Osteochondrosis of the thoracic spine refers to degenerative-dystrophic pathology. The problem of warts occupies the 5th place in the structure of diseases of the musculoskeletal system. They are more common in people over 45 years of age. Timely diagnosis and initiation of treatment help slow the progression of the disease.
Development Mechanism
Degenerative-dystropathy, including osteonecrosis, is characterized by the presence of several key links of the pathological process, including:
- Malnutrition (nutrition) of cartilage tissue, which occurs when subjected to excessive loads or exposure to other stimuli, is known as dystrophy.
- The gradual destruction of cells and intercellular substances 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 cartilage tissue.
- Violation of the functional state of joints or structures of the spine (discs), which contain cartilage tissue.
Osteochondrosis involves the defeat of the intervertebral discs and joints of the spine formation in different parts. The discs between the vertebrae are flattened resulting in compression of the motor and sensory nerve fibers of the spinal roots. The development mechanism of the disease is always accompanied by neurological symptoms.
Cause of disease
Osteoma of the thoracic cage is a multiprotozoal 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:
- Genetic predisposition, determining the nutritional characteristics of cartilage tissue with subsequent disturbances against the background of normal loads. In this case, osteonecrosis may develop in young people.
- Congenital malformations and malformations in the structural development of the musculoskeletal system, leading to changes in blood flow in tissues and impaired nutrition of cartilage components.
- Delayed trauma of various parts of the spine (fractures, bruises, dislocations and accessory joints), leading to a change in the proportions of different structures with subsequent development of the processdegenerative-dystrophic in them.
- Insufficient physical activity (sedentary lifestyle), leading to blockages in the tissues.
- Systematic increase in load on the thoracic spine (hard labor, prolonged static).
- Disruption of mineral salt metabolism in the body, which leads to a decrease in the strength of bone processes, discs and subsequent malnutrition of the cartilage structure.
- Impaired blood supply to the tissues of the spine, which occurs due to compression of the main arteries or veins.
- Bad habits - nicotine and alcohol are vascular toxins that impair blood flow in tissues and violate 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 further appointment of effective treatment, as well as for the prevention of the recurrence of osteonecrosis.
Symptoms of osteonecrosis of the thoracic spine
The development of the degenerative-dystrophic process is accompanied by the appearance and then an increase in the intensity of the following symptoms of osteonecrosis:
- Pain in the thoracic spine - pain at first appears after exertion, the person lies for a long time in one position. Then the discomfort increases and becomes permanent. Often the pathological process is accompanied by dull back pain between the shoulder blades.
- An unpleasant sensation is "squeezed" in the back, not allowing you to fully inhale.
- Violation of skin sensitivity in the form of numbness in different parts of the body (changes in the covering of the skin of the upper or lower extremities on one side of the body) due to compression of the sensitive nerve fibers of the rootsspinal cord.
- Muscle weakness in the arm or leg is usually on one side of the body.
- Violation of the functional state of the digestive system, accompanied by belching, heartburn, abdominal pain, flatulence (distention), unstable stools.
- Changes in the back and arms, including dry skin, brittle nails (resulting from a violation of the state of autonomic nerve fibers when the spinal roots are compressed).
- Changes in the functional state of the pelvic organs, manifested as poor urination, constipation, impotence in men, irregular menstrual cycles in women.
Manifestations appear gradually, a person cannot accurately indicate the time of their development. For a long time, the intensity of symptoms increases, new signs of the pathological process are added. According to the nature and duration of back discomfort, there are 2 types of pain in thoracic spondylolisthesis:
- Dorsago - pain manifests itself in the form of convulsions that limit movement in the back and interfere with adequate breathing.
- Back pain is a constant pain localized in the vertebrae affected by the pathological process.
Tumors of the thoracic spine are the cause of chronic discomfort and reduce people's quality of 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 - bulging (flattening) disc, mild pain occurs, mainly after exertion.
- Stage 3 - formation of herniated discs, invasion of spinal cord roots, appearance of constant aches and pains, neurological symptoms develop.
