Unnatural changes in the cartilage and bones of the spine provoke the development of the disease, which, according to the ICD-10 code, refers to the localization of M42 and is called thoracic osteochondrosis. The middle part of the spine experiences less stress than the lumbar and cervical spine, but the deformities are difficult to heal. The load is unevenly distributed due to the rounded configuration of the sternum, osteophytes and other dysplastic manifestations appear.
Signs and symptoms
The disease occurs in the nucleus pulposus of the intervertebral disc, spreads to the fibrous annulus and other parts of the vertebral segment, which ensure the mobility of the spine. The changes are manifested by compression, reflexes, or mixed neurological disorders and syndromes.
Pain manifests itself with physical effort. There are different types of sensations:
- mild and prolonged pain in the thoracic region is called back pain;
- sharp, sharp colic, causing difficult inhalation or exhalation, leading to immobility of the muscles - dorsago.
The symptoms and treatment of osteochondrosis of the thoracic spine depend on the degree of wear of the bone apparatus and the stage of aging, which are generalized and local.
Symptoms include:
- damage to the peripheral processes of the nerves (neuralgia), characterized by painful attacks along the intercostal vasoconstrictors;
- concentration of pain on the left side of the chest or the appearance of a strong painful sensation of the nature of shingles;
- decreased mobility of the spine in the chest area;
- numbness in arms and hands;
- decreased sexual function;
- the appearance of pain in the area of internal organs, can give to the heart, stomach, liver;
- lumbago in the neck, cheekbones and head, cough or a lump in the throat;
- arrhythmia, tachycardia, fever.
The signs of osteochondrosis are disguised as manifestations of related diseases, so the symptoms are ambiguous. The spinal nerves are concentrated around the spinal column; When held, signals are sent to different parts of the body and organs.
Causes of osteochondrosis.
There is no exact information on what factors deform the intervertebral discs. A common reason for osteochondrosis is scoliosis or curvature of the spine, which occurs most often in childhood and adolescence.
The theory considers such factors of vertebral deformity:
- dysontogenetic;
- hormonal
- vascular;
- functional;
- involutional
- infectious;
- immune;
- dysmetabolic;
- mechanic;
- hereditary.
The deterioration and aging of bones and cartilage occurs as a result of previous exposure to adverse conditions. Atrophic degenerations in the spine are predetermined by a genetic factor, and a disease with clinical symptoms arises under the influence of an exogenous and endogenous environment.
The consequence in the form of complications in the work of the vertebrae occurs when the process of destruction of complex substances prevails over their synthesis. An exacerbation occurs when the power supply of the disc is interrupted and there is a shortage of useful elements. The penetration of dissimilation elements and products decreases, cell viability decreases, and parts of cells accumulate due to self-destruction. The production of complex proteins is reduced, collagen fibers are destroyed.
The mechanical effect on the annular connective formation increases, the layered structure is disorganized, the fibrous skeleton is broken. The disc bruises under the influence of biomechanical factors and body movements, and its fixation capacity decreases. Blood vessels and nerves can grow into the annulus due to a decrease in hydrostatic pressure.
Diagnostic methods
In the recognition process, root, painful, reflex, myotonic, autonomic and vascular factors are identified. The best method of examination is difficult to identify, because in each case, the diagnosis is made individually.
The main methods are:
- X-ray diagnosis;
- Computed tomography;
- Magnetic resonance imaging.
The radiography analyzes the state of the spine, the images are given in oblique, lateral and direct projections. Sometimes for a photo, a person bends over, bends over, or leans to the side.
Contrast radiography is divided into the following studies:
- pneumomyelography — 20 to 40 ml of air is injected into the spinal canal;
- angiography: 10 ml of contrast agent is injected into the spinal lumen and 7 to 9 images are taken in 2 to 3 seconds;
- myelography: an injection of a coloring liquid is made into the subarachnoid lumen, followed by a transillumination of the structure;
- Discography: The stained substance is injected directly into the disc for a localized examination.
Computed tomography assesses bone and tissue structure, the state of blood vessels. The painless method takes three-dimensional images in a few minutes.
Benefits of CT:
- high detection speed;
- detection of "silent" areas during diagnosis in motion;
- the possibility of multispiral angiography;
- Recognition of long objects with obtaining high quality thin cuts.
MRI uses the magnetic field of a machine that builds hydrogen atoms in the human body in parallel with action. The particles point, the response is recorded. The scanner recognizes the waves and displays the result on the screen. With MRI, there is no radiation, the method is less dangerous, but it is not recommended for pregnant women.
Treatment and prevention
It is necessary to treat osteochondrosis in several stages, the complexity depends on the severity of the disease, contraindications and body resources.
Methods:
- drugs and medication;
- physiotherapy methods, exercises for removing clamps, alleviating the patient's condition;
- operation.
There is a direction of kinesitherapy, within which it is possible to cure problems of the spine in the form of hernia, spondylosis with rehabilitation gymnastics. In addition, a method of recovery after surgery has been developed.
Yoga exercises help adult men, women and children to overcome pain, warning that the main thing is a psychological attitude.
