Posterior ramus syndrome

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Posterior ramus syndrome
Synonyms	Thoracolumbar junction syndrome, Maigne syndrome
Pronounce	N/A
Specialty	Orthopedics, Neurology
Symptoms	Lower back pain, buttock pain, groin pain
Complications	N/A
Onset	Often adult
Duration	Chronic
Types	N/A
Causes	Facet joint dysfunction, nerve irritation
Risks	Poor posture, repetitive strain
Diagnosis	Clinical examination, imaging studies
Differential diagnosis	Sciatica, hip joint disorders, sacroiliac joint dysfunction
Prevention	N/A
Treatment	Physical therapy, medication, injections
Medication	N/A
Prognosis	Variable, often manageable with treatment
Frequency	Common
Deaths	N/A

Posterior Ramus Syndrome, also known as dorsal ramus syndrome, is a condition characterized by pain and dysfunction associated with the posterior ramus of a spinal nerve. The posterior ramus is responsible for innervating the deep muscles and skin of the back.

Anatomy

The spinal nerve is a mixed nerve that emerges from the spinal cord. It divides into two primary branches: the anterior ramus and the posterior ramus. The posterior ramus innervates the erector spinae muscles and the facet joints of the spine.

Pathophysiology

Posterior Ramus Syndrome occurs when there is irritation or injury to the posterior ramus. This can result from trauma, degenerative disc disease, or facet joint arthritis. The condition leads to localized pain, muscle spasm, and sometimes referred pain patterns.

Clinical Presentation

Patients with Posterior Ramus Syndrome typically present with:

• Localized back pain
• Muscle tenderness
• Reduced range of motion
• Pain that may radiate to the buttocks or thighs

Diagnosis

Diagnosis is primarily clinical, based on the patient's history and physical examination. Imaging studies such as MRI or CT scan may be used to rule out other conditions. Diagnostic nerve blocks can confirm the involvement of the posterior ramus.

Treatment

Treatment options include:

• Physical therapy
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Corticosteroid injections
• Radiofrequency ablation

Prognosis

With appropriate treatment, many patients experience significant relief of symptoms. However, chronic cases may require ongoing management.

See also

• Spinal nerve
• Facet joint
• Back pain