Dissection of the thoracic paraspinal region – implications for osteopathic palpatory diagnosis: A case study

Abstract

Background Authors in the field of osteopathy have claimed that tissue texture abnormalities in the paravertebral gutter (PVG), the region between the erector spinae mass and the spinous processes, are indicators of intervertebral somatic dysfunction, but the cause of texture abnormality is unknown. Methods The PVG was identified using manual palpation and marked with marker pins before dissection. A progressive dissection of the medial paraspinal thoracic region was performed and the anatomy of this region was reviewed. Results Progressive dissection revealed the trapezius, spinalis, semispinalis, multifidus and rotatores muscles to be immediately deep to the marked location, and deep to these muscles, directly below the marker, was the zygapophysial joint. Discussion The possible relevance of these medial paraspinal structures to tissue texture abnormality detected with palpation was discussed. Authors in the field of osteopathy have suggested that dysfunction of either the rotatores muscles or the underlying zygapophysial joint may be responsible for tissue texture change in the PVG, and these structures were located directly under the palpated site. Conclusion Further research to examine the tissues associated with textural abnormalities in the PVG is warranted.