Unusual changes in the cartilage and bone of the spine lead to 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 pressure than the lumbar and cervical, but the deformity is difficult to heal. The load is unevenly distributed as the round configuration of the sternum, osteophytes and other dysplastic manifestations appear.
Symptoms and Signs
The disease occurs in the nucleus pulposus of the intervertebral disc, spreading to the fibrous fibrous ring and other parts of the vertebral segment, which ensures the mobility of the spine. Changes are indicated by compression, reflex or neurological disorders and mixed syndromes.
Pain manifests itself with physical exertion. There are different types of sensations:
- prolonged mild pain in the thoracic area called dorsalgia;
- sharp and sharp colic, provoking difficult inhalation or breathing, which leads to muscle immobility - dorsago.
The symptoms and treatment of thoracic spine osteochondrosis depend on the degree of wear and tear of the bone apparatus and the stage of aging, which is general and local.
Symptoms include:
- damage to peripheral nerve processes (neuralgia), characterized by painful attacks along the intercostal vasoconstrictors;
- concentration of pain in the left side of the chest or the occurrence of a strong painful sensation of the nature of shingles;
- decreased spinal mobility in the chest area;
- numbness in arms and hands;
- decreased sexual function;
- 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 lump in the throat;
- arrhythmia, tachycardia, fever.
The signs of osteochondrosis masquerade as manifestations of an associated disease, so the symptoms are not obvious. Spinal nerves are concentrated around the spinal column; when it is clamped, signals are sent to different parts of the body and organs.
Causes of osteochondrosis
There is no precise information on what factors deform the intervertebral disc. A common cause for osteochondrosis is scoliosis or curvature of the spine, which is more frequently recorded in childhood and adolescence.
This theory considers factors of vertebral deformity such as:
- disontogenetic;
- hormone;
- vascular;
- functioning;
- involutive;
- infectious;
- immune;
- dysmetabolic;
- mechanical;
- from generation to generation.
Deterioration and aging of bone and cartilage occurs as a result of previous exposure to adverse conditions. Atrophic degeneration of the spine is determined by genetic factors, and diseases with clinical symptoms arise under the influence of exogenous and endogenous environments.
Consequences in the form of complications in the work of the vertebrae occur when the process of destruction of complex materials overrides its synthesis. Severity occurs when the disk power supply is interrupted and there is a lack of useful elements. Penetration of elements and separation products is reduced, cell viability is reduced and cell division accumulates as a result of self -destruction. Complex protein production is reduced, collagen fibers are destroyed.
Mechanical effects on the formation of annular connectors increased, irregular layered structure, torn fibrous skeleton. The disc is bruised under the influence of biomechanical factors and body movements, and its fixation ability is reduced. Blood vessels and nerves can develop into annulus due to a decrease in hydrostatic pressure.
Diagnostic methods
In the recognition process, radicular, pain, 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 diagnostics;
- CT scan;
- Magnetic resonance imaging.
X-rays analyze the condition of the spine, images are given in oblique, lateral and direct projection. Sometimes, for a photo, a person bends, bends or bends 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 vertebral lumen and 7 to 9 images are taken in 2 - 3 seconds;
- myelography - injection of dye liquid is made into the subarachnoid lumen, followed by structural transilumination;
- discography - stained material is injected directly into a disc for local examination.
Computed tomography assesses bone and tissue structure, blood vessel condition. The painless method takes a three -dimensional image in minutes.
Benefits of CT:
- high detection speed;
- examination of "stupid" areas during diagnostics in motion;
- the possibility of multispiral angiography;
- long object recognition by obtaining high -quality low -thickness cuts.
MRI uses a mechanical magnetic field that builds hydrogen atoms in the human body in parallel with that action. Particle signals, reactions are recorded. Tomography recognizes waves and shows the results on a screen. With MRI, no radiation, the method is less dangerous, but not recommended for pregnant women.
Treatment and prevention
It is necessary to treat osteochondrosis in several stages, the complexity of which depends on the severity of the disease, contraindications and body resources.
Method:
- drugs and medications;
- methods of physiotherapy, training to remove clamps, relieving the patient's condition;
- operation.
There is a direction of kinesitherapy, where it is possible to cure spinal problems in the form of hernias, spondylosis with restorative gymnastics. Also, postoperative recovery methods have been developed.
Yoga exercises help adult men, women, children to cope with pain, warning that the main thing is a psychological attitude.
Medications
Medications are prescribed by a neurosurgeon or neuropathologist according to the card and medical history. Patients take the drug in the hospital or at home, the main thing is to follow the instructions and not to deviate from the intake regimen.
