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 vertebral bodies, and surrounding soft tissues. The disease is widespread and affects mainly people of working age (25-45 years old).
Thoracic degenerative disc disease is far less common than lumbar or cervical. This is because this region of the spine, with less static and motor load than the other. However, osteochondrosis in the thoracic spine is much more difficult to diagnose, as it is in most of the cases it happens, it simulates a disease of the lungs, the heart, the organs of the upper parts of the digestive system.
The causes and risk factors
Currently, the exact causes of thoracic degenerative disc disease has not been established. The experts proposed a lot of theories (infectious-allergic, genetic, mechanical, hormonal, vascular), but none of them give a clear and complete explanation of the pathological changes in the spine and causes the degeneration of the tissues. It is most likely that in the pathological mechanism of the development of thoracic osteochondrosis at the same time involved a number of different factors. However, the main value of belonging to a long-static-dynamic overloads in the segment of the spinal column.
The factors causing such an overload are the following:
- abnormalities in the structure of the spinal column;
- the asymmetrical arrangement of the joint and cracks in the discs of the joints;
- a congenital narrowing of the spinal canal;
- spondylogenic of the muscle (myofascial, a), and/or somatic (a, which is derived on the basis of a number of diseases of the blood vessels, and internal organs) pain;
- a long exposure of the spine, the vibrations of, for example, the drivers of the motor vehicle;
- to the physical stress.
- obesity;
- I;
- a sedentary lifestyle (lack of exercise);
- psycho-social factors.
The mobility of the spine is the intervertebral discs, which also play a cushioning role of. In its centre is a flexible nucleus pulposus, which is in a large quantity of water. Osteochondrosis of the nucleus begins to lose water as a result of the demineralization of the polysaccharides. Over a period of time, the nucleus is flattened, and, with it, he flattens and the intervertebral disc. Under the influence of the mechanical loading of the fibrous ring bulges, a process called protrusion. Later in the drive the crack through which to slip out of the fragments of the nucleus pulposus, i.e., the formation of a herniated disc.
The reduction of the disk height leads to a convergence of the adjacent vertebrae, a disorder of the anatomy of the facet joints. All of this leads to a reactive inflammation of the facet joints and the surrounding soft tissues. In addition, the convergence of the vertebral body accompanied by stretching of the articular capsule, and the affected segment of the spine becomes unstable. The vertebral bodies to receive the over-the mobility, that can become a cause of a violation of the spinal column is the root, and radicular syndrome.
On the background of osteochondrosis of the breast has been slowly growing bone tissue of the vertebral bodies forms the bony growths (osteophytes). They can also cause radicular compression syndrome or myelopathy (spinal cord compression).
The classification of the
The classification of thoracic osteochondrosis is situated posindromnoy principle. It depends on which neural structures are affected the structure of the spine is affected, to identify the following syndromes:
- compression – the basis for the development of the lies the tension, the deformation or compression of the nerve root, the part of the spinal cord, or blood vessels, depending on what develops in the spinal column, the circulatory system, or radicular syndromes;
- reflex – is associated with the reflex tension of innervated muscles, degenerative and vascular diseases.
- bioadaptive.
Symptoms of thoracic degenerative disease of the disk
The main symptom of a thoracic degenerative disc disease is a pain. In the majority of cases it is a dull modest.
Prolonged stimulation of the spinal roots causing the innervation of the internal organs. Depending on the degree of injury, thoracic osteochondrosis can occur under the auspices of an organ of the disease.
| The degree of damage to the | Innervated organs | The clinical symptoms of the |
| C7-Th1 | The hands, wrists, arms, windpipe, gullet | The pain in the arms and hands, asthma |
| Th2-Th3 | The heart, pericardium, coronary arteries | Coronary heart disease, arrhythmia |
| Th4-Th5 | The bronchi, lungs, pleura, the mammary glands, the nipples | Bronchitis, pneumonia, pleurisy>[!@#$], bronchial asthma |
| Th5-Th6 | The common bile duct, the gallbladder | Cholelithiasis, a violation of the process of digestion of fats |
| Th6-Th7 | The liver, the solar plexus | Diseases of the liver |
| Th7-Th8 | The stomach | Dyspepsia, gastritis, gastric ulcer, and the ulcer duodenal |
| Th8-Th9 | The duodenum, pancreas | Digestion and stool, duodenitis, pancreatitis |
| Th9-Th10 | The spleen, diaphragm | Hiccup, respiratory disorder |
| Th10-Th11 | The adrenal glands | Allergic reactions, decreased resistance to |
| Th11-Th12 | The kidneys | Pyelonephritis, urolithiasis |
| Th12-L1 | The kidneys and your ureters | Voiding |
In this regard, the most common symptoms of thoracic osteochondrosis are:
- the pain in the breast (behind the sternum, at the sides, the back, the intercostal space) – may be acute, and the pain, tedious; often radiating to the arm;
- pain in the epigastric region – the result, regardless of the type of power supply, the characteristics of the diet; often combined with heartburn, nausea, vomiting;
- the pain in the right upper quadrant – increase so as to change the position of the patient's body, sneezing, cough;
- the pain is in the lumbar region – to simulate an attack of renal colic, often associated with dysuric disorders.
