Osteochondrosis of the thoracic spine refers to a degenerative-dystrophic pathology. Problems with the ridge rank 5th in the structure of all diseases of the musculoskeletal system. They are more common in people over 45 years of age. Timely diagnosis and initiation of treatment make it possible to slow the progression of the disease.
Development mechanism
Degenerative-dystrophic pathology, which includes osteochondrosis, is characterized by the presence of several key links of pathological processes, these include:
- Malnutrition (trophism) of cartilage tissue, which occurs against the background of overload or exposure to other provoking factors, is called dystrophy.
- Gradual destruction of cells and intercellular nutrients of cartilage tissue, which occurs due to lack of nutrients.
- The development of inflammatory reactions, the severity of which depends on the degree of damage to the structure of cartilage tissue.
- Violation of the functional state of the joints or structures of the spine (intervertebral disc), which contains cartilage tissue.
Osteochondrosis involves the defeat of the intervertebral discs and joints of the ridge process in various parts. The discs between the vertebrae are flattened, which causes compression of the motor and sensory nerve fibers of the spinal root. The mechanism of development of this disease is always accompanied by the addition of neurological symptoms.
The cause of the disease
Osteochondrosis of the thoracic ridge is a polyetiological disease. This means that the process of dystrophy and degeneration of cartilage tissue is triggered due to the influence of a large number of provoking factors:
- Hereditary predisposition, which determines the nutritional characteristics of cartilage tissue with subsequent disturbances against the background of normal load. In this case, osteochondrosis can develop in young people.
- Congenital malformations and anomalies in the structural development of the musculoskeletal system, leading to changes in blood flow in tissues and deterioration in the nutrition of cartilage components.
- Delayed injuries of various parts of the ridge (fractures, bruises, dislocations and subluxations of joints), leading to changes in the ratio of various structures with the subsequent development of degenerative-dystrophic processes in them.
- Insufficient physical activity (inactive lifestyle), causes congestion in the tissues.
- Systematically increased load on the thoracic spine (hard physical labor, prolonged static load).
- Disorders of the metabolism of mineral salts in the body, which provoke a decrease in the strength of bone processes, intervertebral discs and subsequent lack of nutrients from the cartilage structure.
- Deterioration of blood supply to spinal tissues, occurs against the background of compression of major arteries or veins.
- Bad habits - nicotine and alcohol are vascular toxins that cause deterioration of blood flow in tissues and violation of their nutrition.
Knowing the causes of the development of pathological processes is an important component of the diagnostic process. This is necessary for the appointment of subsequent effective treatment, as well as the prevention of recurrence of osteochondrosis.
Symptoms of osteochondrosis of the thoracic spine
The development of degenerative-dystrophic processes is accompanied by the appearance and increase in intensity of the following symptoms of osteochondrosis:
- Pain in the spine at the level of the chest - at first, the pain appears after exercise, long stay the human body in one position. Then the sensation of discomfort increases and remains. Often the pathological process is accompanied by dull back pain between the shoulder blades.
- Unpleasant "squeezing" feeling in the back, which doesn’t allow you to inhale fully.
- Violation of skin sensitivity in the form of numbness on various parts of the body (changes covering the skin of the upper or lower legs on one side of the body) due to compression of sensitive nerve fibers at the spinal cord roots.
- Muscle weakness in the arms or legs is usually on one side of the body.
- Violation of the functional state of the digestive system, which is accompanied by abdominal pain, heartburn, abdominal pain, bloating (bloating), unstable stools.
- Changes in the back and arms, which include dry skin, increased fragility of nails (the result of violation of the state of autonomic nerve fibers when the spinal roots are squeezed).
- Changes in the functional state of the pelvic organs, which are indicated by urinary disorders, constipation, impotence in men, unstable menstrual cycles in women.
Manifestations appear gradually, one cannot show the time of its development accurately. For a long time, the intensity of symptoms increases, new signs of pathological processes are added. According to the nature and duration of the sensation of discomfort in the back, there are 2 types of pain in osteochondrosis of the thoracic spine:
- Dorsago - pain manifests itself in the form of cramps that restrict movement in the back and interfere with full breathing.
- Dorsalgia is a persistent pain localized in the area of the vertebrae affected by the pathological process.
Osteochondrosis of the thoracic spine is a cause of constant discomfort and a decline in human quality of life. Depending on the stage of change, 4 stages of pathological development are distinguished:
- Level 1 - minimal changes, increased joint movement between the vertebrae, asymptomatic.
