THORACOLUMBAR JUNCTION SYNDROME: AN OVERLOOKED DIAGNOSIS IN AN ELDERLY PATIENT.

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    • Alternate Title:
      TORAKOLOMBER GEÇİ Ş SENDROMU: YAŞLI BİR OLGUDA GÖZDEN KAÇAN BİR TANI.
    • Abstract:
      Thoracolumbar junction syndrome is defined as a result of a minor intervertebral dysfunction at the thoracolumbar junction and referred pain in the low back and hip region, and can often be confused with other pathologies that may cause these symptoms. A 65-year-old woman with nearly two years of continuous throbbing pain in the low back, right hip and groin region who was scheduled for spinal surgery with the diagnosis of spinal stenosis in the neurosurgery clinic was referred to our clinic for consultation. Physical examination revealed severe limitation of the passive and active range of motion of the lumbar spine, and pain in all directions. There was tenderness at the T12-L1, L5-S1 and L4-L5 intervertebral spaces and at the T12, L1, L4 and L5 spinous processes. On the right side, the maneuver of lateral pressure against the spinous process at the level of T12, the pinch-roll test and the posterior iliac crest point sign were positive. Tenderness over the trochanteric region and the superior aspect of the pubis was detected on the right side. All tests were negative after a right T12 periapophyseal joint block using a local anesthetic, with the prediagnosis of thoracolumbar junction syndrome. The patient was diagnosed with thoracolumbar junction syndrome and treated with conservative methods. Thoracolumbar junction syndrome is a pathology that should be considered in the differential diagnosis in elderly patients with low back, hip and groin pain. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Torakolomber geçiş sendromu, torakolomber bileşkenin disfonksiyonu sonucu bel ve kalça ağ-rısına neden olan ve bu semptomlara neden olabilecek başka patolojilerle sıklıkla karışabilen bir sendromdur. Yaklaşık iki yıldır sürekli zonklayıcı karakterde bel, sağ kasık ve kalça ağrısı olan 65 yaşında kadın olgu spinal stenoz tanısı ile spinal cerrahi yapılmak üzere beyin cerrahi kliniğinde iken klini-ğimizden istenen konsültasyon sonucu değerlendirildi. Fizik muayenesinde tüm yönlere bel hareketleri ileri derecede kısıtlı ve ağrılıydı. T12-L1, L5-S1, L4-L5 intervertebral aralık ve T12, L1, L4, L5 spi-nöz proçesler presyonla ağrılı, sağ taraf T12 itme testi, deri yuvarlama testi, iliak krest nokta testi pozitifti. Sağ tarafta torakanterik ve simpizis pubis hassasiyeti mevcuttu. Torakolomber geçiş sendromu düşünülen olguya yapılan T12 sağ periapofizyal lokal anestetik enjeksiyonu sonrasında tüm testler negatifleşti. Torakolomber geçiş sendromu tanısı konan olgu konservatif yöntemlerle tedavi edildi. Torakolomber geçiş sendromu, bel, kalça ve kasık ağrıları olan yaşlı olgularda ayırıcı tanıda mutlaka düşünülmesi gereken bir patolojidir. [ABSTRACT FROM AUTHOR]
    • Abstract:
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