Thoracic Disc Prolapse
-
What are the common presentations of thoracic disc prolapse?
-
What is the incidence of disc prolapse in the thorax?
-
List five different causes of thoracic pain.
-
What is the level(s) most commonly affected?
-
In 60% of cases, pain and /or numbness is the presenting symptom with the pain occuring midline, unilaterally or bilaterall and may have a radicular distribution. In about 30% of cases, lower limb weakness is the presenting symptom with bladder weakness rarely the initial complaint but becoming present in 30% of patients on examination.
Thoracic disc prolapses make up only about 1% of disc prolapses.
Differential diagnosis includes: malignant or benign neoplasm, ankylosing spondylitis, diabetic thoraco-abdominal neuropathy, intercostal neurlagia, herpes zoster, intramedullary lesions, cardiopathies, compression fractures, gall bladder disease, gastric ulcers, pancreatitis.
Better than 75% of all thoracic prolapses occur below T8 with the majority at T11/12. Trauma is a factor in only 10-20% of cases and the majority of patients have pre-existing degenerative changes.
References:
Rolak, LA. Neurology Secrets. Hanley & Belfus Inc. Philadelphia 1993 ISBN 1-56053-056-1
Dietze DD Jr; Fessler RG; Thoracic disc herniations. Neurosurg Clin N Am 4:75-90 1993
Oppenheim JS; Rothman AS; Sachdev VP; Thoracic herniated discs: review of the literature and 12 cases. Mt Sinai J Med:60:321-6. 1993
Brown CW; Deffer PA Jr; Akmakjian J; Donaldson DH; Brugman JL; The natural history of thoracic disc herniation. Spine 6(suppl)17:97-102 1992
Disclaimer:
The assessment and treatment techniques depicted or described in this site are not intended to replace formal instruction in orthopedic manual or any other type of physical therapy. They are intended to review, augment and facilitate the knowledge and skills previously gained on manual therapy or other course and to stimulate the untrained or trainee physical therapist to increase the bounds of his or her knowledge and skill base.
|
