How it is expressed and treated intervertebral disc degeneration of thoracic
Spinal disc herniation is one of the complications of degenerative disc disease is well-known and very widespread disease. It is a specific protrusion, loss of individual fragments of the intervertebral disc into the spinal canal through weak points or defects. Herniated discs of the thoracic are diagnosed less frequently than in the cervical and lumbar spine. This is due to the nuances of the structure of the thoracic vertebral column.
Anatomical features of the thoracic spine
12 of the thoracic vertebrae are connected to each other through a kind of "shock absorbers" – the intervertebral discs. Thanks to their elastic structure of our spine gains flexibility and strength.
To the vertebrae of the thoracic ribs are attached, forming a rigid frame for the organs located in the chest area. This, combined with the lower height of the vertebrae and longer spikes, explains the lower mobility of the spine in the thoracic, and hence less stress on him. So herniated discs in this part of the spinal column occurs not so often.
Why there are herniated discs
The occurrence of such serious pathology like a herniated of the thoracic spine, can result:
- traumatic injury (a blow or a bad fall on his back);
- changes in degenerative intervertebral discs (osteochondrosis) and the exchange;
- infectious disease
- sharp turns the body or an excessive load on the spine.
A lot of chances to get this disease in the following categories of people:
- drivers behind the wheel of a car more than two hours per day;
- movers and workers of other professions who are forced every day to carry heavy loads
- people looking at a computer screen for more than four hours a day.
The Main manifestation of thoracic spinal hernia is pain. The symptoms of the disease is influenced by the volume of protrusions and the location, and they are shown in the following:
- Central placement: pain, usually localized in the upper region of the back; in this case, quite often thoracic hernia complicated by myelopathy.
A Symptom that affected the structure of the spinal cord may be a feeling of numbness below the area of compression and weakness in the legs, impaired walking. Crashing can give bowel and bladder. In severe cases of myelopathy may end up a paraplegic.
- Side the location such herniated discs can cause severe pain in the chest and abdomen;
- Central lateral placement: in this case, pain is felt in the area between the shoulder blades and in the chest or upper abdomen.
Pain symptoms, which gives a thoracic herniated discs can be aggravated by sneezing, coughing, deep breathing or active movements.
Symptoms of thoracic spinal hernia are not specific in nature. Painful sensation in back and chest can be caused by other pathological processes located in the spine and beyond. For example, fractures of the spine, tumors or diseases of an infectious nature; diseases of the heart, lungs, kidneys or gastrointestinal tract.
Such non-specific symptoms require a thorough diagnosis, which consists of several stages:
- interview with the patient, during which the doctor discovers the main symptoms of which he complains, and possible causes of their occurrence (injury, overload, weight fluctuations, illness, fever, problems with digestion or urination);
- examination of the patient, in particular neurological tests that will help establish, where there is a hernia or a nerve root is affected by pathological process. Also identified symptoms (numbness, pain, weakness, impaired motor functions of the legs);
- additional methods of research:
- x-ray: to identify the hernia of the spine she can't, but to help with the identification of its causes (e.g. Trauma) is quite capable
- magnetic resonance imaging (MRI) is the ideal, also painless and reliable method for the diagnosis of intervertebral hernia of any localization. It allows you to see layer-by-layer structure of a disk;
- computed tomography (CT) – also allows you to see the tissue layers of the intervertebral disc, but with the help of x-ray radiation;
- myelography – a way to see the area of the pathological process through the introduction of a radiopaque substancein the epidural space of the spinal column. In combination with CT is used as an alternative if MRI is contraindicated.
Conservative and operative methods of treatment
Treatment of herniated discs of the thoracic spine includes conservative and surgical methods. What treatment the doctor will prescribe will depend on how pronounced symptoms of the disease, where the protrusion is located and whether there are complications such as myelopathy.
There are many effective methods of conservative treatment of such protrusions without opening the chest:
- rest for 1-2 days with changes in physical activity, in particular limiting the loads on the spine. During this time the symptoms usually go away and can return to normal activities;
- physiotherapy exercises (specially designed exercise program to stabilize your spine, strengthen back muscles)
- spine with the help of special equipment that helps restore the physiological shape of the spine and increase the intervertebral disc space;
- medications intended to relieve pain (narcotic analgesics for the treatment of acute, intense pain, and non-narcotic analgesics – moderate pain)
- inflammatory drugs (treatment of oral nonsteroidal anti-inflammatory drugs and steroids, and epidural steroid injections)
- manual therapy to relieve pain, improve posture and blood circulation in the affected area (treatment is carried out only by an experienced technician), including defamatory;
unconventional treatment you can apply the reflex and dens-therapy.
Most doctors practice a holistic approach to treatment, formed where the protrusion is and how it is painful. The patient is offered several methods, among which select the most effective for him.
exercise for the treatment and prevention of hernias of the spinal column:
Surgical herniated disc treatment is used in extreme cases: when myelopathy, very intense pain, progressive neurological disorders. These symptoms most often are the consequence of traumatic injuries of the spine with involvement of the spinal cord or its roots.
surgical treatment of thoracic intervertebral disc protrusions is aimed at decompression with release of trapped spinal cord or root.
Previously Used a very effective method posterior laminectomy today replaced by more effective methods.
- open thoracotomy using anterior transthoracic access in the case of Central and Central-lateral placement of the hernia;
- customerswelcome (the removal of a rib and the transverse process of the corresponding vertebra) with posterolateral access.