{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:37:19Z","timestamp":1791221839343,"version":"4.1.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Orthop\u00e4de"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:sec>\n                <jats:title>Hintergrund<\/jats:title>\n                <jats:p>Segmentale und somatische Dysfunktionen im Thorakalbereich k\u00f6nnen zu unterschiedlichen klinischen Bildern f\u00fchren. Es gilt, drei wesentliche Varianten zu unterscheiden.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Klinik<\/jats:title>\n                <jats:p>1. Lokale Schmerzen<\/jats:p>\n                <jats:p>Hierbei m\u00fcssen auch potenziell lebensbedrohliche Differenzialdiagnosen bedacht und im Zweifel die Chest-Pain-Notfalldiagnostik initiiert werden.<\/jats:p>\n                <jats:p>2. Vertebro-viszeraler Reflex<\/jats:p>\n                <jats:p>Der sympathische Grenzstrang hat seine segmentalen Urspr\u00fcnge im Wesentlichen in den thorakalen Segmenten, dies f\u00fchrt zu einer hochgradigen neuronalen Vernetzung mit den Thorax- und Oberbauchorganen. \u201eUnspezifische\u201c Thorax- und Bauchbeschwerden k\u00f6nnen deswegen ihre Ursache in segmentalen und somatischen Dysfunktionen der thorakalen Segmente haben.<\/jats:p>\n                <jats:p>3. Viszero-vertebraler Reflex<\/jats:p>\n                <jats:p>Viszerale Noziafferenzen gelangen \u00fcber die vegetative Vernetzung zu thorakalen Segmenten und k\u00f6nnen hier zu schmerzhaften thorakalen Dysfunktionen f\u00fchren. Diese k\u00f6nnen erste Anzeichen einer ernsthaften strukturellen Erkrankung, z.\u202fB. Neoplasie oder Ulkus, der Thorax- und Oberbauchorgane darstellen.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Differenzialdiagnostik<\/jats:title>\n                <jats:p>Die Differenzialdiagnostik ist anspruchsvoll, die manuelle Medizin kann einen entscheidenden Beitrag leisten. Die biomechanischen und neurophysiologischen Besonderheiten am Thorax m\u00fcssen daf\u00fcr bekannt sein.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00132-022-04227-8","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T08:15:26Z","timestamp":1646900126000},"page":"274-282","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Von akutem Koronarsyndrom bis\u00a0Zoster","From acute coronary syndrome to  zoster"],"prefix":"10.1007","volume":"51","author":[{"given":"Hein","family":"Schnell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"key":"4227_CR1","first-page":"124","volume-title":"Lehrbuch der Manuellen Medizin","author":"H-P Bischoff","year":"2011","unstructured":"Bischoff\u00a0H\u2011P, Moll\u00a0H (2011) Diagnostik und Therapie im Thorakalbereich. In: Bischoff\u00a0H\u2011P, Moll\u00a0H (Hrsg) Lehrbuch der Manuellen Medizin, 6.\u00a0Aufl. spitta, Balingen, S 124\u2013151","edition":"6"},{"key":"4227_CR2","series-title":"Manuelle Medizin 1","first-page":"475","volume-title":"Fehlfunktion und Schmerz am Bewegungsorgan verstehen und behandeln","author":"U B\u00f6hni","year":"2015","unstructured":"B\u00f6hni\u00a0U (2015) Sympathikus und BWS. In: Fehlfunktion und Schmerz am Bewegungsorgan verstehen und behandeln, 2.\u00a0Aufl. Manuelle Medizin 1. Thieme, Stuttgart, S\u00a0475\u2013477","edition":"2"},{"key":"4227_CR3","series-title":"Manuelle Medizin 1","first-page":"288","volume-title":"Fehlfunktion und Schmerz am Bewegungsorgan verstehen und behandeln","author":"U B\u00f6hni","year":"2015","unstructured":"B\u00f6hni\u00a0U, Gautschi\u00a0R, Locher\u00a0H, Tal\u00a0A (2015) Die wichtigsten manuellen Behandlungstechniken mit ihren biomechanischen und neurophysiologischen Hintergr\u00fcnden. In: Fehlfunktion und Schmerz am Bewegungsorgan verstehen und behandeln, 2.\u00a0Aufl. Manuelle Medizin 1. Thieme, Stuttgart, S\u00a0288\u2013306","edition":"2"},{"key":"4227_CR4","series-title":"Manuelle Medizin 2","first-page":"547","volume-title":"Diagnostische und therapeutische Techniken praktisch anwenden","author":"U B\u00f6hni","year":"2020","unstructured":"B\u00f6hni\u00a0U, Lauper\u00a0M, Locher\u00a0H (2020) Kapitel\u00a09.8\u20139.11. In: B\u00f6hni\u00a0U, Lauper\u00a0M, Locher\u00a0H (Hrsg) Diagnostische und therapeutische Techniken praktisch anwenden, 2.