- Level 2 - protrusion (flattening) of the intervertebral disc, the appearance of slight pain, especially after exercise.
- Stage 3 - the formation of a herniated disc, violation of the roots of the spinal cord, persistent pain appears, neurological symptoms develop.
- Level 4 - significant changes that cause severe persistent pain, numbness of the skin in various parts of the body, a decrease in muscle strength, especially in the upper limbs.
Determination of the stage of pathological processes is carried out on the basis of clinical manifestations of the disease. To elucidate the nature and severity of the changes, additional objective diagnostics were established using spinal space imaging techniques.
Diagnostics
Based on the clinical picture, the doctor draws an initial conclusion. To determine the localization and nature of the changes, as well as the stage of the pathological process, additional examinations are prescribed with visualization of the thoracic ridge:
- Spinal X-rays are the most common instrumental diagnostic method, allowing you to identify large changes in the structure of the spine.
- Computed tomography is an X-ray technique of scanning tissue layer by layer, which has a high separation capacity and makes it possible to visualize minimal changes in the thoracic ridge.
- Magnetic resonance imaging - for visualization, the core resonance phenomenon of a compound occurring in a magnetic field is used. This technique involves scanning the body, while the human body does not experience radiation exposure.
To determine the functional state of various organs and systems, laboratory tests are prescribed (clinical blood tests, biochemistry, urine tests). After the diagnosis, the doctor has the opportunity to choose the optimal treatment.
Treatment of osteochondrosis of the thoracic spine
The treatment of osteochondrosis of the thoracic spine is always complex. This aims to restore the nutrition of cartilage components, normalize its properties, as well as the functional state of the spine and spinal cord roots. For this, 2 main areas of therapeutic methods are used:
- Conservative treatment.
- Invasive surgical intervention.
Often, both directions of therapeutic measures are combined.
Conservative treatment
The basis of conservative treatment is the use of drugs from several groups:
- Non -steroidal anti -inflammatory drugs - reduce the severity of inflammatory and pain reactions.
- Adrenal hormone - Reduces inflammation and nerve pain.
- Muscle relaxation - the drug reduces the tone of the muscles in the spine, thus reducing the compression of the spinal cord roots.
- Diuretics - means reducing tissue swelling and compression of the spinal cord roots due to increased urine excretion.
- Chondroprotectors - reduce the severity of degenerative processes, destruction of cartilage tissue, contribute to partial recovery.
- Vitamin B - enhances the course of metabolic processes in nerve tissue, contributes to the early restoration of the functional state of the spinal cord roots.
- Vitamin C (ascorbic acid) - strengthens blood vessels, has an antioxidant effect (binds and kills free radicals, which are "fragments" of organic molecules with unpaired electrons and damage the structure of cell membranes).
During the remission period (improvement of the condition and reduction of the phenomenon of acute inflammation), exercise therapy (physiotherapy exercises with special exercises), back massage, physiotherapy procedures (magnetotherapy, mud baths, electrophoresis) are prescribed. During the implementation of therapeutic measures, it is important to meet dietary recommendations (rejection of fatty fried foods, alcohol) and general (adequate sleep, rational work and rest). Conservative therapy makes it possible to achieve a significant improvement in this condition.
Surgical intervention
If there is no necessary therapeutic outcome against the background of the use of drugs, in the event of a pathological process to radically eliminate the problem, then invasive surgical intervention is prescribed. It includes several techniques:
- Microdiscectomy - removal of a herniated disc with a subsequent hernial hole lead.
- Foraminectomy - removal of a bone growth that narrows the duct in the area of the spinal cord root outlet.
- Laminectomy is the canal enlargement of the area out of the spinal root.
In modern hospitals, surgery is performed using minimally invasive endoscopic techniques. For plastic openings of hernial holes, special snares are usually used that are made of durable material that does not cause an inflammatory reaction.
prevention
To prevent the development of pathological processes, you need to follow some simple preventive recommendations, which include:
- Get enough sleep for eight hours.
- Limiting the effect of stress factors (chronic stress can provoke the development of pathological processes).
- Normalization of work and rest regimes.
- Restrictions on difficult physical work.
- Rejection of bad habits.
- Rational diet with adequate intake of vitamins and vegetable fiber.
- Adequate motor regime with dynamic training (filling), walking in the fresh air.
Osteochondrosis of the thoracic spine is characterized by a chronic progressive course. The disease requires long -term therapy, so it is easier and easier to prevent its development.