T4 syndrome - A distinct theoretical concept or elusive clinical entity? A case report

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• 作者：Patricia Miyuki Hirai ; MSc ; DO ; BSc (Hons) ; PT ; Oliver P. Thomson ; PhD ; MSc ; PG Cert ; BSc (Hons) ; DO ; ^{o.thomson@bso.ac.uk" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Thoracic spine ; Sympathetic nervous system ; Osteopathy ; Osteopathic medicine ; T4 syndrome
• 刊名：Journal of Bodywork and Movement Therapies
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：20
• 期：4
• 页码：722-727
• 全文大小：528 K

文摘

T4 syndrome has existed as a clinical concept for more than three decades and it has been identified as a source of upper extremity (UE) symptoms. This case report explores the clinical reasoning in the diagnoses and management of a patient with symptoms consistent with T4-type syndrome and critically discusses the concept of T4 syndrome using recent research to help explain the clinical presentation. Manual therapy treatment focused on stimulation of the sympathetic ganglia, decreasing local upper thoracic pain and UE referral pattern noted during passive examination. The successful outcomes included immediate and lasting symptom relief after upper thoracic spinal manipulation. Although treatment has been based on the theory that mechanical thoracic dysfunction can produce sympathetic nervous system (SNS) referred pain, the role the sympathetic reflexes potentially plays on the referral symptoms to the UE presently remains unclear.