Thoracalgia: uncovered potential of diagnostics and new horizons in understanding pain in the thoracic spine

A comprehensive overview of modern methods for diagnosing thoracalgia is presented, ranging from traditional radiological examinations to innovative neuroimaging techniques. The article emphasizes the importance of early and accurate diagnosis for determining the etiology of pain and selecting optimal treatment strategies.

Particular attention is given to somatosensory evoked potentials and multimodal neurophysiological monitoring, which make it possible to detect disturbances in nerve impulse conduction and help prevent damage to neural structures during surgical procedures.

The prospects of using neuroimaging techniques are also discussed, including functional magnetic resonance imaging, positron emission tomography, and magnetic resonance spectroscopy. These approaches allow the identification of pain biomarkers and contribute to the development of personalized treatment strategies.

The article represents a valuable resource for physicians and researchers involved in the diagnosis and treatment of thoracalgia and highlights the importance of a comprehensive approach that combines traditional and innovative methods to achieve the best outcomes in the management of patients with this common condition.

1. Manchikanti L., Knezevic N.N., Navani A. и др. Epidural interventions in the management of chronic spinal pain // Pain Physician. 2021. Vol. 24 (S1). P. S27–S208.

2. Leboeuf-Yde C., Nielsen J., Kyvik K.O., Fejer R., Hartvigsen J. Pain in spinal regions // BMC Musculoskeletal Disorders. 2009. Vol. 10. P. 47.

