Thoracic osteochondrosis is a chronic disease, which is based on the degenerative-dystrophic lesions of the intervertebral cartilaginous disks, which leads to reactive changes in the bodies vertebral and surrounding soft tissues. The disease is widespread and affects mainly people of working age (25-45 years).
Thoracic degenerative disc disease occurs much less frequently than lumbar or cervical. This is due to the fact that this region of the spine have less static and motor load than others. However, osteochondrosis of the spine thoracic it is much more difficult to diagnose, as in the majority of cases occurs, the simulation of disease of the heart, the lungs, the organs of the upper parts of the digestive system.
Causes and risk factors
Currently the causes exact of thoracic degenerative disc disease is not established. Experts proposed many theories (infectious-allergic, genetic, mechanical, hormonal, vascular), but none of them gives a clear and complete explanation of pathological changes in the spine and lead to degeneration of tissues. Most likely, in the pathological mechanism of development of thoracic osteochondrosis at the same time that a variety of factors. But the main value belongs to the long-static-dynamic overloads of the spinal segment.
The factors that cause an overload are:
- anomalies in the structure of the spine;
- the asymmetric arrangement of the set of cracks in the intervertebral joints;
- congenital narrowing of the spinal canal;
- spondylogenic muscle (myofascial, reflected) and/or somatic (reflected from the bottom of a number of diseases of the blood vessels and internal organs) pain;
- prolonged exposure to the spine of the vibration, for example, drivers of motor vehicles;
- physical stress;
- obesity;
- Not;
- sedentary lifestyle (lack of exercise);
- the psychosocial factors.
The mobility of the spine is provided by the intervertebral discs, which also play a damping role. In its center there is an elastic nucleus pulposus, which in large quantities of water. Osteochondrosis nucleus begins to lose water as a result of demineralization of the polysaccharides. With time, the nucleus is flattened, and he flattens and the intervertebral disc. Under the influence of the mechanical loading of the ring fibrous bulges, a process called protrusion. Later in the unit through the cracks of falling fragments of nucleus pulposus, that is to say, the formation of the herniated disc.
Reduction of disc height leads to a convergence of neighboring vertebrae, interruption of the anatomy of the joints. All of this causes a reactive inflammation in the joints and surrounding soft tissues. In addition, the convergence of the vertebral body accompanied by stretching of the joint capsules, and the affected segment of the spine becomes unstable. The vertebral receive excessive mobility, which can become a cause of infringement of spinal and root syndrome-radicular.
On the background of osteochondrosis of the thoracic been growing bone tissue of the bodies vertebral form the bony growths (osteophytes). Can also cause the syndrome of compression or myelopathy (compression of the spinal cord).
Classification
The classification of thoracic osteochondrosis is posindromnoy principle. Depending on which nerve structures affected structures of the spine have an impact, identify the following syndromes:
- the compression of the basis for its development is the tension, the deformation or compression of the nerve root, part of spinal cord or blood vessel, according to which it develops spinal, vascular or syndromes;
- reflex – is associated with the reflection of the tension of innervated muscles, diseases, and vascular disorders;
- bioadaptive.
Symptoms of thoracic degenerative disc disease
The main symptom of thoracic degenerative disc disease is pain. In the majority of cases it is a dull modest.
Prolonged stimulation of the cord and the roots of the causes innervation of the internal organs. Depending on the level of the lesion thoracic osteochondrosis can occur under the pretext of illness somatic.
| The level of the injury | Innervated organs | Clinical symptoms |
| C7-Th1 | The hand, wrist, hand, trachea, esophagus | Pain in the arms and hands, asthma |
| Th2-Th3 | Heart, pericardium, coronary arteries | Coronary heart disease, arrhythmia |
| Th4-Th5 | Bronchi, lung, pleura, mammary glands, nipples | Bronchitis, pneumonia, pleurisy>[!@#$], bronchial asthma |
| Th5-Th6 | The bile duct, common gallbladder | Cholelithiasis, violation of process of digestion of fats |
| Th6-Th7 | The liver, the solar plexus | Disorders of the liver |
| Th7-Th8 | The stomach | Dyspepsia, gastritis, ulcer gastric and ulcer duodenal |
| Th8-Th9 | The duodenum, the pancreas | Digestion and chair, duodenitis, pancreatitis |
| Th9-Th10 | Spleen, diaphragm | Hiccup, respiratory disorders |
| Th10-Th11 | The adrenal glands | Allergic reactions, decreased immunity |
| Th11-Th12 | Kidney | Pyelonephritis, urolithiasis |
| Th12-L1 | The kidneys and ureters | Cancellation of the |
In this sense, the most common symptoms of thoracic osteochondrosis are:
- pain in the breast (behind the sternum, at the side, back, in the intercostal space) – can be both acute and dull pain; often radiates to the arm;
- pains in the epigastric region arise regardless of the nature of power, the characteristics of the diet, often combined with heartburn, nausea, vomiting;
- pain in the right upper quadrant – increase to change the position of the patient's body, sneezing, cough;
- pain in the lumbar region – to simulate an attack of renal colic, often associated with dysuric disorders.
