The osteochondrosis of the thoracic spine refers to a degenerative-dystrophic pathology. Problems with the ridge rank fifth in the structure of all diseases of the musculoskeletal system. They are more common in people over 45 years of age. Timely diagnosis and initiation of treatment help slow down the progression of the disease.
Development Mechanism
Degenerative-dystrophic pathology, which includes osteochondrosis, is characterized by the presence of several main links of the pathological process, these include:
- Malnutrition (trophism) of cartilage tissue, which occurs in a context of excessive loading or exposure to other provoking factors, is called dystrophy.
- The gradual destruction of cells and intercellular substance of cartilage tissue, which occurs as a consequence of malnutrition.
- The development of an inflammatory reaction, the severity of which depends on the degree of damage to cartilage tissue structures.
- Violation of the functional state of the joint or the structure of the spine (intervertebral discs), which contains cartilaginous tissue.
Osteochondrosis involves the defeat of the intervertebral discs and joints of the ridge processes in various parts. The discs between the vertebrae flatten, which leads to compression of the motor and sensory nerve fibers of the spinal roots. The mechanism of development of the disease is always accompanied by the addition of neurological symptoms.
Causes of the disease
Osteochondrosis of the thoracic crest is a polyetiological disease. This means that the process of dystrophy and degeneration of cartilage tissue is triggered due to the influence of a large number of provoking factors:
- Hereditary predisposition, which determines the nutritional characteristics of cartilage tissue with subsequent alterations 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 cause changes in the blood flow in the tissues and a deterioration in the nutrition of the cartilaginous components.
- Postponed injuries of various parts of the ridge (fractures, bruises, dislocations and subluxations of the joints), leading 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.
- Systematically increased loads on the thoracic spine (hard physical work, prolonged static loads).
- Disruption of the metabolism of mineral salts in the body, which causes a decrease in the strength of bone processes, intervertebral discs and the consequent malnutrition of cartilaginous structures.
- Impaired blood supply to the tissues of the spine, which occurs against the background of compression of the main arteries or veins.
- Bad habits - nicotine and alcohol are vascular toxins that cause impaired blood flow in tissues and a violation of their nutrition.
Finding out 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 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 subsequent increase in the intensity of the following symptoms of osteochondrosis:
- Pain in the spine at chest level: at first, 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 a dull, aching back pain between the shoulder blades.
- Unpleasant "squeezing" feeling in your back, preventing you from inhaling fully.
- Violation of the sensitivity of the skin in the form of numbness in various parts of the body (changes cover the skin of the upper or lower extremities on one side of the body) due to compression of the sensitive nerve fibers of the roots of the spinal cord .
- Muscle weakness in an 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, including dry skin, increased brittleness of the nails (the result of a violation of the state of the autonomic nerve fibers when the spinal root is squeezed).
- Changes in the functional state of the pelvic organs, manifested by impaired urination, 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 sensations of discomfort in the back, 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 that is located in the area of the vertebrae affected by the pathological process.
Osteochondrosis of the thoracic spine is the cause of constant discomfort and a decrease in the quality of human life. Depending on the degree of changes, 4 stages of the development of pathology are distinguished:
- Stage 1: minimal changes, increased mobility of the joints between the vertebrae, no symptoms.
- Stage 2: bulging (flattening) of the intervertebral disc, appearance of mild pain, mainly after exertion.
- Stage 3 - the formation of a herniated disc, infringement of the root of the spinal cord, constant pains appear, neurological symptoms develop.
- Stage 4 - pronounced changes leading to constant severe pain, numbness of the skin in various parts of the body, decreased muscle strength, mainly in the upper extremities.
Determination of the stage of the course of the pathological process is carried out on the basis of the clinical manifestations of the disease. To clarify the nature and severity of the changes, additional objective diagnoses are prescribed using imaging techniques of the spine.
Diagnostics
Based on the clinical picture, the doctor reaches an initial conclusion. To determine the localization and nature of the change, as well as the stage of the pathological process, an additional examination with visualization of the thoracic crest is prescribed:
- Spinal radiography is the most common method of instrumental diagnosis, which allows you to identify important changes in the structures of the spine.
- Computed tomography is a layer-by-layer tissue scanning X-ray technique that has a high separation capacity and allows the visualization of minimal changes in the thoracic crest.
- Magnetic resonance imaging: 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 does not experience radiation exposure.
To determine the functional status of various organs and systems, laboratory tests are prescribed (clinical, biochemical blood tests, urinalysis). After diagnosis, the doctor has the opportunity to choose the optimal treatment.
Treatment of osteochondrosis of the thoracic spine.
Treatment of osteochondrosis of the thoracic spine is always complex. It aims to restore the nutrition of the cartilaginous components, normalizing their properties, as well as the functional state of the vertebrae and roots of the spinal cord. For this, 2 main areas of therapeutic measures are used:
- Conservative treatment.
- Invasive surgical intervention.
Often, both directions of therapeutic measures are combined.
Conservative treatment
The basis of conservative treatment is the use of drugs of several groups:
- Non-steroidal anti-inflammatory drugs: reduce the severity of the inflammatory response and pain.
- Adrenal hormones: reduce inflammation and neurological pain.
- Muscle relaxants: Medications reduce the tone of the striated muscles of the spine, reducing compression of the roots of the spinal cord.
- Diuretics: means to reduce the swelling of the tissues and the compression of the roots of the spinal cord due to the increased excretion of urine.
- Chondroprotectors: reduce the severity of degenerative processes, the destruction of cartilage tissue, contribute to its partial recovery.
- Vitamins B - improve the course of metabolic processes in nervous tissue, contribute to the early restoration of the functional state of the roots of the spinal cord.
- Vitamin C (ascorbic acid): strengthens blood vessels, has an antioxidant effect (binds and inactivates free radicals, which are "fragments" of organic molecules with an unpaired electron and damage cell membrane structures).
During the remission period (improvement of the condition and reduction of acute inflammatory phenomena), exercise therapy (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 adhere to dietary (refusal of fried fatty foods, alcohol) and general (adequate sleep, rational work and rest) recommendations. Conservative therapy makes it possible to achieve a significant improvement in the condition.
Surgical interventions
In the absence of the necessary therapeutic result against the background of the use of drugs, in case of progression of the pathological process to radically eliminate problems, invasive surgical intervention is prescribed. It includes several techniques:
- Microdiscectomy: extraction of a herniated disc with subsequent plasty of the hernial orifice.
- Foraminectomy: removal of bony outgrowths that narrow the canal in the area of the exit of the roots of the spinal cord.
- Laminectomy is an enlargement of the spinal root exit area canal.
In modern hospitals, surgery is performed using minimally invasive endoscopic techniques. For the plastic opening of the hernia hole, special meshes 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 preventive recommendations, including:
- Eight hours of adequate sleep.
- Limit the impact of stressors (chronic stress can provoke the development of pathological processes).
- Normalization of the work and rest regime.
- Restriction of hard physical work.
- Rejection of bad habits.
- Rational nutrition with a sufficient supply of vitamins and vegetable fiber.
- Sufficient engine speed with dynamic exercises (load), walking in the open air.
Osteochondrosis of the thoracic spine is characterized by a chronic progressive course. The disease requires long-term therapy, making it easier and more accessible to prevent its development.