Medicines
Medications are prescribed by a neurosurgeon or neuropathologist according to the card and medical history. Patients take medications in a hospital or at home, the main thing is to follow the instructions and not deviate from the intake regimen.
Common medications:
- NSAIDs relieve pain, fever, and inflammation;
- muscle relaxants reduce the muscle tone of the skeletal skeleton;
- hormones reduce nerve pain;
- vitamins B2, B6, B12, A and C are taken during remission and as simple prophylaxis;
- diuretics relieve swelling and release pinched root nerves;
- neurometabolic stimulants improve metabolism in nervous tissues;
- Chondroprotectors restore the cartilage of the vertebrae after damage.
Sometimes the patient dispenses with medication at the first stage of the onset of unpleasant sensations. Just exercise, use a massager.
Physiotherapy
This type of exposure is used in conjunction with drug treatment or separately. In addition, bed rest is applied, heat is applied to the affected area. Folk recipes are used to relieve pain.
Physiotherapy in a medical institution includes procedures:
- ultrasound and phonophoresis;
- shock wave therapy;
- detector impact;
- laser therapy;
- electrotherapy;
- magnetic waves;
- mud therapy and balneotherapy;
- massage.
Ultrasound involves the effect of high-frequency waves on tissues, reducing sensitivity to pain. With ultraphonophoresis analgesics and anti-inflammatories are added for better delivery to the affected areas.
Shock wave therapy is the transmission of an acoustic wave to the painful area, it is used to improve blood circulation and accelerate metabolism. Tensor therapy involves stretching the spine using the patient's body weight.
Laser therapy is based on the generation of helium-neon lasers to activate bioelectric currents in nerve fibers. The laser acts on inflamed nerve roots in the paravertebral region along the thoracic region.
Electrotherapy improves nutrition and metabolism of products in tissues, and impulse currents affect sensory nerve endings. Low-frequency waves relieve acute pain and are used as an initial aid.
Magnetic therapy is used to relieve swelling, spasms, and inflammation. A magnetic wave inducer is placed on the affected thoracic region. Balneotherapy and mud therapy consists of swimming in pools, taking baths, contrast showers for treatment and during recovery. The metabolism is normalized, blood flow to the affected areas is accelerated, pain and inflammation are reduced.
The therapeutic massage for osteochondrosis of the thoracic spine is a vacuum, punctual and lymphatic drainage, improves blood microcirculation, tissue nutrition and tones muscles. The sessions are led by a competent specialist, if you entrust the spine to amateurs, dangerous consequences can occur. Massage is prescribed after the end of the acute stage, the first session should not exceed 10 minutes.
Operative treatment
The patient is indicated for an operation if medical treatment, massage, and other procedures do not alleviate the condition.
The intervention is divided into 2 stages:
- elimination of the cause of severe pain (decompensation);
- stabilization of the spine.
Using the posterior approach, a facetomy is performed, because the facet joints can press on the nerves. Foraminotomy is the expansion of the root canal through which the nerve exits the vertebra. Laminectomy removes the back of the vertebra, which protects the spinal lumen and presses on the brain due to the deformity. Laminotomy involves enlarging the opening of the canal, where the spinal cord is located, while removing a separate fragment from the posterior region of the vertebra.
The above surgery is done if there is a bulge (bulging of the spinal disc into the spinal lumen) or a hernia that is bulging into the canal.
The following methods are used for frontal decompression:
- discectomy - removal of a complete disc or a separate part of it;
- corpectomy: removal of a complete vertebra and an adjacent disc followed by implantation.
Discectomy and corporectomy destabilize the spine and increase the risk of neurological defects. Rigid fixation or fusion of three vertebrae (fusion) is used.
Prevention of thoracic osteochondrosis.
Exacerbations of the disease reduce the ability to work and the quality of human life, so special attention is paid to prevention. As a result, vertebral degeneration appears later and disability is avoided.
Methods to prevent disease:
- decreased physical activity in the spine;
- you cannot stay still for a long time without changing the supporting limb, you can lean on an improvised object or on a wall;
- sitting at a desk for a long time is not recommended and when working with a computer, you need to take active breaks, walk;
- orthopedic sleeping mattresses and headrests are selected;
- while running and walking, you should avoid sudden turns and jumps, walking in shock-absorbing shoes with small heels;
- Carry a weight of no more than 10 kg, gradually lift it from a sitting position.
In the car, you should use back and head restraints, while the driver's seat should be rigid. Work can not be performed in a half-tilt position, you can stand or sit. Well-developed muscles support the skeleton, so pay attention to feasible physical education and hardening.
Possible complications
The disease develops for a long time, sometimes pain symptoms do not appear immediately. Any degenerative change in the thoracic region leads to the appearance of pathologies.
Types of complications:
- pathology of the heart vessels with subsequent myocardial infarction or angina pectoris;
- intercostal neuralgia or inflammation of the peripheral nerves with chest pain from root compression;
- bulging of intervertebral discs.
Complications occur with advanced forms of osteochondrosis, so timely treatment in the early stages will help to avoid concomitant diseases.