Osteochondrosis of the thoracic spine refers to degenerative-dystrophic pathology. Reef problems rank 5th in the structure of all diseases of the musculoskeletal system. They are more common in people older than 45 years. Timely diagnosis and initiation of treatment allow slowing 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, which includes:
- Malnutrition (trophism) of cartilage tissue, which occurs against the background of excessive load or exposure to other provoking factors, is called dystrophy.
- Gradual destruction of cells and intercellular substances 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 the structures of cartilage tissue.
- 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 process in different parts. The discs between the vertebrae are flattened, which leads to compression of the motor and sensory nerve fibers of the spinal root. The mechanism of disease development is always accompanied by the addition of neurological symptoms.
Causes of disease
Osteochondrosis of the thoracic ridge is a polyetiological disease. This means that the process of dystrophy and degeneration of cartilage tissue is triggered by the influence of a large number of provoking factors:
- Hereditary predisposition that determines the nutritional characteristics of cartilage tissue with subsequent disturbances in 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 leads to changes in blood flow in the tissues and deterioration of the nutrition of cartilaginous components.
- Delayed injuries of different parts of the ridge (fractures, bruises, sprains 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 (inactive lifestyle), which leads to congestion in the tissues.
- Systematically increased loads on the thoracic spine (heavy physical work, prolonged static loads).
- Disorder of mineral salt metabolism in the body, which causes a decrease in the strength of bone processes, intervertebral discs and consequent malnutrition of cartilage structures.
- Deterioration of the blood supply to the spinal tissue occurs against the background of compression of the main arteries or veins.
- Bad habits - nicotine and alcohol are vascular toxins that cause worsening of blood flow in the tissues and violation of their diet.
Discovering the reasons for the development of the pathological process is an important component of the diagnostic process. This is necessary for the subsequent appointment of effective treatment, as well as the prevention of 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:
- Pain in the spine at the level of the chest - in the beginning, the pain appears after exertion, long holding of the human body in one position. Then the feelings of discomfort intensify and become permanent. Often the pathological process is accompanied by dull back pain between the shoulder blades.
- An uncomfortable feeling of "squeezing" in the back, which does not allow you to breathe completely.
- Violation of skin sensitivity in the form of numbness in different 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 root.
- 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 emptying, heartburn, abdominal pain, bloating (bloating), unstable stools.
- Changes in the back and hands, which include dry skin, increased fragility of the nails (the result of a violation of the state of 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 cannot 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. By the nature and duration of the feeling 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 of the back and interfere with full breathing.
- Dorsalgia 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 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, no symptoms.
- Stage 2 - bulge (flattening) of the intervertebral disc, the appearance of mild pain, mostly after exertion.
- Stage 3 - formation of a herniated disc, injury to the roots of the spinal cord, constant constant pain, neurological symptoms develop.
- Stage 4 - pronounced changes that lead to severe constant pain, numbness of the skin in various parts of the body, a decrease in muscle strength, mainly in the upper limbs.
Determining the phase of the pathological process is done on the basis of clinical manifestations of the disease. In order to clarify the nature and severity of the changes, additional objective diagnostics was prescribed using spinal imaging techniques.
Diagnosis
Based on the clinical picture, the doctor makes an initial conclusion. In order 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 ridge is prescribed:
- Spinal X-ray is the most common method of instrumental diagnostics that allows you to recognize gross changes in the structure of the spine.
- Computed tomography is an X-ray technique of gradual tissue scanning that has a high separation capacity and enables the visualization of minimal changes on the thoracic ridge.
- Magnetic resonance imaging - the resonance phenomenon of the nucleus of a compound that occurs in a magnetic field is used for visualization. The technique involves scanning the body while the human body is not exposed to radiation.
In order to determine the functional state of various organs and systems, laboratory tests (clinical, biochemical blood test, urine test) are prescribed. After diagnosis, the doctor has the option of choosing the optimal treatment.
Treatment of osteochondrosis of the thoracic spine
The treatment of thoracic spine osteochondrosis is always complex. It is intended to restore the nutrition of cartilage components, normalize their properties, as well as the functional state of the vertebrae and spinal cord roots. For this, 2 main areas of therapeutic measures are used:
- Conservative treatment.
- Invasive surgical intervention.
Both directions of therapeutic measures are often combined.
Conservative treatment
The basis of conservative treatment is the use of drugs of several groups:
- Nonsteroidal 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 of the spine, thus reducing the compression of the spinal cord roots.
- Diuretics - mean that they reduce tissue swelling and compression of the spinal cord roots due to increased urine excretion.
- Chondroprotectors - reduce the severity of degenerative processes, destruction of cartilage tissue, contribute to its partial recovery.
- B vitamins - improve the course of metabolic processes in the nervous tissue, 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 unpaired electrons and damage cell membrane structures).
In the period of remission (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 meet dietary (rejection of fatty fried foods, alcohol) and general (adequate sleep, rational work and rest). Conservative therapy enables significant improvement of the condition.
Surgical interventions
In the absence of the necessary therapeutic result in the background of the use of drugs, in case of progression of the pathological process for the radical elimination of the problem, invasive surgical intervention is prescribed. It contains several techniques:
- Microdiscectomy - removal of a herniated disc with subsequent plastic of the hernial opening.
- Foraminectomy - removal of bone growths by narrowing the canal in the area of the spinal cord root outlet.
- Laminectomy is an enlargement of the canal of the exit area of the spinal root.
In modern hospitals, surgery is performed with minimally invasive endoscopic techniques. For the plastic opening of the hernial opening, 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 need to follow a few simple preventive recommendations, which include:
- Adequate eight hours of sleep.
- Limiting the influence of stress factors (chronic stress can cause the development of pathological processes).
- Normalization of work and rest.
- Limitation of heavy physical work.
- Rejecting bad habits.
- Rational diet with sufficient intake of vitamins and plant fibers.
- Sufficient motor regime 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.