\u00a0Aufl. Manuelle Medizin 2. Thieme, Stuttgart, S\u00a0547\u2013559","edition":"2"},{"key":"4227_CR5","series-title":"Manuelle Medizin 2","first-page":"563","volume-title":"Diagnostische und therapeutische Techniken praktisch anwenden","author":"U B\u00f6hni","year":"2020","unstructured":"B\u00f6hni\u00a0U, Lauper\u00a0M, Locher\u00a0H (2020) propriozeptive Druckinhibition. In: B\u00f6hni\u00a0U, Lauper\u00a0M, Locher\u00a0H (Hrsg) Diagnostische und therapeutische Techniken praktisch anwenden, 2.\u00a0Aufl. Manuelle Medizin 2. Thieme, Stuttgart, S\u00a0563\u2013564","edition":"2"},{"key":"4227_CR6","unstructured":"Complete Anatomy App\u20143D4medical 2021, Professional License, Elsevier"},{"issue":"3","key":"4227_CR7","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1002\/aja.1001880307","volume":"188","author":"GJ Groen","year":"1990","unstructured":"Groen\u00a0GJ, Baljet\u00a0B, Drukker\u00a0J (1990) Nerves and nerve plexuses of the human vertebral column. Am J Anat 188(3):282\u2013296","journal-title":"Am J Anat"},{"key":"4227_CR8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.07.053","author":"M Gulati","year":"2021","unstructured":"Gulati\u00a0M et\u00a0al (2021) 2021 AHA\/ACC\/ASE\/CHEST\/SAEM\/SCCT\/SCMR guideline for the evaluation and diagnosis of chest pain:\u00a0a report of the American college of cardiology\/American heart association joint committee on clinical practice guidelines. J\u00a0Am Coll Cardiol. https:\/\/doi.org\/10.1016\/j.jacc.2021.07.053","journal-title":"J Am Coll Cardiol"},{"key":"4227_CR9","series-title":"Manuelle Medizin 1","first-page":"306","volume-title":"Fehlfunktion und Schmerz am Bewegungsorgan verstehen und behandeln","author":"W von Heymann","year":"2015","unstructured":"von Heymann\u00a0W, B\u00f6hni\u00a0U (2015) Viszerale Ph\u00e4nomene und Techniken. In: Fehlfunktion und Schmerz am Bewegungsorgan verstehen und behandeln, 2.\u00a0Aufl. Manuelle Medizin 1. Thieme, Stuttgart, S\u00a0306\u2013312","edition":"2"},{"key":"4227_CR10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1706222","author":"R Hofman","year":"2017","unstructured":"Hofman\u00a0R et\u00a0al (2017) Oxygen therapy in suspected acute myocardial infarction. N\u00a0Engl J Med. https:\/\/doi.org\/10.1056\/NEJMoa1706222","journal-title":"N Engl J Med"},{"key":"4227_CR11","first-page":"348","volume-title":"European core curriculum \u201eManual Medicine\u201c, Manuelle Medizin","author":"H Locher","year":"2018","unstructured":"Locher\u00a0H et\u00a0al (2018) European Scientific Society of Manual Medicine (ESSOMM)\u2014executive Board. In: European core curriculum \u201eManual Medicine\u201c, Manuelle Medizin. Springer, Berlin, S\u00a0348\u2013358"},{"key":"4227_CR12","first-page":"48","volume-title":"Anatomy Trains","author":"T Myers","year":"2015","unstructured":"Myers\u00a0T (2015) Das muskuloskelettale System als Tensegrity-Struktur. In: Myers\u00a0T (Hrsg) Anatomy Trains. Elsevier, M\u00fcnchen, S 48\u201369"},{"key":"4227_CR13","first-page":"510","volume-title":"Atlas osteopathische Techniken","author":"A Nicholas","year":"2017","unstructured":"Nicholas\u00a0A, Nicholas\u00a0E (2017) Viszeraltechniken. In: Nicholas, Nicholas (Hrsg) Atlas osteopathische Techniken. Elsevier, M\u00fcnchen, S\u00a0510"},{"issue":"2","key":"4227_CR14","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1097\/00007632-200101150-00007","volume":"26","author":"Ohtori","year":"2001","unstructured":"Ohtori et\u00a0al (2001) Sensory innervation of the cervical facet joints in rats. Spine 26(2):147\u2013150","journal-title":"Spine"},{"key":"4227_CR15","first-page":"118","volume-title":"Foundations of osteopathic medicine","author":"M Patterson","year":"2011","unstructured":"Patterson\u00a0M, Wurster\u00a0R (2011) Somatic dysfunction, spinal facilitation and viscerosomatic integration. In: Chila\u00a0A (Hrsg) Foundations of osteopathic medicine, 3.