Thoracic osteochondrosis is a chronic disease, which is the basis of the degenerative-dystrophic lesions of inter-vertebral cartilaginous disc that reactive changes in the vertebral bodies, as well as the surrounding tissue. The disease is widespread and affects primarily the working-age (25-45 years).
Thoracic degenerative disc disease occurs much less frequently than lumbar or cervical. This is because this region of the spine less static, engine load, than others. However, osteochondrosis of the thoracic spine is much harder to diagnose as most cases occur, simulating disease of the lungs, the heart, the organs of the upper part of the digestive system.
Causes and risk factors
Currently, the exact cause of thoracic degenerative disc disease is not established. Experts proposed a number of theories (infectious-allergic, genetic, mechanical, hormonal, vascular), but none gives a clear, full explanation of the pathological changes in the spine leads to degeneration of the tissues. It is likely that the pathological mechanism of the development of thoracic osteochondrosis at the same time, in several different factors. But the main value belongs to the long-static-dynamic overload of the spine segment.
The factors causing such an overload or:
- anomalies in the structure of the spine;
- asymmetrical arrangement of joint cracks in the inter-vertebral joints;
- congenital narrowing of the spinal canal;
- spondylogenic muscular (myofascial, mirrored) and/or somatic (mirrored arising from the background of a number of diseases of the blood vessels of internal organs) pain;
- prolonged exposure to the spine vibration, for example, drivers of motor vehicles;
- physical stress;
- obesity;
- Smoking;
- sedentary lifestyle (lack of exercise);
- psycho-social factors.
The mobility of the spine in which the intervertebral discs, which also play a cushioning role. In the center is a flexible nucleus pulposus, which in large quantities in the water. Osteochondrosis you start to lose water as a result of demineralizáció the polysaccharides. Over time, the seeds flattened, with together, he flattens the intervertebral disc. Under the influence of the mechanical load on the fibrous ring bulges, a process called protrusion. Later in the drive cracks through which to fall fragments of the nucleus pulposus, i.e., the formation of a herniated disc.
Reduction of the disk height leads to convergence of the adjacent vertebrae, disorders of the anatomy of the facet joints. This triggers the reactive inflammation of the facet joints and the surrounding tissues. In addition, the convergence of the vertebral body accompanied by stretching of the joint capsule and the affected segment of the spine becomes unstable. The vertebral bodies have excessive mobility, which can become, because violation of the spinal roots, the radiculáriszt syndrome.
On the background of osteochondrosis of the thoracic gradually growing bone tissue of the vertebral bodies forms the bony lumps (arthritis). They can cause radiculáriszt compression syndrome, and myelopathia (spinal cord compression).
Classification
The classification of thoracic osteochondrosis lies posindromnoy principle. Depending on which neural structures affected structures of the spine correct effect identify the following symptoms:
- compression – the basis for the development lies, the tension, the deformation or compression of the nerve root, part of spinal cord or vascular, depending on what develops, spinal, vascular or radiculáriszt syndromes;
- reflex – is associated with reflex tension innervated muscles, degenerative and vascular diseases;
- bioadaptive.
Symptoms of thoracic degenerative disc disease
The main symptoms of thoracic degenerative disc disease pain. In most cases it is a dull modest.
Prolonged stimulation of spinal roots causing innervation of the internal organs. Depending on the level of the lesion, thoracic osteochondrosis can occur under the guise of somatic diseases.
| The level of the lesion | Innervated organs | Clinical symptoms |
| C7-Th1 | The hand, wrist, hand, trachea, esophagus | Pain in the arms, hands, asthma |
| Th2-Th3 | Heart, pericardium, coronary arteries | Coronary heart disease, arrhythmia |
| Th4-Th5 | Bronchi, lungs, pleura, mammary glands, nipples | Bronchitis, pneumonia, pleurisy>[!@#$], bronchial asthma |
| Th5-Th6 | The common bile duct, the gallbladder | Cholelithiasis, is a violation of the process of digestion of fats |
| Th6-Th7 | Liver, solar plexus | Disorders of the liver. |
| Th7-Th8 | Stomach | Dyspepsia, gastritis, gastric ulcer, duodenal ulcer |
| Th8-Th9 | Duodenum, pancreas | Digestion, chairs, duodenitis, pancreatitis |
| Th9-Th10 | Spleen, diaphragm | Hiccup, respiratory disorders |
| Th10-Th11 | The adrenal glands | Allergic reactions, decreased immunity |
| Th11-Th12 | Kidney | Pyelonephritis, urolithiasis |
| Th12-L1 | The kidney, ureter | Voiding |
In this regard, the most common symptoms of thoracic osteochondrosis are the following:
- pain in the chest (the sternum, behind, side, in the back, the intercostal space) – can be both acute and aching, boring; often radiates to the arm;
- pain in the epigastric region – is raised, regardless of the nature, characteristics of the diet; it is often coupled with heartburn, nausea, vomiting;
- pain in the right upper quadrant – increase by changing the position of the patient's body, sneezing, cough;
- pain in the lumbar region – to simulate an attack of renal colic, often associated with dysuric disorders.
