Thoracic spine osteochondrosis refers to degenerative dystrophic pathology. Crest problems rank 5th in the structure of all diseases of the musculoskeletal system. They are most common in people over 45 years of age. Timely diagnosis and initiation of treatment can delay the progression of the disease.
development mechanism
Degenerative dystrophic pathology, which includes osteochondrosis, is characterized by the presence of several major links in the pathological process, including:
- Malnutrition (trophism) of the cartilaginous tissue, which occurs in the context of excessive load or exposure to other triggering factors, is called dystrophy.
- Gradual destruction of cells and intercellular substance in the cartilage tissue, which occurs as a result of malnutrition.
- Development of an inflammatory reaction, whose severity depends on the degree of damage to cartilage tissue structures.
- Violation of the functional state of the joint or of the structure of the spine (intervertebral discs), which contains cartilage tissue.
Osteochondrosis involves the defeat of the intervertebral discs and joints of the crestal processes in several parts. The discs between the vertebrae are flattened, which leads to compression of the motor and sensory nerve fibers in the spinal roots. The disease development mechanism is always accompanied by the addition of neurological symptoms.
Causes of disease
Thoracic crest osteochondrosis is a polyetiological disease. This means that the process of dystrophy and degeneration of the cartilaginous tissue is triggered by the influence of a large number of triggering factors:
- Hereditary predisposition, which determines the nutritional characteristics of cartilage tissue with subsequent disturbances in the context of normal loads. In this case, osteochondrosis can develop in young people.
- Congenital malformations and anomalies in the development of structures of the musculoskeletal system, leading to changes in blood flow in tissues and deterioration in the nutrition of cartilage components.
- Delayed lesions of various parts of the crest (fractures, bruises, joint dislocations and subluxations), which lead to a change in the proportion of various structures with the subsequent development of degenerative-dystrophic processes in them.
- Insufficient physical activity (sedentary lifestyle), leading to tissue congestion.
- Systematic increased loads on the thoracic spine (heavy physical work, prolonged static loads).
- Disruption of the metabolism of mineral salts in the body, which causes a decrease in the resistance of bone processes, intervertebral discs and the consequent malnutrition of cartilaginous structures.
- Deterioration of blood supply to spinal tissues, occurring in the context of compression of major arteries or veins.
- Bad habits - Nicotine and alcohol are vascular toxins that cause a deterioration in blood flow to tissues and a violation of their nutrition.
Discovering the reasons for the development of the pathological process is an essential component of the diagnostic process. This is necessary for the subsequent consultation of an effective treatment, as well as for the prevention of the new development of osteochondrosis.
Symptoms of osteochondrosis of the thoracic spine
The development of the degenerative-dystrophic process is accompanied by the appearance and consequent increase in the intensity of the following symptoms of osteochondrosis:
- Pain in the spine at the level of the chest - in the beginning, the pain appears after exertion, a long stay of the human body in one position. Then the feelings of discomfort intensify and become permanent. Often, the pathological process is accompanied by back pain between the shoulder blades.
- Unpleasant "squeezing" feeling in the back, which does not allow you to fully inhale.
- Violation of skin sensitivity in the form of numbness in various parts of the body (the changes cover the skin of the upper or lower extremities on one side of the body) due to compression of the sensitive nerve fibers in the roots of the spinal cord.
- Muscle weakness in an arm or leg usually occurs on one side of the body.
- Violation of the functional state of the digestive system, which is accompanied by burping, heartburn, abdominal pain, flatulence (bloating), unstable stools.
- Changes in the back and arms, which include dry skin, increased fragility of the nails (resulting from the violation of the state of the autonomic nerve fibers when the spinal root is compressed).
- Changes in the functional status of Organs pelvic organs, manifested by difficulty in urinating, constipation, impotence in men, unstable menstrual cycle in women.
Manifestations appear gradually, a person cannot accurately indicate the time of their development. For a long time, the intensity of symptoms increases, new signs of the pathological process are added. Due to the nature and duration of the discomfort sensations in the back, there are 2 types of pain in osteochondrosis of the thoracic spine:
- Dorsago - Pain manifests in the form of seizures that restrict movement in the back and interfere with deep breathing.