\u00a0Aufl. Wolters Kluwer \/ Lippincott Williams &Wilkins, Baltimore\/Philiadelphia, S\u00a0118\u2013133","edition":"3"},{"key":"4227_CR16","first-page":"198","volume-title":"Anatomie","author":"Th Schiebler","year":"1999","unstructured":"Schiebler\u00a0Th, Schmidt\u00a0W, Zilles\u00a0W (1999) Vegetatives Nervensystem \u2013 Sympathikus. In: Schiebler\u00a0Th, Schmidt\u00a0W, Zilles\u00a0W (Hrsg) Anatomie, 8.\u00a0Aufl. Springer, Berlin, S\u00a0198\u2013200","edition":"8"},{"key":"4227_CR17","series-title":"Springer-Lehrbuch","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-01651-6_20","volume-title":"Physiologie des Menschen","author":"W J\u00e4nig","year":"2010","unstructured":"J\u00e4nig\u00a0W (2010) Vegetatives Nervensystem. In: Schmidt\u00a0R, Lang\u00a0F, Heckmann\u00a0M (Hrsg) Physiologie des Menschen. Springer-Lehrbuch. Springer, Berlin, Heidelberg https:\/\/doi.org\/10.1007\/978-3-642-01651-6_20"},{"key":"4227_CR18","first-page":"326","volume-title":"Prometheus, Kopf und Neuroanatomie","author":"M Sch\u00fcnke","year":"2006","unstructured":"Sch\u00fcnke\u00a0M et\u00a0al (2006) Funktionelle Systeme und klinische Bez\u00fcge. In: Prometheus, Kopf und Neuroanatomie, 1.\u00a0Aufl. Thieme, Stuttgart, S\u00a0326\u2013383","edition":"1"},{"key":"4227_CR19","first-page":"316","volume-title":"Prometheus, Kopf und Neuroanatomie","author":"M Sch\u00fcnke","year":"2006","unstructured":"Sch\u00fcnke\u00a0M et\u00a0al (2006) Vegetatives Nervensystem. In: Prometheus, Kopf und Neuroanatomie, 1.\u00a0Aufl. Thieme, Stuttgart, S\u00a0316\u2013325","edition":"1"},{"key":"4227_CR20","volume-title":"Segment-Akupunktur. Der wissenschaftliche Hintergrund der chinesischen Akupunktur","author":"I Wancura-Kampik","year":"2021","unstructured":"Wancura-Kampik\u00a0I (2021) Segment-Akupunktur. Der wissenschaftliche Hintergrund der chinesischen Akupunktur, 2.\u00a0Aufl. Kiener, M\u00fcnchen","edition":"2"},{"key":"4227_CR21","first-page":"134","volume-title":"Foundations of osteopathic medicine","author":"F Willard","year":"2011","unstructured":"Willard\u00a0F (2011) Autonomic nervous system. In: Chila\u00a0A (Hrsg) Foundations of osteopathic medicine, 3.\u00a0Aufl. Wolters Kluwer \/ Lippincott Williams &Wilkins, Baltimore, Philiadelphia, S\u00a0134\u2013161","edition":"3"},{"key":"4227_CR22","doi-asserted-by":"publisher","unstructured":"Zalpour\u00a0C (Hrsg) (2010) Springer Lexikon Physiotherapie. Springer, Berlin, Heidelberg. https:\/\/doi.org\/10.1007\/978-3-642-34730-6_8","DOI":"10.1007\/978-3-642-34730-6_8"}],"container-title":["Der Orthop\u00e4de"],"original-title":[],"language":"de","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00132-022-04227-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00132-022-04227-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00132-022-04227-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T16:45:46Z","timestamp":1648658746000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00132-022-04227-8"}},"subtitle":["Differenzialdiagnostik bei segmentaler und somatischer Dysfunktion an Brustwirbels\u00e4ule und Rippen","Differential diagnostics in segmental and somatic dysfunction of the thoracic spine and ribs"],"short-title":[],"issued":{"date-parts":[[2022,3,10]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["4227"],"URL":"https:\/\/doi.org\/10.1007\/s00132-022-04227-8","relation":{},"ISSN":["0085-4530","1433-0431"],"issn-type":[{"value":"0085-4530","type":"print"},{"value":"1433-0431","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,10]]},"assertion":[{"value":"3 February 2022","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 March 2022","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}},{"value":"H.\u00a0Schnell erhielt 2020 ein Beraterhonorar der Fa. STADA.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}},{"value":"F\u00fcr diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgef\u00fchrt. F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}