Osteochondrosis of the thoracic spine refers to degenerative-dystrophic pathology. Crest problems occupy the 5th place in the structure of all diseases of the musculoskeletal system. They are most common in people over the age of 45. Timely 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 several main links of the pathological process, these include:
- Malnutrition (trophism) of cartilage tissue, which occurs against the background of excessive load or exposure to other provocative factors, is called dystrophy.
- Gradual destruction of cells and intercellular substance of cartilage tissue, which occurs as a result of malnutrition.
- 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 joints or structure of the spine (intervertebral discs), which contains cartilage tissue.
Osteochondrosis involves the defeat of intervertebral discs and ridges of ridge processes in various parts. The discs between the vertebrae are flattened, which leads to compression of the motor and sensory nerve fibers of the spinal roots. The mechanism of disease development is always associated with the increase of neurological symptoms.
Causes of the disease
Chest crest osteochondrosis is a polyetiological disease. This means that the process of dystrophy and degeneration of cartilage tissue is caused due to the influence of a large number of provocative factors:
- Hereditary predisposition, which determines the nutritional characteristics of cartilage tissue with subsequent disturbances against the background of normal loads. In this case, osteochondrosis can develop in young people.
- Congenital malformations and abnormalities in the development of structures of the musculoskeletal system, leading to changes in blood flow to tissues and a deterioration in the nutrition of cartilaginous components.
- Delayed injuries of different parts of the crest (fractures, bruises, dislocations and subluxations of the joints), which lead to a change in the ratio of different structures with the subsequent development of degenerative-dystrophic processes in them.
- Insufficient physical activity (sedentary lifestyle), leading to tissue overload.
- Increased systemic loads on the thoracic spine (hard physical work, prolonged static loads).
- Disruption of the metabolism of mineral salts in the body, which provokes a decrease in the strength of bone processes, intervertebral discs and subsequent malnutrition of cartilaginous structures.
- Deterioration of blood supply to the spinal tissues, which occurs against the background of compression of the main arteries or veins.
- Bad habits - nicotine and alcohol are vascular toxins that cause deterioration of blood flow to tissues and violations of their nutrition.
Finding 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 the prevention of re-development of osteochondrosis.
Symptoms of osteochondrosis of the thoracic spine
The development of the degenerative-dystrophic process is associated with the appearance and subsequent increase in the intensity of the following symptoms of osteochondrosis:
- Back pain at chest level - at first, the pain appears after straining, a long stay of the human body in one position. Then the feelings of anxiety intensify and become permanent. Often the pathological process is accompanied by a dull aching pain between the shoulders.
- Unpleasant feeling of "squeezing" in the back, which does not allow you to fully absorb.
- Violation of skin sensitivity 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 sensitive nerve fibers of the spinal cord roots.
- Muscle weakness in one 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, gas (bloating), unstable stools.
- Changes in the back and arms, which include dry skin, increased brittleness of the nails (result of violation of the condition of the autonomic nerve fibers when squeezing the spinal root).
- Changes in the functional state of the pelvic organs, which is manifested by impaired urination, constipation, impotence in men, unstable menstrual cycle in women.
Manifestations appear gradually, a person can not accurately indicate the time of their development. For a long time, the intensity of symptoms increases, new signs of the pathological process are added. By the nature and duration of the sensations of discomfort in the spine, there are 2 types of pain in osteochondrosis of the thoracic spine:
- Dorsago - the pain appears in the form of seizures that restrict movement in the spine and interfere with taking a full breath.
- Dorsalgia is a persistent aching pain localized in the area of the vertebrae affected by the pathological process.
Osteochondrosis of the thoracic spine is the cause of constant discomfort and a decline in the quality of human life. Depending on the degree of changes, there are 4 stages of pathology development:
- Stage 1 - minimal changes, increased mobility of the joints between the vertebrae, asymptomatic.
- Stage 2 - lengthening (flattening) of the intervertebral disc, the appearance of slight pain, mainly after straining.
- Stage 3 - the formation of a disc herniation, violation of the spinal cord root, persistent pain, neurological symptoms.
- Stage 4 - marked changes leading to constant constant pain, numbness of the skin in various parts of the body, decrease in muscle strength, mainly in the upper limbs.
Determination of the course stage of the pathological process is carried out on the basis of clinical manifestations of the disease. To clarify the nature and severity of the changes, additional objective diagnostics are described using spinal imaging techniques.
Diagnosing
Based on the clinical picture, the doctor makes 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 described:
- X-rays of the spine are the most common method of instrumental diagnosis, which allows you to identify gross changes in the structures of the spine.
- Computed tomography is an X-ray technique of scanning tissue layer by layer, which has a high separation capacity and allows visualization of minimal changes in the thoracic crest.
- Magnetic resonance imaging - for visualization, the resonance phenomenon of compound nuclei that occurs in a magnetic field is used. The technique involves scanning the body while the human body is not experiencing radiation exposure.
To determine the functional state of various organs and systems, laboratory tests are prescribed (clinical test, blood biochemistry, urine test). 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 cartilaginous components, normalize 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.
- Kidney hormones - Reduce inflammation and neurological pain.
- Muscle relaxants - medicines reduce the tone of stretched muscles in the spine, thus reducing the pressure on the spinal cord roots.
- Diuretics - means swelling of the tissues and oppression of the spinal cord roots due to increased urine secretion.
- Chondroprotectors - reduce the severity of degenerative processes, destroy cartilage tissue, contribute to its partial recovery.
- B vitamins - improve the flow of metabolic processes in nerve tissues, contribute to the early restoration of the functional state of the spinal cord roots.
- 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 damages the membrane structures of cells).
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. When implementing therapeutic measures, it is important to follow the dietary recommendations (refusal from fried foods with fat, alcohol) and general (proper sleep, rational work and rest). Conservative therapy makes it possible to achieve a significant improvement in the condition.
Surgical interventions
In the absence of the necessary therapeutic result in the background of the use of drugs, in case of progress of the pathological process to radically eliminate the problems, an invasive surgical intervention is prescribed. It includes several techniques:
- Microdiscectomy - removal of a disc herniation with subsequent hernia of the hernia.
- Foraminectomy - removal of bone outgrowths that narrow the canal in the outlet area of the spinal cord roots.
- Laminectomy is an enlargement of the canal of the spinal root outlet area.
In modern hospitals, surgery is performed using minimally invasive endoscopic techniques. For plastic opening of the hernial throat, special nets 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 some simple preventive recommendations, which include:
- Eight hours of enough sleep.
- Limiting the influence of stress factors (chronic stress can provoke the development of pathological processes).
- Normalization of work and rest regime.
- Limiting heavy physical work.
- Rejection of bad habits.
- Rational diet with a sufficient intake of vitamins and plant fiber.
- Adequate motor mode 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 therapy, so it is easier and more accessible to prevent its development.