Common medications:
- NSAIDs relieve pain, fever and inflammation;
- muscle relaxants lower skeletal muscle tone;
- hormones reduce neuralgic pain;
- vitamins B2, B6, B12, A and C are taken during remission and for easy prophylaxis;
- diuretics relieve swelling and release pinched radicular nerves;
- neurometabolic stimuli increase metabolism in nerve tissue;
- chondroprotectors restore vertebral cartilage after damage.
Sometimes patients do without medication in the first stage of the onset of unpleasant sensations. Just exercise, use a massage tool.
Physiotherapy
This type of exposure is used in conjunction with drug treatment or separately. In addition, bed rest is used, heat is applied to the affected area. Folk recipes are used to relieve pain.
Physiotherapy in medical institutions includes procedures:
- ultrasound and phonophoresis;
- shock wave therapy;
- detensor effect;
- laser therapy;
- electrotherapy;
- magnetic waves;
- mud therapy and balneotherapy;
- massage.
Ultrasound involves the effect of high -frequency waves on tissues, which reduces pain sensitivity. With ultrafonophoresis, painkillers and anti-inflammatory drugs are added for better delivery to the affected area.
Shock wave therapy is the transmission of acoustic waves to the painful area, it is used to improve blood circulation, speed up metabolism. Detensor therapy consists of stretching the spine using the patient’s weight.
Laser therapy is based on the generation of helium-neon lasers to activate bioelectric currents in nerve fibers. The laser acts on the inflamed nerve roots in the paravertebral region along the thoracic region.
Electrotherapy improves nutrition and metabolism of products in tissues, and impulse currents affect the sensory ends of nerves. Low frequency waves relieve acute pain and are used as first aid.
Magnetic therapy is used to relieve swelling, cramping, and inflammation. A magnetic wave inductor is placed on the affected thoracic area. Balneo and mud therapy consists of swimming in a pool, bathing, contrast baths for treatment and during recovery. Metabolism is normalized, blood flow to the affected area is accelerated, pain and inflammation are reduced.
The therapeutic sequence for osteochondrosis of the thoracic spine is vacuum, point and lymphatic drainage, improving blood microcirculation, tissue nutrition, and muscle tone. Sessions are conducted by competent specialists, if you trust the spine to an amateur, dangerous consequences can occur. Massage is prescribed after the end of the acute stage, the first session should not exceed 10 minutes.
Surgical treatment
Patients are indicated for surgery 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);
- spinal column stabilization.
By means of a posterior approach, a facetomy is performed, because the facet joints can press on the nerve. Foraminotomy is the expansion of a radicular canal in which nerves leave the vertebrae. Laminectomy removes the back of the vertebrae, which protects the lumen of the spine and presses on the brain due to the deformity. Laminotomy involves enlarging the opening of the duct, where the spinal cord is located, while removing separate fragments of the posterior region of the vertebrae.
Anterior surgery is performed if there is a protrusion (bulging of the vertebral disc toward the spinal lumen) or a hernia protruding toward the duct.
The following methods are used for forward decompression:
- discectomy - removal of the entire disc or a separate part thereof;
- corpectomy - removal of the entire vertebra and adjacent discs followed by implantation.
Discectomy and corpectomy lead to column instability and increase the risk of neurological defects. Rigid fixation or a combination of three vertebrae (investment) is used.
Prevention of chest osteochondrosis
The severity of the disease reduces the ability to work and the quality of human life, therefore, special attention is paid to prevention. As a result, vertebral degeneration appears later and disability can be avoided.
Methods to prevent disease:
- decreased physical activity in the spinal column;
- you cannot stand still for long periods of time without changing support limbs, you can lean against improvised objects or walls;
- not recommended to sit at a desk for a long time and when working with a computer, you need to actively rest, take a walk;
- orthopedic mattresses and head restraints are chosen for sleeping;
- while running and walking, you need to avoid sudden turns and jumps, walking with shock-absorbing shoes with small heels;
- carrying a weight of not more than 10 kg, lift gradually from a sitting position.
In the car, you have to use bolsters for the rear and head restraints, while the driver’s seat must be rigid. Work cannot be done in a half -inclined position, you can stand or sit. Well -developed muscles support the skeleton, so they pay attention to proper physical education and hardening.
Possible complications
The disease develops for a long time, sometimes the symptoms of pain do not come immediately. Any degenerative changes in the thoracic region lead to the appearance of pathology.
Type of complication:
- cardiac pathology with subsequent myocardial infarction or angina pectoris;
- intercostal neuralgia or inflammation of the peripheral nerves with chest pain due to root compression;
- protrusion of the intervertebral disc.
Complications occur with advanced forms of osteochondrosis, so timely treatment at an early stage will help to prevent the corresponding disease.