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Maigne syndrome, or thoracolumbar junction syndrome (TLJS), causes pain in the iliac crest and is a treatable cause of low back pain. Patients often respond well to manual therapy, exercises, and medication.

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Area of Science:

  • Spine biomechanics
  • Pain management
  • Neurology

Background:

  • Thoracolumbar junction syndrome (TLJS), also known as Maigne syndrome, presents as iliac crest pain and tenderness at the T12-L1 vertebral junction.
  • This often unrecognized condition is a treatable cause of low back pain, though pain may manifest in the lower abdomen, pelvic region, or groin due to nerve involvement.
  • The thoracolumbar junction (T9-L2) is susceptible to lesions and nerve impingement due to the transition in spinal mobility between the thoracic and lumbar regions.

Purpose of the Study:

  • To elucidate the characteristics and clinical presentation of thoracolumbar junction syndrome (Maigne syndrome).
  • To highlight the diagnostic challenges and potential referred pain patterns associated with TLJS.
  • To review the efficacy of various treatment modalities for Maigne syndrome.

Main Methods:

  • Clinical observation and palpation for tenderness at the thoracolumbar junction.
  • Assessment of referred pain patterns in the lower abdomen, pelvic, and groin regions.
  • Review of patient responses to manual therapy, therapeutic exercises, and pharmacological interventions.

Main Results:

  • Maigne syndrome is characterized by specific pain referral patterns, often misdiagnosed as other conditions.
  • The T12-L1 facet joints and surrounding nerves are frequently implicated, but lesions can occur between T9 and L2.
  • Patients typically show positive responses to conservative treatments.

Conclusions:

  • Thoracolumbar junction syndrome is an important differential diagnosis for low back pain and associated referred pain syndromes.
  • Manual therapy, targeted exercises, and nerve blocks are effective in managing Maigne syndrome.
  • Understanding the biomechanics of the thoracolumbar junction is crucial for accurate diagnosis and effective treatment.