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. They are more common in people over the age of 45. Timely diagnosis and the start of treatment allow you to 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, including:
- Malnutrition (trophism) of cartilage tissue, which occurs against the background of excessive load or exposure to other provoking factors, is called dystrophy.
- The gradual destruction of cells and intercellular substance of cartilage tissue, which occurs due to malnutrition.
- The development of an inflammatory reaction, the severity of which depends on the degree of damage to the structures of the 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 joints of the processes of the ridge 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 development of the disease is always accompanied by the addition of neurological symptoms.
Causes of the disease
Thoracic crest osteochondrosis is a polyetiological disease. This means that the process of dystrophy and degeneration of cartilage tissue is activated due to the influence of a large number of provoking factors:
- Hereditary predisposition, which determines the nutritional characteristics of cartilage tissue resulting in ailments against the background of normal loads. In this case, osteochondrosis can develop in young people.
- Congenital malformations and anomalies in the development of the structures of the musculoskeletal system, which lead to changes in blood flow in the tissues and a deterioration in the nutrition of cartilage components.
- Postponed injuries of various parts of the ridge (fractures, bruises, dislocations and subluxations of the joints), which lead to a change in the relationship between various structures with the subsequent development of degenerative-dystrophic processes in them.
- Insufficient physical activity (sedentary lifestyle), which leads to tissue congestion.
- Systematic increase in 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 subsequent malnutrition of cartilage structures.
- Deterioration of the 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 a deterioration of blood flow in the 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 re-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 intensity of the following symptoms of osteochondrosis:
- Pain in the spine at the level of the chest: 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 pain in the back between the shoulder blades.
- Unpleasant "squeezing" sensation in the back, which does not allow you to inhale fully.
- 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 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, which include dry skin, increased fragility 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, which is 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 the symptoms increases, new signs of the pathological process are added. Due to the nature and duration of the discomfort sensations in the back, there are 2 types of pain in osteochondrosis of the thoracic spine:
- Dorsago: Pain occurs in the form of seizures that restrict back movement and interfere with full breathing.
- The back is a constant 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 decrease in the quality of human life. Depending on the degree of change, 4 stages of the development of the pathology are distinguished:
- Stage 1: minimal changes, increased mobility of the joints between the vertebrae, no symptoms.
- Stage 2: protrusion (flattening) of the intervertebral disc, the appearance of slight pain, mainly after exertion.
- Stage 3 - the formation of a herniated disc, violation of the spinal cord root, constant painful 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 limbs.
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 spine imaging techniques.
Diagnostics
Based on the clinical picture, the doctor makes a first 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:
- X-ray of the spine is the most common method of instrumental diagnostics, which allows you to identify gross changes in the structures of the spine.
- Computed tomography is an X-ray technique of scanning tissues layer by layer, which has a high separation capacity and allows you to visualize minimal changes in the thoracic crest.
- Magnetic resonance: the phenomenon of resonance of the nuclei of compounds that occurs in a magnetic field is used for visualization. The technique involves scanning the body, while the human body does not undergo radiation exposure.
To determine the functional state of various organs and systems, laboratory tests are prescribed (clinical blood test, biochemistry, urinalysis). After the 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 is aimed at restoring the nutrition of cartilage 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 surgery.
Often, both directions of therapeutic measures are combined.
Conservative treatment
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: Medicines reduce the tone of the striated muscles of the spine, thereby reducing the compression of the spinal cord roots.
- Diuretics - means to reduce tissue swelling and compression of the spinal cord roots due to increased urine excretion.
- Chondroprotectors - reduce the severity of degenerative processes, the destruction of cartilage tissue, contribute to its partial recovery.
- Vitamins of group B - improve the course of metabolic processes in the 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 period of remission (improvement of the condition and reduction of acute inflammatory phenomena), physical therapy (physiotherapy exercises with special exercises), back massage, physiotherapy procedures (magnetotherapy, mud, electrophoresis) are prescribed. During the implementation of therapeutic measures, it is important to comply with dietary recommendations (refusal of fatty fried foods, alcohol) and general (adequate sleep, rational work and rest). Conservative therapy allows you 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 in order to radically eliminate the problems, invasive surgical intervention is prescribed. It includes several techniques:
- Microdiscectomy - removal of a herniated disc with subsequent plasty of the hernial orifice.
- Foraminectomy - removal of bone growths that narrow the canal in the area of the exit of the spinal cord roots.
- Laminectomy is an enlargement of the canal of the exit area of the spinal roots.
In modern hospitals, surgery is performed using minimally invasive endoscopic techniques. For the plastic opening of the hernial orifice, special nets made of resistant material that does not cause inflammatory reactions are usually used.
Prevention
To prevent the development of a pathological process, it is necessary to follow several simple preventive recommendations, which include:
- Eight hours of adequate sleep.
- Limit the impact of stressors (chronic stress can provoke the development of pathological processes).
- Normalization of the regime of work and rest.
- Restriction of hard physical work.
- Refusal of bad habits.
- Rational nutrition with a sufficient supply of vitamins and plant fibers.
- Sufficient motor regime with dynamic exercises (charge), 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.