3. Boden S.D. и др. Cervical spine MRI abnormalities // J Bone Joint Surg Am. 1990. Vol. 72 (7). P. 1178–1184.

4. Wood K.B. и др. Thoracic spine MRI // J Bone Joint Surg Am. 1995. Vol. 77 (11). P. 1631–1638.

5. Chen G. и др. Thoracic stenosis review // Eur Spine J. 2020. Vol. 29. P. 2164– 2172.

6. Aoki Y. и др. Lumbar spondylolysis // Sci Rep. 2020. Vol. 10. P. 6739.

7. Di Filippo L. и др. Vertebral fractures in COVID-19 // J Clin Endocrinol Metab. 2021. Vol. 106 (2). P. e602–e614.

8. Parenteau C.S. и др. Spine degeneration epidemiology // Sci Rep. 2021. Vol. 11. P. 5389.

9. Manchikanti L. и др. Chronic spinal pain guidelines // Pain Physician. 2013. Vol. 16. P. S49–S283.

10. Chen G. и др. Thoracic stenosis // Eur Spine J. 2020. Vol. 29. P. 2164–2172.

11. Maselli F. и др. Red flags in thoracolumbar pain // Disabil Rehabil. 2022. Vol. 44 (8). P. 1190–1206.

12. Ota Y. и др. Mechanisms of spinal pain // Radiographics. 2020. Vol. 40 (4). P. 1163–1181.

13. Marshall K., McLaughlin K. Thoracic pain management // Thorac Surg Clin. 2020. Vol. 30 (3). P. 339–346.

14. Manchikanti L. и др. Facet joint guidelines // Pain Physician. 2020. Vol. 23 (3S). P. S1–S127.

15. Christelis N. и др. Persistent spinal pain syndrome // Pain Med. 2021. Vol. 22 (4). P. 807–818.

16. Schwab J.H., Shah A.A. Spinal epidural abscess // JAAOS. 2020. Vol. 28 (21). P. e929–e938.

17. Price M. и др. Cervical myelopathy case // J Bodyw Mov Ther. 2021. Vol. 26. P. 315–319.

18. Ma C. и др. Spinal epidural abscess // Beijing Da Xue Xue Bao. 2019. Vol. 51 (4). P. 574–580.

19. Sarzi-Puttini P. и др. Fibromyalgia // Nat Rev Rheumatol. 2020. Vol. 16 (11). P. 645–660.

20. Hwang J. и др. Thoracic outlet syndrome // Ann Vasc Surg. 2021. Vol. 76. P. 454–462.

21. Jia P. и др. CT spinal fractures // J Healthc Eng. 2021. Vol. 2021. P. 1–8.

22. Kim G.-U. и др. Spine diagnostics // Asian Spine J. 2022. Vol. 16. P. 764– 775.

23. Ravikanth R. Percutaneous biopsy // J Craniovertebr Junction Spine. 2020. Vol. 11. P. 93–98.

24. Melachuri S.R. и др. Evoked potentials // J Neurosurg Spine. 2020. Vol. 33. P. 35–40.

25. Zhang C.W. и др. Neuro monitoring TB // Zhongguo Gu Shang. 2021. Vol. 34 (11). P. 1065–1071.

26. Tracey I. Pain biomarkers // Sci Transl Med. 2021. Vol. 13. P. eabc0918.

27. Desai M., Safriel Y. MRI ablation // J Pain Res. 2022. Vol. 15. P. 423–430.

28. Speldewinde G. Thoracic neurotomy // Pain Med. 2020. Vol. 21 (9). P. 1811– 1818.

29. Carey S. и др. Chest imaging comparison // Radiology. 2020. Vol. 296. P. 89–96.

30. Hamd Z.Y. Pulmonary embolism imaging // Int J Biomedicine. 2023. Vol. 13. P. 12–18.

31. Carrabba N. и др. CTA chest pain // Biomed Res Int. 2019. Vol. 2019. P. 1– 8.

32. Kashani M.A. и др. MRI biopsy guidance // J Thorac Imaging. 2022. Vol. 37 (6). P. 375–382.

33. Rajasekar B. и др. Photoacoustic imaging // Biomed Res Int. 2022. Vol. 2022. P. 1–9.

34. Hwang J.S. и др. Thoracic outlet syndrome // Ann Vasc Surg. 2021. Vol. 76. P. 454–462.

35. Lin I. и др. Musculoskeletal pain care // Br J Sports Med. 2019. Vol. 53. P. 276–284.

36. Tender G.C. и др. CT-SPECT // Neurosurg Focus. 2019. Vol. 47. P. E18.

37. Hoy D. и др. Low back pain prevalence // Arthritis Rheum. 2012. Vol. 64. P. 2028–2037.

38. Patrick N. и др. Low back pain // Med Clin North Am. 2014. Vol. 98. P. 777–789.

39. Dieleman J.L. и др. Healthcare spending // JAMA. 2020. Vol. 323. P. 863– 884.

40. Zheng F. и др. Spine surgery predictors // Spine. 2002. Vol. 27. P. 818–824.

41. Cusi M. и др. SPECT-CT SI joint // Eur Spine J. 2013. Vol. 22. P. 1674– 1682.

42. Choi B.W. и др. Cervical imaging // Clin Orthop Surg. 2021. Vol. 13. P. 499–504.

43. Kang K.W. и др. Nuclear medicine // Seoul: Korea Medicine; 2019. P. 1– 850.

44. Anderson K. и др. SPECT stress injuries // J Pediatr Orthop. 2000. Vol. 20. P. 28–33.

45. Perez-Roman R.J. и др. SPECT facet pain // World Neurosurg. 2020. Vol. 137. P. e487–e492.

46. Ryan R.J. и др. SPECT spine // Nucl Med Commun. 1992. Vol. 13. P. 497– 502.

47. McDonald M. и др. CT-SPECT fusion // Neurosurg Focus. 2007. Vol. 22. P. E2.

48. Ravikanth R. Biopsy // J Craniovertebr Junction Spine. 2020. Vol. 11. P. 93– 98.

49. Lee S.A. и др. CT vs fluoroscopy biopsy // Spine J. 2020. Vol. 20. P. 1114– 1124.

50. Roschan S. Biopsy system // J Southeast Asian Orthop. 2022. Vol. 46. P. 24– 28.

51. Nourbakhsh A. и др. Spine biopsy review // JAAOS. 2021. Vol. 29. P. e681– e692.

52. Gala K.B. и др. CT biopsy technique // J Clin Interv Radiol. 2021. Vol. 5. P. 150–157.

53. Marruzzo D. и др. Biopsy improvement // Eur Spine J. 2023. Vol. 32. P. 221–227.

54. Basu S. и др. Needle biopsy // Eur Spine J. 2021. Vol. 30. P. 1450–1455.

55. Melachuri S.R. и др. Evoked potentials // J Neurosurg Spine. 2020. Vol. 33. P. 35–40.

56. Fustes O. и др. Review // Arq Neuropsiquiatr. 2021. Vol. 79. P. 824–831.

57. Markand O.N. Evoked potentials // 2020. P. 139–207.

58. Reddy R.P. и др. Meta-analysis // Spine J. 2021. Vol. 21. P. 555–570.

59. Lachance B. и др. Neuroprognosis // Neurocrit Care. 2020. Vol. 32. P. 847– 857.

60. Moustafa I.M. и др. Head posture // J Clin Med. 2023. Vol. 12. P. 3217.

61. Zhang C.W. и др. Monitoring TB // Orthop Surg. 2021. Vol. 13. P. 1359– 1368.

62. Zhang C.W. и др. Monitoring TB // Zhongguo Gu Shang. 2021. Vol. 34. P. 1065–1071.

63. Xu N.J. и др. Lumbar TB // Spine. 2019. Vol. 44. P. E123–E130.

64. Wu P. и др. Thoracolumbar TB // Eur Spine J. 2020. Vol. 29. P. 980–987.

65. Jiang L. и др. TB surgery // BMC Musculoskelet Disord. 2022. Vol. 23. P. 619.

66. Zhong Y. и др. Bone graft TB // Eur Spine J. 2021. Vol. 30. P. 2500–2510.

67. Peng Y., Guan Q. Dexmedetomidine // Evid Based Complement Alternat Med. 2021. Vol. 2021. P. 6363188.

68. Eldabe S. и др. Pain biomarkers // Pain Res Manag. 2022. Vol. 2022. P. 1– 10.

69. Xu X., Huang Y. Pain assessment // F1000Research. 2020. Vol. 9. P. 1–10.

70. Diaz M.M. и др. Neuropathic pain // Front Pain Res. 2022. Vol. 3. P. 869215.

71. Lee J.J. и др. Neuroimaging biomarker // Nat Med. 2021. Vol. 27. P. 174– 182.

72. Ferraro S. и др. Insula biomarker // Hum Brain Mapp. 2022. Vol. 43. P. 998– 1010.

73. Davis K.D. и др. Pain biomarkers // Nat Rev Neurol. 2020. Vol. 16. P. 381– 400.

74. Martins D. и др. Neuroimaging biomarker // Brain Commun. 2022. Vol. 4. P. fcab302.

75. Zhang Z. и др. Brain imaging // Front Neurol. 2022. Vol. 12. P. 734821.

76. Kim S., Seo J. Radiofrequency ablation // Cardiovasc Intervent Radiol. 2005. Vol. 28. P. 779–788.

77. Davis T. и др. Knee pain RFA // Reg Anesth Pain Med. 2019. Vol. 44. P. 499–506.

78. Kapural L. и др. Cooled RFA // J Pain Res. 2022. Vol. 15. P. 2577–2586.