Posterior ramus syndrome
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Posterior ramus syndrome, also referred to as thoracolumbar junction syndrome, Maigne 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). This nerve irritation causes referred pain in a well described tri-branched pattern. The diagnosis is made clinically with the variable presence of four criteria.
Posterior ramus syndrome | |
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Other names | Thoracolumbar junction syndrome, Maigne syndrome |
Dorsal ramus |
Descriptions of clinical involvement of posterior rami were found as early as 1893, but not until 1980 that LDRS was so precisely described. While any (or all) of the three branches may present themselves, their constancy of location is what allows this to be defined as a distinct syndrome. One branch sets off anteriorly to the groin or pubic region. A second branch remains posterior, innervating the lower back and upper gluteal region. Thirdly a lateral take-off passed down the anterolateral thigh or trochanter region. The term sclerotome, distinct from dermatome for anterior rami involvement, has been proposed to describe the pattern of pain produced from posterior rami.