestigation. presencoef t her ibsi mposessu bstantidalilfyf erent Ia m grateful toh avet hiosp portunittyob ea blet o biomechaniinfclaule nceasn dt hersee emst ob el ess expresmsy personaglr atitutdoe t hea uthorasn d patholoing yt harte gioonf t hes pine. editofrosr f tllianng i mportannitc hei nt hes pinal Taking accounotf t hirse latlivaeco kf p asitn terestl iteratuarned I c onfidentlpyr edictth aatn yonew ho in thet horacsipci naen dt here freshainndgt horough hasa ni ntereisnbt a ck pain iatcnsad u sewsi lrle ach approachd isplaybeyd D r Gileasn dP rofessSoirn ger a similcaorn clusion. too therre gionosft hes pinael reacdoyv ereind this three-volusmeer ieIs, h avel ookedf orwarwdi th ProfessBoarr riVee rnon-RobeMrDt,s PhD particulkaerelnay n ticipattoit ohne iorf ferionng t he DirectoIrn,s titouftM ee dicaaln dV eterinaSrcyi ence thoracsipci neI.am notd isappointaesdt hey have AdelaidNeo,v ember19 99 Copyrighted Material Preface Ouri ntentiino cno mpilitnhgi nse w texste rieisst o asa llc liniciwahnos s eeka comprehensirveev ieowf providaen i nternatipoenraslp ectoinv et her ationalt horacsipci ne paIintn h.e b elietfh atq ualiirlyl ustra approactho managinmge chanicsapli napla inW.e tionsf acilittahtee m essagec,a refuls electioofn presenat comprehensirveev iewa nd analysoifs materiaanld d etailceadp tiohnasv eb eenp reparetdo clinicraellleyv ainntf ormatfiroonm t heb asiscc iences complementth et extAn. importanste conodb jective leadintgo diagnosainsd treatmeonft mechanical ist oe ncouraggree atecro mmunicatiobne tween the spinadli sorders. c1.inical schools iinnt thiesr seusbtjeedc tth,r ough Thisv olumeh ighlightthse valueo f a team whicha stronger scibeansitsif fiocre valuatiaonnd approacihn a ppreciattihnecg o mplexiryo ft horacic managemenotf t horacsipci npea inw ilelm erge. spinep aina nd a rangeo f treatmeanptp roaches. Thet exits o rganizesdo t hati tca nb ea pproached Thoraciscp inpea inp oseas specicahla llentgoet he ins everwaaly sa,c corditnogt hen eedso ft her eader. clinicwihaon m,u sta ppreciatthee v arieoryf syn SectioIni ntroductehser easonibnegh intdh itse xt, dromesa nd referrpaalt ternwsh ich can min1ic describitnhge e nigmao f thoracsipci nep aint,h e disordearts d istansti tesC.o ntemporaryc ontribuknown epidemioloogyf t hep roblema,n di tsm any tionfsr omt hefi eldso f anatomyp,a thoglyo,b io complexitfioerts h ec liniciSaenc.t ioInIp resentthse mechanicnse,u roanatomcyl,i nimceald iicne, pain clinicaaln atomyp,a thologya nd biomechaniocfs contr,or ladioloogryt,h opaedincesu,r osurgecrhyir,o thet horacriecg ioann dc ontainssp ecicahla pteorns practioCs,t eopatahnyd physiotheraaprye a llp re the adjoinicnegr vicorhoraancdi ct horacolumbar sentedin thisv olumeE.a chs ectiownr,i ttebny junctiornealg ionTsh.i ss ectioanl sop resenat sv ery experiencaecda demiccl iniciapnrso,v ideas s um detaileodv ervieowf t horacniecu roanatotmoyp ro mary of pertinemnatt eriatlh.a tw illl eadt o an videa basifso ru nderstanditnhge d iagnostcihca l improveudn derstandoifn tgh ec auseosf thoracic lengaew aititnhge c linician. spinpea ine,m phasizipnrgi marimleyc hanicsaolu r The cliniciwahno wishesa quicko vervieowf ces. Manageampepnrto achaerse o utlinebda,s edo n clinicaals sessmecnotn cepts shcoounlsdu lSte ction routine assessment taencdh nsiuqpupeosr tebdy IIIDi,a gnosoifsT horaciScp ineP ainT.h isi ncludes clinicraela soninsgt rategiTehsi.s t extd oes not diagnostiimca gingp rocedureasn d medicala nd attemptot endorsae singlteh erapbyu,t r athetro surgicaaplp roachetso thoraciscp inep ain, and highlitghhetc ommon approactho m echanictarle atseparatceh apterosn thea ssessmeanntd manage ment thatm ay be providebdy medicals,u rgical,m ent strategies prboyv icdheidr opractoosrtse,o chiropracotsitce,o patahnyd physiotherparpayc tipathasn dp hysiotherapAi ssptesc.i cahla ptebry the tionerNse.w erin vasivpea inc ontroslt rategairees lateH arryF FarfaMnD describheiss r emindetro alsoou tlinteodi nforcml inicioafns su cho ptionfso r clinicitaone sx aminteh ew hole perwshoenn assess them anagemenotf chronic thoracic pain.i ngt horacpiaci n. Ourg oails t op resetnt hiisnf ormatiionna manner SectioIVn p resenat msu ltidiSCiplainpaprryo actho whichw illb enefitb oth the undergraduaatned them anagemenotf thoracsipci nep aina,n d con postgradusattued enotfm echanictahle ra,pa ysw ell cludewsi tha comprehensicvhea ptesru mmarizing Copyrighted Material
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