- Back pain is a constant pain located in the area of vertebrae affected by the pathological process.
Osteochondrosis of the thoracic spine is a cause of constant discomfort and a decrease in human quality of life. Depending on the degree of change, 4 stages of pathology development are distinguished:
- Stage 1 - minimal changes, increased mobility of joints between vertebrae, no symptoms.
- Stage 2 - protrusion (flattening) of the intervertebral disc, onset of mild pain, especially after exertion.
- Stage 3 - formation of a herniated disc, spinal cord root violation, onset of constant pain, development of neurological symptoms.
- Stage 4 - pronounced changes leading to constant severe pain, numbness of the skin in various parts of the body, decreased muscle strength, especially in the upper limbs.
The determination of the stage of the pathological process is based on the clinical manifestations of the disease. To clarify the nature and severity of the changes, additional objective diagnoses are prescribed using spinal imaging techniques.
Diagnosis
Based on the clinical picture, the physician comes to an initial conclusion. To determine the location and nature of the change, as well as the stage of the pathological process, an additional examination is prescribed with visualization of the thoracic crest:
- Spinal X-ray is the most common method of instrumental diagnosis, which allows the identification of gross changes in spinal structures.
- Computed tomography is a layer-by-layer radiographic technique of tissue scanning, which has a high separation capacity and allows the visualization of minimal changes in the thoracic crest.
- Magnetic resonance - for visualization, the phenomenon of resonance of the nuclei of compounds that occurs in a magnetic field is used. The technique involves scanning the body while the human body is not exposed to radiation.
To determine the functional status of various organs and systems, laboratory tests (clinical examination, biochemical blood test, urine test) are prescribed. After 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. It aims to restore the nutrition of cartilaginous components, normalizing their properties, as well as the functional state of the vertebrae and spinal cord roots. For this, 2 main areas of therapeutic measures are used:
- Conservative treatment.
- Invasive surgical intervention.
Often, the two directions of therapeutic measures are combined.
Conservative treatment
The basis of conservative treatment is the use of drugs from various groups:
- Non-steroidal anti-inflammatory drugs - reduce the severity of the inflammatory response and pain.
- Adrenal hormones - reduce inflammation and neurological pain.
- Muscle relaxants - drugs reduce the tone of the striated muscles of 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.
- Chondroprotective - reduce the severity of degenerative processes, the destruction of cartilage tissue, contribute to its partial recovery.
- B vitamins - improve the course of metabolic processes in nervous tissue, contribute to the early restoration of the functional state of the spinal cord roots.
- Vitamin C (ascorbic acid) - strengthens blood vessels, has an antioxidant effect (it binds and inactivates free radicals, which are "fragments" of organic molecules with unpaired electrons and damage cell membrane structures).
During the period of remission (improvement of the condition and reduction of acute inflammatory phenomena), physiotherapy (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 comply with dietary (refusal of fatty fried foods, alcohol) and general (adequate sleep, rational work and rest) recommendations. Conservative therapy allows for a significant improvement in the condition.
surgical interventions
In the absence of the necessary therapeutic result in the context of the use of medications, in case of progression of the pathological process towards the radical elimination of the problems, an invasive surgical intervention is prescribed. It includes several techniques:
- Microdiscectomy - removal of a herniated disc with subsequent hernia repair.
- Foraminectomy - removal of bony protuberances by narrowing the canal at the exit area of the spinal cord roots.
- A laminectomy is an enlargement of the canal in the exit area of the spinal roots.
In modern hospitals, surgery is performed using minimally invasive endoscopic techniques. For the plastic opening of the hernial orifice, special screens made of durable material that do not cause inflammatory reactions are usually used.
Prevention
To prevent the development of a pathological process, you need to follow several simple preventative recommendations, which include:
- Eight hours of adequate sleep.
- Limit the impact of stressors (chronic stress can trigger the development of pathological processes).
- Standardization of work and rest regime.
- Restriction of hard physical work.
- Rejection of bad habits.
- Rational nutrition with sufficient intake of vitamins and vegetable fiber.
- Sufficient engine regime with dynamic exercises (loading), walking outdoors.
Thoracic spine osteochondrosis is characterized by a chronic progressive course. The disease requires long-term therapy, so it is easier and more affordable to prevent its development.