Osteochondrosis of the thoracic spine refers to degenerative-dystrophic pathology. Problems with the ridge occupy the 5th place in the structure of all diseases of the musculoskeletal system. It is more common in people over 45 years of age. Early 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 various main links of the pathological process, such as:
- Malnutrition (cartilage) of cartilage tissue, which occurs in the context of excessive load or exposure to other triggers, is called dystrophy.
- The gradual destruction of cells and intercellular substance of cartilage tissue, which occurs as a result of malnutrition.
- The development of an inflammatory reaction, the severity of which depends on the degree of damage to the structures of cartilage tissue.
- Violation of the functional state of the joint or the structure of the spine (intervertebral discs), which contains cartilage tissue.
Osteochondrosis involves the defeat of the intervertebral discs and the joints of the ridge processes in various places. The discs between the vertebrae are flattened, which leads to compression of the motor and sensory nerve fibers of the spinal cord. The mechanism of development of the disease is always accompanied by the addition of neurological symptoms.
Causes of the disease
Osteochondrosis of the thoracic ridge is a multiethnic disease. This means that the process of dystrophy and degeneration of cartilage tissue is activated due to the influence of a large number of provocative factors:
- Hereditary predisposition, which determines the nutritional characteristics of cartilage tissue with consequent disorders in the context of normal loads. In this case, osteochondrosis can develop in young people.
- Congenital malformations and abnormalities in the development of the structures of the musculoskeletal system, which lead to changes in the blood flow to the tissues and to a deterioration in the nutrition of the cartilaginous components.
- Delayed injuries of various parts of the ridge (fractures, bruises, dislocations and overflow of the joints), which lead to a change in the ratio of different structures with the consequent development of degenerative-dystrophic processes in them.
- Inadequate physical activity (sedentary lifestyle), leading to tissue congestion.
- Systematically increased loads on the thoracic spine (hard physical work, prolonged static loads).
- Disorder of the metabolism of minerals in the body, which causes a decrease in the resistance of bone processes, intervertebral discs and the consequent malnutrition of cartilaginous structures.
- Deterioration of the blood supply to the tissues of the spine, which occurs in the context of compression of the main arteries or veins.
- Bad habits - nicotine and alcohol are vascular toxins that cause poor blood flow to the tissues and violate their diet.
Discovering the reasons for the development of the pathological process is an essential component of the diagnostic process. This is necessary for the subsequent appointment of effective treatment, as well as to prevent the recurrence 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:
- Spine pain at chest level - in the beginning, the pain appears after exercise, a long stay of the human body in one place. Then the sensations of discomfort intensify and become permanent. Often the pathological process is accompanied by a dull pain in the back between the shoulders.
- Unpleasant feeling of "compression" 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 limbs on one side of the body) due to compression of the sensitive nerve fibers of the spinal cord roots.
- Muscle weakness in the arm or leg is usually on one side of the body.
- Violation of the functional state of the digestive system, which is accompanied by belching, heartburn, abdominal pain, flatulence (bloating), unstable stools.
- Changes in the back and arms, which include dry skin, increased fragility of the nails (resulting in a violation of the condition of the autonomic nerve fibers when the spinal cord is compressed).
- Changes in the functional state of the pelvic organs, which is manifested by reduced urination, constipation, impotence in men, unstable menstrual cycle in women
The manifestations appear gradually, a person can not accurately indicate the time of his development. For a long time, the intensity of the symptoms increases, new signs of the pathological process are added. From the nature and duration of back discomfort, there are 2 types of pain in osteochondrosis of the thoracic spine:
- Dorsago - pain manifests itself in the form of seizures that restrict movement in the back and interfere with full breathing.
- Back pain is a constant pain located in the area of the vertebrae that is affected by the pathological process.
Osteochondrosis of the thoracic spine is the cause of constant discomfort and reduced quality of human life. Depending on the degree of change, there are 4 stages of pathology development:
- Stage 1 - minimal changes, increased mobility of the joints between the vertebrae, without symptoms.
