- Dedication
- Preface
- Contributors
- Chapter 1 History and Examination of the Spine
- Chapter 2 Clinical Imaging of the Spine
- Chapter 3 Behavioral Assessment of the Spine Patient
- Chapter 4 Cervical Disc Disease and Extremity Pain
- Chapter 5 Cervical Facet Dysfunction
- Chapter 6 Cervical Spinal Stenosis
- Chapter 7 Cervical Spine Trauma
- Chapter 8 Degenerative Conditions of the Cervical Spine
- Chapter 9 Thoracic Disc Disease
- Chapter 10 Thoracic Facet Dysfunction/Costotransverse Joint Pathology
- Chapter 11 Thoracic Spinal Stenosis
- Chapter 12 Intercostal Neuralgia and Thoracic Radiculopathy
- Chapter 13 Lumbar Disc Disorders
- Chapter 14 Lumbar Facet Arthropathy
- Chapter 15 Lumbar Spondylolisthesis
- Chapter 16 Lumbar Spinal Stenosis
- Chapter 17 Lumbar Radiculopathy and Radicular Pain
- Chapter 18 Surgical Approaches for Degenerative Lumbar Stenosis
- Chapter 19 Sacroiliac Joint Dysfunction
- Chapter 20 Sacroiliac Joint Fusion: Percutaneous and Open
- Chapter 21 Spinal Deformity and Scoliosis
- Chapter 22 Approaches and Relative Benefits of Open Versus Minimally Invasive Surgery for Degenerative Conditions
- Chapter 23 Spinal Tumors: Surgical Considerations and Approaches
- Chapter 24 Pelvic Pain and Floor Dysfunction
- Chapter 25 Core Strengthening
- Chapter 26 Ultrasound-Guided Spine Interventions
- Chapter 27 Biologic and Regenerative Therapies
- Chapter 28 Platelet-Rich Plasma Injections
- Chapter 29 Opioids in Spine Pain: Indications, Challenges, and Controversies
- Chapter 30 Sympathetic Blockade of the Spine
- Chapter 31 Post Spine Surgery Syndrome
- Chapter 32 Intrathecal Pumps
- Chapter 33 Spinal Cord Stimulation
- Chapter 34 Peripheral Nerve Stimulation
- Index
(p. 209) Thoracic Facet Dysfunction/Costotransverse Joint Pathology
- Chapter:
- (p. 209) Thoracic Facet Dysfunction/Costotransverse Joint Pathology
- Author(s):
Brian A. Young
, Phillip S. Sizer
, and Miles Day
- DOI:
- 10.1093/med/9780199350940.003.0010
The thoracic facet and costotransverse joints are often implicated as the source of thoracic pain, yet definitive diagnostic and treatment guidance is significantly limited. This chapter reviews the anatomy, innervation, and biomechanics of these joints, as well as associated pathology. Definitive innervation of the posterior primary rami has yet to be established, and significant pain pattern overlap between the thoracic facet joint, costotransverse joints, and visceral referral patterns, as well as the limitations of current biomechanics, challenge the clinician’s ability to examine pain of suspected thoracic origin. The use of clinical reasoning in the absence of definitive diagnostic and treatment approaches is necessary to optimize outcomes in patients with pain of suspected thoracic musculoskeletal origin. A progression from noninvasive to minimally invasive to interventional techniques may be warranted based on the patient’s response to treatment.
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- Dedication
- Preface
- Contributors
- Chapter 1 History and Examination of the Spine
- Chapter 2 Clinical Imaging of the Spine
- Chapter 3 Behavioral Assessment of the Spine Patient
- Chapter 4 Cervical Disc Disease and Extremity Pain
- Chapter 5 Cervical Facet Dysfunction
- Chapter 6 Cervical Spinal Stenosis
- Chapter 7 Cervical Spine Trauma
- Chapter 8 Degenerative Conditions of the Cervical Spine
- Chapter 9 Thoracic Disc Disease
- Chapter 10 Thoracic Facet Dysfunction/Costotransverse Joint Pathology
- Chapter 11 Thoracic Spinal Stenosis
- Chapter 12 Intercostal Neuralgia and Thoracic Radiculopathy
- Chapter 13 Lumbar Disc Disorders
- Chapter 14 Lumbar Facet Arthropathy
- Chapter 15 Lumbar Spondylolisthesis
- Chapter 16 Lumbar Spinal Stenosis
- Chapter 17 Lumbar Radiculopathy and Radicular Pain
- Chapter 18 Surgical Approaches for Degenerative Lumbar Stenosis
- Chapter 19 Sacroiliac Joint Dysfunction
- Chapter 20 Sacroiliac Joint Fusion: Percutaneous and Open
- Chapter 21 Spinal Deformity and Scoliosis
- Chapter 22 Approaches and Relative Benefits of Open Versus Minimally Invasive Surgery for Degenerative Conditions
- Chapter 23 Spinal Tumors: Surgical Considerations and Approaches
- Chapter 24 Pelvic Pain and Floor Dysfunction
- Chapter 25 Core Strengthening
- Chapter 26 Ultrasound-Guided Spine Interventions
- Chapter 27 Biologic and Regenerative Therapies
- Chapter 28 Platelet-Rich Plasma Injections
- Chapter 29 Opioids in Spine Pain: Indications, Challenges, and Controversies
- Chapter 30 Sympathetic Blockade of the Spine
- Chapter 31 Post Spine Surgery Syndrome
- Chapter 32 Intrathecal Pumps
- Chapter 33 Spinal Cord Stimulation
- Chapter 34 Peripheral Nerve Stimulation
- Index