Zeit für einen Paradigmenwechsel? Vom T4-Syndrom zur exakteren Diagnose

Zusammenfassung

Viele Symptome, viele Therapieansätze – Mit einer vielfältigen Symptomkonfiguration assoziierte interskapuläre Schmerzen bezeichnet die Manuelle Therapie als T4-Syndrom. Das kritische Auseinandersetzen mit der Klinik und Pathophysiologie des Syndroms trägt dazu bei, eine rationalere Diagnose und einen neuen Behandlungsansatz für die Patienten zu entwickeln.

• Literatur

• 1 Andrae R. Über Knorpelknötchen am hinteren Ende der Wirbelbandscheiben im Bereich des Spinalkanals. Beitrage zur Pathologie und Anatomie 1929; 82: 464-474
• 2 Arroyo JF, Jolliet P, Junod AF. Costovertebral joint dysfunction: another misdiagnosed cause of atypical chest pain. Postgraduate Medicine Journal 1992; 68: 655-659
• 3 Bechgaard P. The pain syndrome in the thoracic portion and the importance of its differential diagnosis. Nord Med. 1963; 69: 676-80
• 4 Briggs AM, Smith AJ, Straker LM et al. Thoracic spine pain in the general population: prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskeletal Disorders 2009; a 10: 77
• 5 Briggs AM, Bragge P, Smith AJ et al. Prevalence and associated factors for thoracic spine pain in the adult working population: a literature review. Journal of Occupational Health 2009; b 51: 177-92
• 6 Bruckner FE, Greco A, Leung AW et al. ‚Benign thoracic pain‘ syndrome: role of magnetic resonance imaging in the detection and localization of thoracic disc disease. Journal of the Royal Society of Medicine 1989; 82: 81-3
• 7 Conroy JL, Schneiders AG. The T4 syndrome. Manual Therapy 2005; 10: 292-296
• 8 DeFranca GG, Levine LJ. The T4 syndrome. J Manipulative Physiol Ther. 1995; Jan 18 (1) 34-7
• 9 Edmondston SJ, Singer KP. Thoracic spine: anatomical and biomechanical considerations for manual therapy. Manual Therapy 1997; 2: 132-143
• 10 Erwin WM, Jackson PC, Homonko DA et al. Innervation of the human costovertebral joint: implications for clinical back pain syndromes. Journal of Manipulative and Physiological Therapeutics 2000; 23 (6) 395-403
• 11 Evans P. The T4 syndrome. Some basic science aspects. Physiotherapy 1997; 83: 186-189
• 12 Fam AG. Chest wall pain: If not cardiac disease, then what?. Journal of Musculoskeletal Medicine 1987; 4: 65-74
• 13 Farfan H. The tired neck syndrome. In: Giles L, Singer K, Eds. Clinical Anatomy and Management of Thoracic Spine Pain. Edinburgh: Butterworth Heinemann; 2000
• 14 Griegel-Morris P, Larson K, Mueller-Klaus K et al. Incidence of common postural abnormalities in the cervical, shoulder, and thoracic regions and their association with pain in two age groups of healthy subjects. Physical Therapy 1992; 72: 425-31
• 15 Grieve GP. Modern Manual Therapy of the Vertebral Column. Edinburgh: Churchill Livingstone; 1986
• 16 Grieve GP. Referred pain and other clinical features. In: Boyling JD, Palastanga N, Eds. Grieve‘s Modern Manual Therapy. Edinburgh: Churchill Livingstone; 1994
• 17 Groen GJ, Baljet B, Drukker J. Nerves and nerve plexuses of the human vertebral column. American Journal of Anatomy 1990; 188: 282-96
• 18 Groen GJ, Stolker RJ. Thoracic neural anatomy. In: Giles L, Singer K, Eds. Clinical Anatomy and Management of Thoracic Spine Pain. Edinburgh: Butterworth Heinemann; 2000
• 19 Haydar AA, Morgan-Hughes G, Roobottom C. Investigating severe interscapular pain. BMJ 2008; 337 a688
• 20 Ishizuka K, Sakai H, Tsuzuki N et al. Topographic anatomy of the posterior ramus of thoracic spinal nerve and surrounding structures. Spine 2012; 37 (14) E817-22
• 21 Iyer S, Christiansen BA, Roberts BJ et al. A biomechanical model for estimating loads on thoracic and lumbar vertebrae. Clinical Biomechanics 2010; 25: 853-8
• 22 Keller TS, Colloca CJ, Harrison DE et al. Influence of spine morphology on intervertebral disc loads and stresses in asymptomatic adults: implications for the ideal spine. Spine 2005; 5 (3) 297-309
• 23 Maigne R. On the cervical origin of certain benign and refractory backaches in adults. Revue du Rhumatisme et Des Maladies Ostéo-Articulaires 1964; 9: 497-503
• 24 Maitland G. Vertebral manipulation. 5th Ed. Oxford: Butterworth Heinemann; 1986
• 25 McGuckin N. The T4 syndrome. In: Grieve GD, Ed. Modern Manual Therapy of the Vertebral Column. London: Churchill Livingston; 1986
• 26 Resnick D. Degenerative diseases of the vertebral column. Radiology 1985; 156: 3-14
• 27 Schmorl G, Junghanns H. The human spine in health and disease. 2 Edn. New York: Grunne & Stratton; 1971
• 28 Shaw NE. J Bone Joint Surg 1975; 57B: 412
• 29 Singer KP. Pathology of the thoracic spine. In: Giles L, Singer K, Eds. Clinical Anatomy and Management of Thoracic Spine Pain. Edinburgh: Butterworth Heinemann; 2000: 63-82
• 30 Singer KP, Edmondston SJ. The enigma of the thoracic spine. In: Giles L, Singer K, Eds. Clinical Anatomy and Management of Thoracic Spine Pain. Edinburgh: Butterworth Heinemann; 2000
• 31 Sultan HE, Younis El-Tantawi GA. Role of dorsal scapular nerve entrapment in unilateral interscapular pain. Arch Phys Med Rehabil. 2012;
• 32 Tanaka Y, Kokubun S, Sato T et al. Cervical roots as origin of pain in the neck or scapular regions. Spine 2006; 31 (17) E568-73
• 33 Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain 2011; 152 (Suppl. 03) S2-15