CT in diagnosis of thoracolumbar region diseases

The lumbalgia caused by affected thoracolumbar transition (Th11-L2) imitates the clinical symptomatic of disc lesions in the lower lumbar segments. The syndrome is presented by a pain projected in the area of the three branchings of the spinal nerves, coming from thoracolumbar segments. The aim of this study is to determine the pathological processes, causing the clinical symptoms of this syndrome, using computer tomography. 51 patients are studied with clinically proved thoracolumbar transition syndrome: 14 men and 37 women. CT slices of 96 vertebral segments are made. Two patient are scanned at Th11-Th12 and L1-L2. Only Th12-L1 scans are made on 10 patients and 42 are made on two neighbouring segments (41 of them on Th11-Th12 and Th12-L1 and one on Th11-L1 and L1-L2). An asymmetry (facet tropism) has been found at 59 levels, 21 if them are with spondiloarthrosis. Spondiloarthrosis has been found in 24 segments - 21 of them with osteochondrosis, one with disc prolapse, and 2 with disc protrusion. It is also found osteoporotic changes osteolysis in multiple myeloma, metastasis etc. During the 3 level examination no evidence for either of the mentioned changes is obtained. The CT slices of two neighbouring segments showed an unexpected change from thoracic to lumbar type of the intervertebral joints in 34 patients. The results from this study support the hypothesis about joints origin of the clinical symptoms of the thoracolumbar transition and demonstrate the importance of the computer tomography as a diagnostic method in this disease