Unnatural changes in the cartilage and bones of the spine cause the development of the disease, which according to the ICD-10 code refers to the localization of M42 and is called thoracic osteochondrosis. The middle part of the spine experiences less stress than the lumbar and cervical ones, but the deformities are difficult to treat. The load is unevenly distributed due to the rounded configuration of the sternum, osteophytes and other dysplastic manifestations appear.
Symptoms and signs
The disease occurs in the pulpal nucleus of the intervertebral disc, spreads to the fibrous fibrous ring and other parts of the spinal segment, which provide mobility of the spine. The changes are manifested by compression, reflex or mixed neurological disorders and syndromes.
The pain manifests itself during exercise. There are different types of sensations:
- mild prolonged chest pain is called dorsalgia;
- acute and acute colic, provoking difficulty inhaling or exhaling, leading to immobility of the muscles - dorsago.
The symptoms and treatment of osteochondrosis of the thoracic spine depend on the degree of wear of the skeletal system and the stage of aging, which are generalized and local.
Symptoms include:
- damage to peripheral nervous processes (neuralgia), characterized by painful attacks along the intercostal vasoconstrictors;
- concentration of pain in the left side of the chest or the appearance of a very painful sensation of the nature of shingles;
- reduced mobility of the spine in the chest;
- numbness of the hands and arms;
- reduced sexual function;
- the appearance of pain in the internal organs, can give the heart, stomach, liver;
- lumbago of the neck, cheekbones and head, cough or lump in the throat;
- arrhythmia, tachycardia, fever.
The signs of osteochondrosis are disguised as manifestations of related diseases, so the symptoms are ambiguous. The spinal nerves are concentrated around the spine; when captured, signals are sent to different parts of the body and organs.
Causes of osteochondrosis
There is no exact information on what factors deform the intervertebral discs. A common cause of osteochondrosis is scoliosis or curvature of the spine, which is more common in childhood and adolescence.
The theory considers such factors for vertebral deformity:
- dysontogenetic;
- hormonal;
- vascular;
- functional;
- involutional;
- infectious;
- immune;
- dysmetabolic;
- mechanical;
- hereditary.
Deterioration and aging of bones and cartilage occurs as a result of previous exposure to adverse conditions. Atrophic degenerations in the spine are determined by genetic factors, and disease with clinical symptoms occurs under the influence of exogenous and endogenous environment.
The consequence in the form of complications in the work of the vertebrae occurs when the process of destruction of complex substances prevails over their synthesis. Exacerbation occurs when the disk power is damaged and there is a shortage of useful elements. The penetration of elements and products of dissimilation decreases, cell viability decreases and parts of the cells accumulate due to self-destruction. The production of complex proteins is reduced, collagen fibers are destroyed.
The mechanical effect on the annular joint formation increases, the layered structure is disorganized, the fibrous skeleton is torn. The disc is bruised under the influence of biomechanical factors and body movements and its fixation capacity decreases. Blood vessels and nerves can grow in the ring due to a decrease in hydrostatic pressure.
Diagnostic methods
Radical, pain, reflex, myotonic, vegetative and vascular factors are identified in the recognition process. The best method of examination is difficult to identify, as in each case the diagnosis is made individually.
The main methods are:
- X-ray diagnostics;
- CT scan;
- Magnetic resonance.
X-ray analyzes the condition of the spine, images are given in oblique, lateral and direct projections. Sometimes for a photo a person bends, unfolds or bends sideways.
Contrast radiography is divided into the following studies:
- pneumomyelography - 20 to 40 ml of air is injected into the spinal canal;
- angiography - 10 ml of contrast agent is injected into the lumen of the vertebrae and take 7 to 9 pictures in 2-3 seconds;
- myelography - an injection of staining fluid is made in the subarachnoid lumen, followed by transillumination of the structure;
- discography - the stained substance is injected directly into the disk for localized examination.
Computed tomography assesses the structure of bones and tissues, the condition of blood vessels. The painless method makes 3D images in minutes.
Advantages of CT:
- high detection speed;
- screening of "dull" areas during on-the-go diagnostics;
- the possibility of multislice angiography;
- recognition of long objects with obtaining high-quality cuts with low thickness.
MRI uses the machine's magnetic field, which builds hydrogen atoms in the human body in parallel with the action. The particles signal, the response is recorded. The tomograph recognizes the waves and displays the result on the screen. MRI has no radiation, the method is less dangerous, but is not recommended for pregnant women.
Treatment and prevention
Treatment of osteochondrosis is necessary in several stages, the complexity depends on the severity of the disease, contraindications and resources of the body.
methods:
- medicines and drugs;
- methods of physiotherapy, exercises to remove braces, alleviate the patient's condition;
- operation.
There is a direction of kinesitherapy, within which it is possible to treat spinal problems in the form of hernias, spondylosis with rehabilitation gymnastics. A method of recovery after surgery has also been developed.
Yoga exercises help older men, women, children to overcome pain, warning that the main thing is the psychological attitude.
