Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

43. Thoracolumbar Syndrome
James A. Rydlewicz and Dean J. Mikami
Editor’s Comment (BPJ)
Thoracolumbar syndrome (TLS) is a very rare but real etiology of
lower back pain and referred chronic groin pain. The diagnosis is often
by exclusion, and based primarily on history and physical examination
alone, TLS is a challenge to diagnose and treat, but should be part of the
groin pain differential diagnosis. Distal sensory nerves that originate
from the posterior primary rami of the thoracolumbar spinal nerves
T12–L2 can be irritated without any obvious magnetic resonance imaging
(MRI) or X-ray findings, thus increasing the challenge of making the
diagnosis. Treatment should initially be aimed at physical therapy and
rehabilitation modalities. Pain management specialists can then inject
the trigger points. Outcomes after surgical intervention have not been
well documented .
Introduction
Patients who present with groin pain may be experiencing referred
pain from a spinal pathology. Robert Maigne first described thoracolumbar
syndrome in 1974; it is sometimes called Maigne’s Syndrome [ 1 ].
The thoracolumbar junction is comprised of the T10–11, T11–12, and
T12–L1 vertebrae. The dermatomes T10–L2 are responsible for the
referred pain that patients experience [ 2 ]. Patients usually complain of
low back pain, but can also have ipsilateral gluteal and groin pain.
Thoracolumbar syndrome is defined by a dysfunction of the thoracolumbar
junction referring pain in the corresponding dermatomes of
T10–L2. In particular, T12 and L1 are specifically located in the
groin region, and they emerge at the level of the thoracolumbar junction.
© Springer International Publishing Switzerland 2016
B.P. Jacob et al. (eds.), The SAGES Manual of Groin Pain,
DOI 10.1007/978-3-319-21587-7_43
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