Maigne’s Syndrome. Lumbo-Pelvic Pain Part 1. William E. Morgan. It is natural to associate the site of pain as the source of pain. If the pain is over the sacroiliac. PDF | Thoracolumbar junction syndrome is defined as a result of a minor intervertebral dysfunction at the thoracolumbar junction and referred pain in the low. PDF | Thoracolumbar junction syndrome is characterized by referred pain which may originate at the thoracolumbar junction, which extends.

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The thoracolumbar junction syndrome is clearly defined by a triad pattern of pain involving the posterior pelvis, lateral thigh, and inguinal region. But I do think that the iliolumbar ligament can be quite clinically significant and can be another syhdrome to referred pain into the buttock. The patient was an active year-old female who, while ice skating, banged into the side of the rink, bruising her left flank clue one: The fourth criterion ,aigne the diagnosis: Positive injection response to local anesthestics maihne exclusion of other lumbar diseases with MRI were the key point of the patient selection.

I am confused as to whether this could be the Iliolumbar ligament or Dorsal Ramus. Lamina means a very thin layer. After I read Maigne’s paper, the patient happened to come in and did show the classic trigger point, 7 cm lateral to midline in the upper gluteals.

I agree that this gluteal trigger point is not directly over the iliolumbar ligament.

Posterior ramus syndrome

The treatment given to the first group of patients of the 3 group patients was just exercise therapies. It also innervates the multifidus muscle, one or two levels Distal Away from the trunk.

The anatomy of dorsal ramus nerves and its implications in lower shndrome pain. Towards the back like posterior. This site uses Akismet to reduce spam. Posterior ramus syndromealso referred to as thoracolumbar junction syndromeMaigne syndrome and dorsal ramus syndrome is caused by the unexplained activation of the primary division of a posterior ramus of a spinal nerve dorsal ramus of spinal nerve.

Maigne’s Syndrome – Dr. William E. Morgan

Since the facet syndroem injection was applied to the patients during our study, the local steroid injection was induced to magne patients receiving the injection therapy in the thoracolumbar junction region; yet the manual therapy applications have not been applied. Note 2, the lateral femoral cutnaneous nerves, wrapping around should actually be exiting slightly lower in the spine.


Patients with pain in any of these three regions should have a complete physical exam of the entire spinal column including palpation of the facets and spinous processes in hopes of determining the level of origin.

Does it show abnormal sensitivity and tenderness, and a lack of motion? The typical degenerative changes seen on most images may lead to unnecessary surgery or false diagnosis.

The diagnosis is made clinically with the variable presence of four criteria. Here is a recent case history to illustrate. I corrected, via mobilization and manipulation, the T-L restrictions.

It usually will have become much softer, much less synvrome. Correct the restricted and tender T-L junction segments with your own combination of manipulation, mobilization and soft-tissue therapies.

We aimed in our study to search the effectiveness of the exercise, and local steroid injection treatment as a TLS treatment modality [ 5 ]. He notes that most upper thoracic pain comes from the lower cervical spine. Similarly, entrapment of the Lateral Away from the median plane.

This diagnostic procedure can also be therapeutic; the injection of steroids or radiofrequency denervation of the medial branch can be added for refractory cases. The application results of corticosteroid injection are summed up as the pain and inflammation reduction which enhances the effectiveness of exercise through maignr of the muscles and the thoracolumbar region, so they have been considered as satisfactory treatment effects for corticosteroids [ 15 ].

Thirdly a lateral take-off passed down the anterolateral thigh or trochanter region. If the psoas or diaphragm is dysfunctional, it can create problems or reinforce dysfunction at these spinal levels.

You can help by adding to it. Find the direction of maximum tenderness and the direction of maximal fixation. The patient cannot pass to the next step without completing the previous step of doing the exercise smoothly, securely and distinctly considering the pain VAS from 0 to10 and 5 and sgndrome identifies considerable pain. Your browser version is outdated.

Thoracolumbar Junction Syndrome

Author information Article notes Copyright and License information Disclaimer. The self-correction for this restriction could be attention to breathing and getting better extension into the thoracolumbar junction with a foam roller or similar extension exercise.

In the differential diagnosis, musculoskeletal diseases need to be paid attention which cause the back pain and are as follows: A small number of case reports have been shown that it is successful in relation to the corticosteroid injection practices in the thoracolumbar junction syndrome in literature scan.


This is an open access article distributed under the terms of the Creative Commons Attribution 4. However, new studies must be conducted on different populations regarding this topic. If you position the patient correctly by slacking the area and go deeply enough, you can provide cross-friction to both the origin and insertion of the iliolumbar ligament.

In addition to spinal adjustments, the patient can also self-treat at home with the use of a foam roller figure 2. I released the QL; I did visceral to the kidney. Table 1 Baseline values of age and BMI of 3 groups. The first group received exercise therapy, the second group was treated with local steroid injections and the third group was the combination therapy group of both injection and exercise. These sensory nerves come out of the T-L junction and go down across the lower back, crossing over the pelvic brim into the buttock.

Peripheral Nerve Entrapment While the thoracolumbar spinal segments may be a source of pain in the inguinal region, buttocks, and lateral thigh regions as described by Maigne, there are other sources of symptoms. As a result of bone diseases such as the osteogenesis imperfecta and osteoporosis which have been reported in the literature, the developing T11 has been taken into consideration in cases such as the thoracolumbar junction syndrome due to the compression fractures.

The manner in which the exercise is done is as follows: Away from the trunk. J Can Chiropr Assoc. On the other hand, sundrome exercises provide the advantage of doing other exercises at the same time in order to face the growing differences in muscle length, the elimination of muscle strength imbalance and the development of proprioception. In hindsight, I was wrong; dysfunction at the thoracolumbar junction is maigen and can be the direct source of lower back pain. By using this site, you agree to the Terms of Use and Privacy Policy.

Besides exercise therapy, no manual therapy methods were used.