Medicines
Medicines are prescribed by a neurosurgeon or neurologist according to the chart and medical history. Patients take medication in hospital or at home, the main thing is to follow the instructions and not to deviate from the regimen.
Common medicines:
- NSAIDs relieve pain, fever and inflammation;
- muscle relaxants reduce skeletal muscle tone;
- hormones reduce neuralgic pain;
- vitamins B2, B6, B12, A and C are taken during remission and for simple prophylaxis;
- diuretics relieve swelling and release compressed radicular nerves;
- neurometabolic stimulants improve metabolism in nervous tissues;
- chondroprotectors restore vertebral cartilage after injury.
Sometimes the patient copes without medication in the first stage of the appearance of unpleasant sensations. It is enough to exercise, use a massager.
Physiotherapy
This type of exposure is used in conjunction with medication or separately. In addition, apply bed rest, heat on the affected area. Folk recipes are used to relieve pain.
Physiotherapy in a medical institution includes procedures:
- ultrasound and phonophoresis;
- shock wave therapy;
- sensory shock;
- laser therapy;
- electrotherapy;
- magnetic waves;
- mud therapy and balneotherapy;
- massage.
Ultrasound involves the effect of high-frequency waves on tissues, which reduces sensitivity to pain. In ultraphonophoresis, painkillers and anti-inflammatory agents are added to better deliver them to the affected areas.
Shock wave therapy is the transmission of an acoustic wave to the painful area, used to improve blood circulation, speed up metabolism. Detensor therapy consists of stretching the spine with the help of the patient's body weight.
Laser therapy is based on the generation of helium-neon lasers to activate bioelectric currents in nerve fibers. The laser acts on the inflamed nerve roots in the paravertebral area along the chest area.
Electrotherapy improves the nutrition and metabolism of products in the tissues, and impulse currents affect the nerve sensory endings. Low frequency waves relieve acute pain and are used as a first aid.
Magnetic therapy is used to relieve swelling, cramps and inflammation. A magnetic wave inductor is placed on the affected chest area. Spa and mud therapy consists of swimming in pools, taking baths, contrast showers for treatment and during recovery. Metabolism is normalized, blood flow to the affected areas is accelerated, pain and inflammation are reduced.
Therapeutic massage for osteochondrosis of the chest is vacuum, point and lymphatic drainage, improves blood microcirculation, tissue nutrition, tones muscles. The sessions are conducted by a competent specialist, if you trust the spine of amateurs, dangerous consequences can occur. The massage is prescribed after the end of the acute stage, and the first session should not exceed 10 minutes.
Surgery
The patient is indicated for surgery if medication, massage and other procedures do not alleviate the condition.
The intervention is divided into 2 stages:
- elimination of the cause of severe pain (decompensation);
- stabilization of the spine.
Facetomy is performed through the posterior access, because the facet joints can compress the nerves. Foraminotomy is an enlargement of the radicular canal through which the nerve leaves the vertebra. In laminectomy, the back of the vertebra is removed, which protects the spinal lumen and compresses the brain due to deformation. Laminotomy involves widening the opening of the canal where the spinal cord is located, while removing a single fragment from the back of the vertebra.
Anterior surgery is performed if there is a protrusion (protrusion of the spinal disc to the spinal lumen) or a hernia protrudes toward the canal.
The following methods are used for anterior decompression:
- discectomy - removal of the whole disc or a separate part of it;
- corpectomy - removal of the entire vertebra and adjacent disc, followed by implantation.
Discectomy and corpectomy lead to destabilization of the colon and increase the risk of neurological defects. Rigid fixation or fusion of three vertebrae (fusion) is used.
Prevention of thoracic osteochondrosis
Exacerbations of the disease reduce the ability to work and the quality of human life, which is why special attention is paid to prevention. As a result, vertebral degeneration occurs later and damage is avoided.
Methods of disease prevention:
- reduction of physical activity of the spine;
- you can not stand still for a long time without changing the supporting limb, you can lean on a makeshift object or wall;
- it is not recommended to sit at the desk for a long time and when working with a computer, you should take active breaks, walk;
- mattresses and orthopedic headrests are chosen for sleeping;
- while running and walking, you should avoid sudden turns and jumps, walk in shock-absorbing shoes with small heels;
- carry weights no more than 10 kg, lift gradually from a sitting position.
In the car, you must use backrests and headrests, while the driver's seat must be firm. The work cannot be done in a semi-inclined position, you can stand or sit. Well-developed muscles support the skeleton, so pay attention to possible physical education and hardening.
Possible complications
The disease develops over a long period of time, sometimes the symptoms of pain do not appear immediately. Any degenerative changes in the chest area lead to the appearance of pathologies.
Types of complications:
- cardiovascular pathology with subsequent myocardial infarction or angina pectoris;
- intercostal neuralgia or inflammation of peripheral nerves with chest pain from root compression;
- protrusion of the intervertebral discs.
Complications occur in advanced forms of osteochondrosis, so timely treatment in the early stages will help avoid comorbidities.