What is Posterior Ramus Syndrome?- Causes, Treatment for Posterior Ramus Syndrome
Posterior Ramus Syndrome is also called â€œ
Maigne Syndrome, Dorsal Ramus Syndrome and, Thoracolumbar Junction Syndrome
â€. This is caused by the unexplained activation of primary division of dorsal ramus of spinal nerve or posterior ramus of spinal nerve. The nerve irritation causes reflective pain in the well explained tri branched pattern.
The diagnosis is done clinically in the absence of radiological signs. Thoracolumbar junction comprises of T10-11, T11-12 and, T12-1 motion segments. This transitional area, that is interposed between lumbar and thoracic spine is more frequently the source of characteristic pain syndrome. This is characterized by the referred pain in the related dermatomes, that is T10 to L1.
Anatomy Of Posterior Ramus Syndrome:
The rami regenerates the back skin and intrinsic muscles of apophyseal joints and also the inter and supra spinous ligaments. These posterior ramus disunites at right angles from the merging spine nerves. These ramus passes about apophyseal joints along the superior articular apophysis of the vertebra lying beneath.
Causes Of Posterior Ramus Syndrome:
The common cause for this is the minor intervertebral dysfunction at thoracolumbar junction. This dysfunction’s nature is unknown, though involvement of either discs or facets is very likely. Thoracolumbar junction is more involved in the rotatory movements than any other parts of the spine.
This leads to overuse of motion segment that initiates facet or disc degeneration. Disc herniation of vertebral body of T11, T12 or L1 are also responsible.
Sometimes cutaneous dorsal ramus of L1 gets entrapped while crossing the iliac crest. As a result it becomes superficial. It perforates the fibro-osseous tunnel formed by thoracolumbar fascia in the above region and below it the rim of the crest. This also causes Posterior Ramus Syndrome
Treatment For Posterior Ramus Syndrome:
The following are the treatments involved for thoracolumbar syndrome:
- Spinal manipulation
- Anesthetic Blocks
- Anti inflammatory drugs