Effectiveness of Exercise and Local Steroid Injections for the Thoracolumbar Junction Syndrome (The Maigne’s Syndrome) Treatment

Kerem Alptekin,Mehmet Toprak,Nurettin Irem Örnek,Tuğba Aydın,Leyla A Balcı,Jülide Öncü Alptekin,Mirsad Alkan

doi:10.2174/1874325001711010467

Abstract

Purpose:Patients diagnosed as thoracolumbar junction syndrome were divided into 3 treatment groups and the results of each modality were compared.Materials and Method:30 Patients were included in the study with the definitive diagnosis of Maigne’s Syndrome. 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.Findings:30 Patients were divided into 3 groups. Each group had 10 patients. The average age of the groups was detected to be 23.43 ± 3.75. A flattening was detected in 4 patients of the first group (40%), 6 patients of the second group (60%) and 4 patients of the third group (40%) during the lumbar lordosis. While the average difference of the VAS values was (2.80) as the lowest for the injection group before and after treatment at rest, the highest value (3.30) was observed in the combined treatment group. The results shown on the Oswestry scale of the first month difference (16.10), and the third month difference (22.40) were statistically better than the other groups in the combined treatment group.Results:As a result of this study, while in all three treatment groups in the Oswestry scale, VAS scores at rest or at movement during the regular controls before and after the treatment showed statistically significant difference; the best results were obtained in the group administered to the combined injection and exercise therapy.

Highlights

The Maigne’s Syndrome known as the thoracolumbar junction syndrome (TLS) caused by thoracolumbar lateral nerve branch was first described by Maigne [1]
By excluding any other diseases which did not have any pathology or had only flattening of the lumbar lordosis, the physical examination and the thoracolumbar junction were performed with local anesthetic injection showing the definitive diagnosis of Maigne’s Syndrome in patients with ages ranging between 19-33 years; among them, 37 patients were evaluated for their suitability to the study and a total of 30 patients (1 female, 29 male) were included in the study
By judging from a much wider angle, the deterioration of sexual function in young adults regarding the weakness of these muscles up to the urinary incontinence development occurring in much older individuals has shown that the patients had various negative effects in the patients applying to the mentioned muscle clinics with complaints of back pain

Summary

Introduction

The Maigne’s Syndrome known as the thoracolumbar junction syndrome (TLS) caused by thoracolumbar lateral nerve branch was first described by Maigne [1]. The clinical diagnosis may be reaffirmed in one or more thoracolumbar region (between T11-L3 vertebrae) by the tenderness on palpation test; comparing the sensitivity difference on the iliac crest (cluneal nerve), the inguinal canal (inguinal nerve) or the greater trochanter (lateral perforator nerve) and by rolling and tightening the skin on the normal side. The examiner raises a fold of skin between thumb and forefinger and “rolls” it along the trunk or, on the extremities, perpendicular to the course of the dermatomes. The examiner compares both sides and states where the skin is rolled more heavily [4]

Methods

Discussion

Conclusion