Dr. Ebraheim’s educational animated video describes innervation of the thoracic nerve roots.
There are 12 vertebrae in the thoracic region. The spinal canal in the thoracic region is relatively small. The spinal cord could be easily injured in this area.
Pain in the thoracic region can occur due to thoracic disc herniation or different types of etiology such as:
•Cardiovascular
•Retroperotineal
•Neoplastic
•Thoracic spine pathology
Point of consideration is thoracic disc herniation. It occurs more in the lower thoracic region usually during the fifth decade of life. Pain radiates to the ribs and anteriorly at the same level . the incidence of disc herniation is up to 15%, but most are asymptomatic.
Clinical presentation
•Radicular pain anterior towards the ribs.
•Myelopathy could occur. Patient could have gait disturbance, leg weakness, as well as baldder and bowel dysfunction.
Diagnosis usually by MRI.
Conservative treatment includes:
•NSAIDs
•Physical therapy.
Surgery is indicated when the pain is severe and not responding to long periods of conservative treatment.
Thoracic disc herniation with myelopathy.
•Herniated disc T1-T2 bulge
•Sensory T1
•T1 interossei muscles
•No reflex
•Sensory T2
•Sensory T3 third intercostal space
•Sensory T4 nipple line
•Sensory T5 fifth intercostal space
•Sensory T6 sixth intercostal space
•Sensory T7 xiphoid process
•Sensory T8 eighth intercostal space
•Sensory T9 ninth intercostal space
•T10 umblicus
•Sensory T11 eleventh intercostal space
•Sensory T12 inguinal ligament
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Негізгі бет Neurological Examination Spinal Cord Part 3 - Everything You Need To Know - Dr. Nabil Ebraheim
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