- Stage 2 - protrusion (flattening) of the intervertebral disc, the appearance of slight pain, especially after exercise.
- Stage 3 - hernia formation, violation of the spinal cord root, appearance of constant pain, development of neurological symptoms.
- Stage 4 - intense changes that lead to severe constant pain, numbness of the skin in various parts of the body, reduction of muscle strength, especially in the upper extremities.
The determination of the stage of the pathological process is made on the basis of the clinical manifestations of the disease. To clarify the nature and severity of the changes, additional objective diagnostics are prescribed using spinal imaging techniques.
Diagnostics
Based on the clinical picture, the doctor makes an initial conclusion. To determine the location and nature of the change, as well as the stage of the pathological process, an additional examination with visualization of the thoracic ridge is prescribed:
- Spine x-ray is the most common method of diagnosing organs, which allows you to detect large changes in the structures of the spine.
- Computed tomography is a layer-by-layer scanning tissue x-ray technique that has a high separation capacity and allows the visualization of minimal changes in the thoracic ridge.
- Magnetic resonance imaging is used - for visualization, the resonant effect of the nuclei of the compounds that occurs in a magnetic field is used. The technique involves scanning the body while the human body is not exposed to radiation.
Laboratory tests (clinical, biochemical blood test, urine test) are prescribed to determine the functional status of the various organs and systems. 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 complicated. It aims to restore the nutrition of the cartilaginous components, normalizing their properties, as well as the functional state of the vertebrae and the roots of the spinal cord. For this, 2 main areas of therapeutic measures are used:
- Conservative therapy.
- Surgical invasive intervention.
Often, both directions of treatment are combined.
Conservative therapy
The basis of conservative treatment is the use of drugs of different 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 in the spine, thus reducing the compression of the spinal cord roots.
- Diuretics - mean reduction of tissue swelling and compression of spinal cord roots due to increased urinary excretion.
- Chondroprotectors - reduce the severity of degenerative processes, destroy cartilage tissue, contribute to its partial recovery.
- Vitamins B - improving the course of metabolic processes in the nervous tissue, contributing to the early restoration of the functional state of the spinal cord roots.
- Vitamin C (ascorbic acid) - strengthens blood vessels, has antioxidant activity (binds and inactivates free radicals, which are "fragments" of organic molecules with a pair of electrons and damage the structures of membrane cells).
During the period of remission (improvement of the condition and reduction of the acute inflammatory phenomena), exercise therapy (physiotherapy exercises with special exercises), back massage, physiotherapy procedures (magnetotherapy, mud baths, electrophoresis) are prescribed. When implementing therapeutic measures, it is important to adhere to dietary (refusal of fatty fried foods, alcohol) and general (adequate sleep, reasonable work and rest). Conservative treatment allows to achieve a significant improvement of the condition.
Surgical procedures
In the absence of the necessary therapeutic effect in the context of the use of drugs, in case of progress of the pathological process in order to radically eliminate the problems, invasive surgery is prescribed. Includes various techniques:
- Microdyscectomy - removal of a disc herniation with subsequent coating of the hernia orifice.
- Foraminectomy - removal of the bones that narrow the canal in the spinal cord root area.
- Laminatectomy is an enlargement of the canal of the spinal cord outlet area.
In modern hospitals, surgery is performed using minimally invasive endoscopic techniques. For the plastic opening of the hernia orifice, special eyes made of durable material that does not cause inflammatory reactions are usually used.
Prevention
To prevent the development of a pathological process, you should follow many simple preventive recommendations, which include:
- Adequate eight hours of sleep.
- Limiting the effect of stressors (chronic stress can cause the development of pathological processes).
- Normalization of work and rest regime.
- Limit hard physical work.
- Rejection of bad habits.
- Rational diet with adequate intake of vitamins and fiber.
- Engine adequacy with dynamic exercises (charging), walking in the fresh air.
Osteochondrosis of the thoracic spine is characterized by a chronic progressive course. The disease requires long-term treatment, so it is easier and more affordable to prevent its development.