Posterior ramus syndrome

Posterior ramus syndrome, also known as thoracolumbar junction syndrome, Maigne syndrome, or dorsal ramus syndrome, is caused by the irritation of the primary division of a spinal nerve's posterior ramus. This results in referred pain in three distinct regions: the groin or pubic area, the lower back and upper gluteal region, and the anterolateral thigh or trochanter area. The condition was first described as early as 1893 but was more precisely defined by 1980.

Diagnosis is based on four criteria:

The syndrome is distinct from other spinal pain conditions due to its unique referred pain pattern and response to treatment. Referral patterns overlap significantly, making standard dermatome maps less reliable for diagnosis. Treatment often involves local anesthetic injections, with possible adjunct therapies like steroid injections or radiofrequency denervation for refractory cases.

References include works by Maigne, Scott-Charlton, McCall et al., Marks, Fukui, and Sherrington, among others, contributing to the understanding of this condition.