Unnatural changes in the cartilage and bones of the spine cause the development of a 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 ones, 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.
Symptoms and signs
The disease occurs in the nucleus pulposus of the intervertebral disc, spreads to the fibrous fibrous ring and other parts of the spinal segment that ensure the mobility of the spine. The changes are manifested by compression, reflex or mixed neurological disorders and syndromes.
Pain is manifested by physical exertion. There are different types of sensations:
- mild prolonged pain in the thoracic region is called dorsalgia;
- sharp and sharp colic, which causes difficulty inhaling or exhaling, which leads to immobility of the muscles - dorsago.
The symptoms and treatment of thoracic spine osteochondrosis depend on the degree of wear and tear of the skeletal system and the degree of aging, which are generalized and local.
Symptoms include:
- damage to peripheral nerve processes (neuralgia), characterized by painful attacks along intercostal vasoconstrictors;
- concentration of pain in the left side of the chest or the appearance of a strong painful feeling of the nature of shingles;
- reduced mobility of the spine in the chest area;
- numbness in hands and fists;
- decreased sexual function;
- the appearance of pain in the area of internal organs, can affect the heart, stomach, liver;
- lumbago in the neck, cheekbones and head, cough or 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 tightened, signals are sent to different parts of the body and organs.
Causes of osteochondrosis
There is no accurate information on which factors deform the intervertebral discs. A common cause of osteochondrosis is scoliosis or curvature of the spine, which is more common in childhood and adolescence.
The theory considers such factors of vertebral deformity:
- dysontogenetic;
- hormonal;
- vascular;
- functional;
- involutivno;
- contagious;
- immune;
- dysmetabolic;
- mechanical;
- hereditary.
Decay and aging of bones and cartilage occurs as a result of previous exposure to adverse conditions. Atrophic degenerations in the spine are predetermined by genetic factors, and disease with clinical symptoms occurs under the influence of 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. Worsening occurs when the disk power supply is disrupted and there is a lack of useful elements. The penetration of the elements and products of dissimilation is reduced, the vitality of the cells is reduced, and parts of the 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 torn. Under the influence of biomechanical factors and body movements, the disc is crushed and its ability to fix is reduced. Blood vessels and nerves can grow into the ring due to a decrease in hydrostatic pressure.
Diagnostic methods
In the process of recognition, radicular, painful, reflex, myotonic, autonomic and vascular factors are identified. The best method of examination is difficult to determine, because in each case the diagnosis is made individually.
The main methods are:
- X-ray diagnostics;
- CT scanner;
- M. R. I.
X-ray analysis of the spine is performed, images are given in oblique, lateral and direct projection. Sometimes a person bends, unwinds or bends to the side for a photo.
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 lumen of the vertebrae and 7 to 9 images are taken in 2-3 seconds;
- myelography - staining fluid is injected into the subarachnoid lumen, followed by transillumination of the structure;
- discography - the stained substance is injected directly into the disc for localized examination.
Computed tomography assesses the structure of bones and tissues, the condition of blood vessels. The painless method captures three-dimensional images in minutes.
Advantages of CT:
- high detection rate;
- screening of "stupid" areas during on-the-go diagnostics;
- possibility of multispiral angiography;
- recognizing long objects while obtaining high-quality cuts of low thickness.
MRI uses a machine’s magnetic field that builds hydrogen atoms in the human body in parallel with the action. Particles signal, response is recorded. The tomograph recognizes the waves and displays the result on the screen. There is no radiation in magnetic resonance imaging, the method is less dangerous, but it is not recommended for pregnant women.
Treatment and prevention
Osteochondrosis needs to be treated in several stages, the complexity depends on the severity of the disease, contraindications and physical resources.
Methods:
- medicines and drugs;
- physiotherapy methods, exercises to remove clamps, alleviate the patient's condition;
- operation.
There is a direction of kinesitherapy within which it is possible to cure spinal problems with rehabilitation gymnastics in the form of hernia, spondylosis. Also, a method of recovery after surgery has been developed.
Yoga exercises help adult men, women, children to overcome pain, warning that the main thing is a psychological attitude.