The compression of the nerve root of a patient's thoracic osteochondrosis develops in the attack of intercostal neuralgia. It is characterized by the occurrence of acute pain on one side of the chest (thoracalgia). Pain around the character, or the public during one of the intercostal nerves, the spine, the sternum. The patients describe them as "shock" or "cross". The pain radiates from the region of the epigastrium, retrosternal region, shoulder, arm, or combined with some other symptoms (local hyperhidrosis, pallor, or flushing of the skin) associated with lesion of the sympathetic fibers of intercostal nerves.
The intercostal neuralgia characterized by orgasm, the pain lasting several seconds to several minutes. During the attack the pain becomes unbearable. Trying to somehow alleviate the condition, the patients freeze in a certain position of the body, avoiding the deep breaths, coughing, sneezing, turn.
The pain attack in the patients observed paresthesia (subjective violation of skin sensitivity in the form of needles, tickling, pricking with needles) in the intercostal space.
Diagnosis
Diagnosis of rib osteochondrosis is carried out based on the data of objective examination of the patient, laboratory, instrumental examination, including the following:
- General blood count (mild leukocytosis, increased ESR);
- the serum electrolytes (low levels of calcium);
- urine test;
- blood biochemical examination;
- x-ray examination of the thoracic spine (detected by the flattening of the intervertebral disc, the deformation of the end plates of the adjacent vertebral bodies, a shift of the adjacent vertebral bodies relative to each other);
- scintigraphy of the spine (revealing in the process of active mineralization of bone tissue of the vertebral bodies);
- myelography;
- computer magnetic resonance tomography.
Breast low back pain requires a differential diagnosis the following diseases, pathological conditions:
- dishormonal spondylopathy;
- spondylolisthesis;
- inflammation;
- ankylosing spondylitis;
- osteomyelitis of the spine;
- rheumatoid arthritis;
- neoplastic processes (metastatic or primary tumors of the chest);
- fractures of the spine;
- diseases of the gastrointestinal tract (chronic pancreatitis, gastric ulcer or duodenal ulcer, diverticulitis, irritable bowel syndrome);
- diseases of the genitourinary system (urolithiasis, pyelonephritis);
- cardiovascular disease (ischemic heart disease, arrhythmia).
Treatment of thoracic osteochondrosis
Treatment of thoracic osteochondrosis is performed ambulatory conditions. When expressed pain syndrome patients 2-3 days in bed for the prescribed. Visible, traction the affected segment of the spine, which helps to eliminate compression of the nerve root, thereby to stop the pain. When expressed pain syndrome carried out infiltration of the soft tissue 2% solution of novocaine. A short course can be assigned to a non-steroidal anti-inflammatory drugs.
The system in the complex treatment of thoracic osteochondrosis are also included:
- antihistamines;
- the b-vitamins;
- sedative;
- acupuncture;
- massage;
- manual therapy.
After improvement, the patient was sent to physical therapy. Regular performance of physical exercise in breast osteochondrosis promotes the formation of a well-developed musculature, which allows the spine in the correct physiological position, eliminate the excessive static loads.
It's very important in the treatment of thoracic osteochondrosis get regular, moderate exercise (swimming, yoga, tai Chi), normalization of body weight. Jumping, running, weight lifting, and other sports, the increased load on the spine, is contraindicated.
Surgical treatment of thoracic osteochondrosis will be displayed only if significant spinal cord compression. In such cases, depending on whether the measured values are the following:
- stabilization of the spinal segment;
- the replacement of the affected disc implant;
- laser reconstruction of the disk;
- puncture ablation of the affected disc;
- a micro discectomy.
Possible consequences, complications
Prolonged irritation or compression of the nerve roots can trigger the somatic diseases of the chest upper part of the trophic system, kidneys. The biggest danger thoracic osteochondrosis of the heart muscle.
Effects of thoracic degenerative disc disease can be a disease of the esophagus, stomach, duodenum, pancreas, gall bladder, lungs, and the formation of inter-vertebral hernia.
Forecast
Thoracic osteochondrosis characteristic wavy road on which remission is accompanied by exacerbations. Time treatment started, the patient complies with the doctor's recommendations regarding both the treatment of the disease, as well as the lifestyle changes, the prognosis is favorable.
Prevention
Prevention breast osteoarthritis include:
- normalization of body weight;
- Smoking cessation;
- active life.