For the compression of a nerve root in a patient with thoracic osteochondrosis develops an attack of neuralgia intercostal. It is characterized by the appearance of acute pain in one side of the chest (thoracalgia). The pain is around the character and disseminated in the course of one of the intercostal nerves from the spine to the sternum. Patients described as "electric shock" or "cross". The pain may radiate to the region of the epigastrium, retrosternal region, shoulder, arm, and along with some other symptoms (local hyperhidrosis, pal.lidesa or redness of the skin) associated with a lesion of the sympathetic fibers of the nerves intercostal.
For neuralgia intercostal characteristic paroxysms of pain, with a duration of a few seconds up to several minutes. During the attack, the pain becomes unbearable. Trying to alleviate in any way their condition, the patients to freeze in a certain position of the body, avoiding deep breaths, coughing, sneezing, by turns.
Out of pain attack in the patients observed paresthesia (subjective violations of the sensitivity of the skin in the form of pins and needles, tickling, pricking with needles) in the course of the intercostal space.
Diagnosis
Diagnosis of thoracic osteochondrosis is conducted on the basis of the data of the objective examination of the patient, laboratory and instrumental examination, including:
- General blood count (mild leukocytosis, increased ESR);
- the serum electrolytes (low levels of calcium);
- of urine;
- biochemical analysis of blood;
- x-ray examination of the spine thoracic (detected by the flattening of the intervertebral disc, the deformation of the end plates of vertebral adjacent bodies, a change of the vertebral adjacent bodies relative to the other);
- bone scans of the spine (which reveals the process of active mineralization of bone tissue of the bodies vertebral);
- myelography;
- computer and magnetic resonance tomography.
Breast low back pain requires a differential diagnosis with the following diseases and diseased states:
- dishormonal spondylopathy;
- spondylolisthesis;
- the inflammation;
- ankylosing spondylitis;
- osteomyelitis of the spine;
- rheumatoid arthritis;
- neoplastic processes (metastatic or primary tumors of the chest);
- fractures of the spine;
- diseases of the gastrointestinal tract (chronic pancreatitis, peptic ulcer and duodenal ulcer, diverticulitis, irritable bowel syndrome);
- diseases of the genitourinary system (urolithiasis, pyelonephritis);
- cardiovascular diseases (ischemic heart disease, arrhythmia).
Treatment of thoracic osteochondrosis
Treatment of thoracic osteochondrosis is conducted in ambulatory conditions. When expressed pain syndrome of the patient by 2-3 days of rest in bed is prescribed. Sample of pull of the affected segment of the spine, which helps to eliminate compression of the nerve root and, thus, stop the pain. When expressed pain syndrome carried out the infiltration of the soft tissues 2% solution of novocaine. A short course can be assigned a non-steroidal anti-inflammatory drugs.
In the scheme of complex treatment of thoracic osteochondrosis are also included:
- antihistamines;
- vitamins of the b group;
- tranquilizers;
- acupuncture;
- massage;
- manual therapy.
After the improvement of the patient was sent to physical therapy sessions. Regular performance of physical exercise in breast osteochondrosis promotes the formation of a good development of the muscular system, which allows to keep the spine in the correct position, physiological, removes the excess charges static.
Of great importance in the treatment of thoracic osteochondrosis is given regular moderate exercise (swimming, yoga, tai-Chi), the normalization of body weight. Jump, run, weight lifting and other sports, with increase of the loads on the spine, is contraindicated.
Surgical treatment of thoracic osteochondrosis are only shown if significant compression of the spinal cord. In these cases, depending on the readings, do the following:
- stabilization of the spinal column segment;
- replacement of the affected disc with artificial implant;
- laser reconstruction of a disk;
- puncture of vaporization of the affected disc;
- a microdiscectomy.
Possible consequences and complications
Prolonged irritation or compression of the nerve roots that can trigger the development of somatic diseases of the thorax, upper part of the food system, the kidneys. The greatest danger thoracic osteochondrosis is for the myocardium.
Also the effects of thoracic degenerative disk disease can be a disease of the esophagus, stomach, duodenum, pancreas, gallbladder, lungs, and the formation of intervertebral hernia.
Forecast
Thoracic osteochondrosis is characterized by undulating course in which remission followed by exacerbations. Timely begun treatment, the patient's compliance with all recommendations of your doctor about both the treatment of the disease and the lifestyle changes, the prognosis is favorable.
Prevention
Prevention breast osteoarthritis includes:
- the normalization of body weight;
- Stop smoking;
- active way of life.