thoracic
Introduction
Introduction to thoracic spine Thoracic spondylosis is a type of syndrome that is caused by various factors to stimulate and affect the thoracic vertebrae, spinal cord, etc., mainly due to thoracic degenerative hyperplasia, the following thoracic vertebrae are more common. The symptoms are mainly back pain and intercostal neuralgia, but the symptoms are extensive, including dyspepsia, dysfunction, sexual dysfunction, etc. Because of the low incidence of this disease, it is easy to be ignored. Clinically, it is often one of the root causes of many difficult diseases such as back pain, diabetes, and chronic gastritis. basic knowledge Probability ratio: Susceptible people: no special people Mode of infection: non-infectious Complications: chronic low back pain
Cause
Thoracic spondylosis
Working and living factors (15%)
Long-term shoulder load, such as loading and unloading; long-term desk work, such as sewing workers, teachers, typists, etc.; long-term bad entertainment habits, such as long-term Internet access, playing cards, watching TV and books and other factors lead to chronic thoracic Strain and thoracic spine.
Disease factor (25%)
Vertebral and facet joint hyperplasia, dislocation; thoracic disc herniation; calcification of the posterior longitudinal ligament of the thoracic spine. Most of the patients with these symptoms have a history of strain or cold, a history of trauma, recurrence after surgery or sequelae after surgery. Some patients also have cervical, thoracic, and lumbar spondylosis.
Damage (40%)
Back muscle strain and trauma are the main causes of thoracic disc, vertebrae and surrounding fibrous soft tissue degeneration to produce thoracic spondylosis.
Individual factor (5%)
Age growth and metabolic dysfunction and decline are the underlying factors of the disease.
Congenital factors (5%)
The spine is congenitally malnourished.
pathology
The main pathological changes include thoracic disc herniation, intervertebral disc sag, intervertebral space and intervertebral foramen stenosis, pseudo spondylolisthesis, vertebral body edge and joint bone hyperplasia, and ligamentum flavum hypertrophy. Among them, the most common stenosis of the intervertebral space and intervertebral foramen, the vertebral body edge, especially the anterior lateral margin, forms lip-like bone hyperplasia, and the range is wide, often involving several thoracic vertebrae. As for the thoracic disc herniation, it is extremely rare in the clinic, and only occasionally occurs in the lower third thoracic vertebra.
These changes, or the resulting changes in the membranes, fibrosis, adhesion of the outer tissue and nerve root sheath, and dural membranes, may cause compression of the thoracic spinal cord, nerve roots, and sympathetic nerves. Or ischemia, and produce the corresponding clinical symptoms.
Prevention
Thoracic spine prevention
1, sitting posture should be correct, often change posture when resting, relieve back muscle spasm.
2, the sleeping posture should be correct. When you take a break, you often change your posture and relieve your back muscles. The bed should be soft and moderate, avoiding the bed being too hard or too soft, so that the chest can be fully rested; avoid the wind and cold.
3. Strengthen reasonable exercise methods.
Complication
Thoracic vertebral complications Complications chronic low back pain
1. Abdominal pain is accompanied by severe heartburn and constipation, but there is no acid reflux.
2, when the lower thoracic spine damage, occasionally combined with the nature of renal colic pain, dysuria, as well as loss of libido and male impotence.
3. It is quite similar to the compression syndrome caused by spinal cord tumor or localized adherent spinal arachnoiditis. The main symptoms are typical intercostal neuralgia or banded abdominal pain, lower limb weakness, numbness, and sphincter and sexual dysfunction.
Symptom
Thoracic symptoms common symptoms intercostal neuralgia chest pain hunchback low back pain shoulder pain in the anterior region
Generally chronic low back pain, chest pain, intercostal neuralgia, arm numbness, numbness of shoulder and back, ant feeling, sweating or no sweat, chest tightness, palpitations, dizziness, insomnia, indigestion, standing instability in severe cases Difficulties in walking, feeling of a belt on the chest and abdomen, abnormal bowel movements, paraplegia and so on.
1. The main manifestations of thoracic spondylosis are chest and back pain and hunchback. Chest pain is heavy when bending.
2. The pain caused by the degeneration of the upper thoracic vertebrae is radiated to the chest.
3, the next thoracic lesion, the pain can be radiated to the abdominal wall, sometimes mistaken for angina.
4, hyperplasia such as stimulation of the sympathetic nerve located next to the spine, can produce autonomic symptoms such as circulatory disorders.
5. The patient has a hunchback in the chest kyphosis due to the narrowing of the intervertebral space.
6. The respiratory amplitude is reduced due to limited rib activity.
7. If the spinal cord is compressed, the lower extremity numbness and vertebral body bundle sign may occur.
Examine
Thoracic examination
1, X-ray inspection
Lateral thoracic vertebral slices showed lip-like hyperplasia of the anterior border of the vertebral body. Most of them show a widening of the thoracic intervertebral space narrowing, cartilage plate sclerosis, anterior or lateral margin of the vertebral body. In some cases, the shadows of the Smolen nodules, the curvature of the thoracic spine, and the deepening of the physiological curvature were observed. Occasionally, the posterior margin of the thoracic vertebrae is found to have a lip-like hyperplasia. It is believed that the diagnosis of this disease is of great significance, often suggesting the possibility of disc herniation.
2, laboratory inspection
HLA-B27, ESR, ASO, and RF should be investigated to rule out rheumatic or ankylosing spondylitis.
Diagnosis
Diagnosis of thoracic spine
diagnosis
1. History and clinical manifestations
Chronic low back pain, chest pain, intercostal neuralgia, arm numbness, numbness of shoulder and back, ant feeling, sweating or no sweat, chest tightness, palpitations, dizziness, insomnia, indigestion, standing instability during severe, walking Difficulties, chest and abdomen have a sense of belt, abnormal bowel movements, paraplegia and so on.
2, X-ray inspection
Lateral thoracic vertebral slices showed lip-like hyperplasia of the anterior border of the vertebral body. Most of them show a widening of the thoracic intervertebral space narrowing, cartilage plate sclerosis, anterior or lateral margin of the vertebral body. In some cases, the shadows of the Smolen nodules, the curvature of the thoracic spine, and the deepening of the physiological curvature were observed. Occasionally, the posterior margin of the thoracic vertebrae is found to have a lip-like hyperplasia. It is believed that the diagnosis of this disease is of great significance, often suggesting the possibility of disc herniation.
3, laboratory inspection
HLA-B27, ESR, ASO, and RF should be investigated to rule out rheumatic or ankylosing spondylitis. Check for diagnosis.
According to the above clinical manifestations and examinations can be diagnosed.
Differential diagnosis
The disease does not need to be differentiated from other diseases.
