The thoracic paraspinal line: Further significance

Abstract

Three hundred and seventeen cases which included 100 normal individuals have been studied for roentgen significance of the thoracic paraspinal line (TPL). The descending thoracic aorta greatly determines the course and configuration of the TPL. In a right-sided aorta, the TPL is seen on the right side as a mirror image of a left-sided TPL. Lateral deviation of the TPL and descending aorta occur as an ageing process. In systemic hypertension where there is an aortic unfolding, the TPL also unfolds and the degree of TPL deviation has a fair degree of linear relationship with the severity and duration of hypertension in young individuals. Most cases of mitral valvular disease show lateral deviation of the TPL and descending aorta. In these cases the enlarged left atrium displaces the descending aorta and hence the posteromedial border of left lung posterolaterally tangential to the vertebral column resulting in deviation of the TPL and aorta. Perioesophageal spread of carcinoma of the oesophagus into the posterior mediastinum is indicated by changes in pleuro-oesophageal interface and TPL. Mediastinal lymphadenopathy in cases of testicular tumours may be detected by discovery of TPL deviation on frontal radiographs of the thoracic spine. In extradural masses such as granulomas, abscesses and metastatic deposits, the TPL shows a localised bulge corresponding to the clinical and myelographic level of spinal compression. © 1979.