The compression of the nerve root in a patient with thoracic osteochondrosis develops an attack of intercostal neuralgia. It is characterized by the occurrence of acute pain on one side of the chest (thoracalgia). The pain is in the nature of, and distribute, in the course of one of the intercostal nerves from the spine to the sternum. Patients have described as "electric shock" or "cross". The pain may radiate to the region of the epigastrium, retrosternal region, the shoulder, the arm, and along with some of the other symptoms (local hyperhidrosis, pallor or flushing of the skin, which is associated with a lesion of the sympathetic fibers of intercostal nerve.
For the intercostal neuralgia characterized by paroxysms of pain, lasting from a few seconds up to several minutes to complete. During the attack, the pain becomes unbearable. Trying to somehow alleviate their condition, patients are stuck in a certain position of the body, the avoidance of deep breaths, cough, sneeze, turn.
Of the 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 context of the intercostal space.
The diagnosis of
The diagnosis of thoracic osteochondrosis is carried out on the basis of the data of objective examination of the patient, laboratory and instrumental examination, including the following:
- General blood count (mild leukocytosis, increased of the ESA);
- serum electrolytes (low levels of calcium);
- of the urine;
- the biochemical analysis of blood;
- an x-ray inspection of thoracic vertebral column (detected by the flattening of the intervertebral disc, the deformation of the end plates of the adjacent vertebral bodies, the displacement of the adjacent vertebral bodies relative to each other);
- scintigraphy of the spine (reveals the process of active mineralization of bone tissue of the vertebral bodies);
- myelography;
- computer and magnetic resonance tomography.
Breast low back pain requires a differential diagnosis with the following diseases and illnesses:
- dishormonal spondylopathy;
- spondylolisthesis;
- inflammation of the joint;
- ankylosing spondylitis;
- osteomyelitis of the spine;
- rheumatoid arthritis;
- neoplastic processes (metastatic or primary tumors of the chest);
- fractures of the spinal column;
- diseases of the digestive organs (chronic pancreatitis, peptic ulcer and duodenal ulcer, diverticulitis, irritable bowel syndrome);
- diseases of the genitourinary system (urolithiasis, pyelonephritis);
- diseases of the circulatory system (ischemic heart disease, arrhythmia).
Treatment of thoracic osteochondrosis
Treatment of thoracic osteochondrosis is conducted in ambulatory conditions. When expressed pain syndrome, the patient for 2 to 3 days of bed rest is required. Shown in the traction of the affected segment of the spine, which helps to eliminate compression of the nerve roots, and thus stop the pain. When expressed pain syndrome carried out an infiltration of the soft tissues of a 2% solution of novocaine. A short course may be granted to non-steroidal anti-inflammatory drugs.
In the complex treatment of thoracic osteochondrosis are also included:
- antihistamines;
- of the b vitamins;
- tranquilizers;
- acupuncture;
- massage;
- the manual therapy.
After the improvement, the patient was sent to physical therapy sessions. Regular performance of physical exercise in breast osteochondrosis promotes the formation of a well-developed muscular system, which allows the spine in the correct physiological position by eliminating excessive static loads.
Of great importance in the treatment of thoracic osteochondrosis is listed as a regular moderate exercise (swimming, yoga, tai Chi), the normalization of body weight. Jumping, running, weightlifting, and other sports, the more the load on the spine, is contraindicated.
Surgical treatment of thoracic osteochondrosis are shown only if significant spinal cord compression. In such a case, depending on the readings, do the following:
- the stabilization of the spinal column segment;
- replacing the damaged disc of the artificial implant;
- the laser is the restoration of the disk;
- the puncture vaporization of a disk;
- a microdiscectomy.
The potential consequences and complications
Long-term irritation, or compression of the nerve roots, which may cause the development of the body and diseases of the chest, the upper part of the alimentary system, the kidneys. The greatest risk of thoracic osteochondrosis is a to the myocardium.
The effects of thoracic degenerative disc disease can be a disease of the esophagus, stomach, duodenum, pancreas, gall bladder, lungs, and the formation of intervertebral hernia.
The announcement
Thoracic osteochondrosis is characterized by the course in which the release accompanying the exacerbations. In due time begun treatment, the patient, to take into account all the recommendations of your doctor concerning the treatment of the disease and the lifestyle changes, the prognosis is favorable.
The prevention of
Prevention breast osteoarthritis include:
- the normalization of body weight.
- The cessation of smoking;
- an active way of life.