- Stage 4 - pronounced changes leading to constant severe pain, numbness of the skin in different parts of the body, decreased muscle strength, mainly in the upper extremities.
Determining the stage 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 imaging techniques of the spine.
Diagnose
Based on the clinical picture, the doctor makes an initial conclusion. To determine the locality and nature of the change, as well as the stage of the pathological process, an additional examination is prescribed with imaging of the thoracic rib:
- X-rays of the spine are the most common instrumental diagnostic method, allowing you to identify overall changes in the structure of the spine.
- Computed tomography is a layer-by-layer tissue-scanning X-ray technique that is highly dissectable and allows minimal changes in the thoracic cavity to be visualized.
- Magnetic resonance imaging - for visualization, the phenomenon of resonance of the nuclei of compounds occurring in a magnetic field is used. This technique involves scanning the body, while the human body is not exposed to radiation.
To determine the functional state of various organs and systems, laboratory tests are prescribed (clinical blood tests, biochemistry, urinalysis). After the diagnosis, the doctor has the opportunity to choose the optimal treatment method.
Treatment of osteonecrosis of the thoracic spine
Treatment of osteonecrosis of the thoracic spine is always complicated. It is aimed at restoring nutrition of cartilaginous 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 surgical intervention.
Often, both directions of therapeutic measures are combined.
Conservative treatment
The basis of conservative treatment is the use of drugs of several groups:
- Non-steroidal anti-inflammatory drugs - reduce the severity of the inflammatory response and pain.
- Adrenal Hormone - Reduces inflammation and nerve pain.
- Muscle relaxants - drugs that reduce the tone of the striated muscles of the spine, thereby reducing compression of the roots of the spinal cord.
- Diuretics - means to reduce tissue swelling and compression of the roots of the spinal cord due to increased urinary excretion.
- Chondroprotectors - reduce the severity of degenerative processes, the destruction of cartilage tissue, contribute to its partial restoration.
- Vitamin B - improves metabolic processes in nervous tissue, contributes to the early restoration of the functional state of the spinal roots.
- Vitamin C (ascorbic acid) - strengthens blood vessels, has an antioxidant effect (binds and deactivates free radicals, is "fragmentation" of organic molecules with one unpaired electron anddamage to the membrane structure of the cell).
During remission (improvement of condition and reduction of acute inflammatory phenomena), exercise therapy (physical therapy exercises with special exercises), back massage, physical proceduresTherapy (acupuncture, mud bath, electrophoresis) is indicated. During the course of treatment, it is important to follow dietary recommendations (refuse greasy fried foods, alcohol) and general recommendations (get enough sleep, reasonable work and rest). Conservative treatment significantly improves the condition.
Surgical intervention
In the absence of the necessary therapeutic outcome against the background of the use of the drug, in the event of progression of the pathological process in order to radically eliminate the problems, an invasive surgical intervention is prescribed. It includes several techniques:
- Microdiscectomy - removal of a herniated disc with subsequent craniotomy.
- Fetusectomy - removal of bony growths that narrow the spinal canal in the exit area of the spinal cord's roots.
- A spinal ablation is an extension of the tube in the exit area of the spinal roots.
In modern hospitals, surgery is performed using minimally invasive laparoscopic techniques. For the plastic opening of the cranial fossa, special meshes are often used that are made of durable materials and do not cause inflammatory reactions.
Prevent
To prevent the development of a pathological process, you need to follow a number of simple preventive recommendations, which include:
- Get eight hours of sleep.
- Limit the impact of stress factors (chronic stress can provoke the development of pathological processes).
- Normalize the mode of work and rest.
- Limit heavy work.
- Reject bad habits.
- Proper nutrition with adequate amounts of vitamins and plant fiber.
- Full exercise mode with active exercises (charging), walking in the fresh air.
Osteochondrosis of the thoracic spine is characterized by a chronic progressive process. This disease requires long-term treatment, so it is easier and more accessible to prevent its development.