Medications
Medicines are prescribed by a neurosurgeon or neuropathologist in accordance with the card and anamnesis. Patients take medication in the hospital or at home, the main thing is to follow the instructions and do not deviate from the regimen.
Common medicines:
- NSAIDs relieve pain, fever and inflammation;
- muscle relaxants reduce skeletal muscle tone;
- hormones reduce neuralgic pain;
- vitamins B2, B6, B12, A and C are taken during remission and for simple prophylaxis;
- diuretics relieve swelling and release trapped radicular nerves;
- neurometabolic stimulants improve metabolism in nervous tissues;
- chondroprotectors restore vertebral cartilage after damage.
Sometimes the patient does not take medication in the first phase of the appearance 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;
- shock absorber;
- laser therapy;
- electrotherapy;
- magnetic waves;
- mud therapy and balneotherapy;
- massage.
Ultrasound involves the action of high-frequency waves on tissues, which reduces sensitivity to pain. In addition to ultraphonophoresis, painkillers and anti-inflammatory drugs are added to deliver them better to the affected areas.
Shock wave therapy is the transmission of an acoustic wave to a painful area, it is used to improve blood circulation, speed up metabolism. Detensor therapy consists of stretching the spine with the help of the patient's body weight.
Laser therapy is based on the helium-neon generation of 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 the nutrition and metabolism of products in tissues, and impulse currents affect nerve sensory endings. Low frequency waves relieve acute pain and are used as an initial aid.
Magnetic therapy is used to relieve swelling, cramps and inflammation. The magnetic wave inductor is placed on the affected thoracic part. Balneotherapy and mud therapy consists of swimming in pools, bathing in the bathroom, contrast shower for treatment and during recovery. Metabolism is normalized, blood flow to the affected areas is accelerated, pain and inflammation are reduced.
Therapeutic massage for osteochondrosis of the thoracic spine is vacuum, point and lymphatic drainage, improves blood microcirculation, tissue nutrition, tones muscles. 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 phase, the first session should not last longer than 10 minutes.
Surgical treatment
The patient is indicated for surgery if medical treatment, massage and other procedures do not alleviate the condition.
The intervention is divided into 2 phases:
- elimination of the cause of severe pain (decompensation);
- spinal stabilization.
The posterior approach is a facetomy, because facet joints can press on the nerves. Foraminotomy is an extension of the radicular canal through which the nerve leaves the vertebra. Laminectomy removes the back of the vertebrae, which protects the lumen of the spine and compresses the brain due to deformities. Laminotomy involves widening the opening of the canal, where the spinal cord is located, while removing a special fragment of the posterior region of the vertebra.
Anterior surgery is performed if there is protrusion (protrusion of the spinal disc toward the lumen of the spine) or a hernia protruding toward the canal.
The following methods are used for anterior decompression:
- discectomy - removal of the entire disc or its separate part;
- corpectomy - removal of the entire vertebra and adjacent disc followed by implantation.
Discectomy and corpectomy lead to destabilization of the column 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 working ability and quality of life of people, so special attention is paid to prevention. As a result, vertebral degeneration occurs later and disability is avoided.
Disease prevention methods:
- reduction of physical activity on the spine;
- you cannot stand still for long without changing the supporting limb, you can rely on an improvised object or wall;
- long sitting at a table is not recommended, and when working with a computer, you must take active breaks, walk around;
- mattresses and orthopedic headrests were chosen for sleeping;
- while running and walking, you must avoid sudden turns and jumps, walking in shoes that absorb bumps with small heels;
- carry weights not exceeding 10 kg, lift gradually from a sitting position.
In the car, you need to use backrests and headrests, while the driver's seat must be rigid. The work cannot be performed in a semi-bent position, you can stand or sit. Well-developed muscles support the skeleton, so they pay attention to feasible physical education and hardening.
Possible complications
The disease develops over a long period of time, sometimes the symptoms of pain do not come immediately. All degenerative changes in the thoracic region lead to the appearance of pathologies.
Types of complications:
- cardiovascular pathology with subsequent myocardial infarction or angina pectoris;
- intercostal neuralgia or inflammation of peripheral nerves with chest pain due to root compression;
- protrusion of intervertebral discs.
Complications occur with advanced forms of osteochondrosis, so timely treatment in the early stages will help avoid comorbidities.