Thoracic Spine

The thoracic spine is stabilized by the ribs and has less range of motion than the other segments of the spinal column. Thoracic pain is relatively uncommon. However, it is important from a management perspective because dorsal back pain can be as disabling as cervical and lumbar pain (17). While histological studies of the thoracic discs are currently being reevaluated (18), it has been revealed that branches of the rami communicantes provide innervation circumferentially (17). MRI reveals that a substantial number (11-12.5%) of asymptomatic degenerative or protruded discs also exist in the thoracic spine (19). However, anatomical changes on imaging studies do not necessarily equate with pain generation. In one investigation, approximately one quarter of the discs injected provoked a pain response that did not match MRI findings or morphologic findings at discography (20). One case series on thoracic discography concluded that useful information is obtained for treatment planning (21). In this study, in addition to painful segments, control discs were also injected, which did not provoke pain.

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