Thoracic facet joint disorder
Introduction
Introduction to thoracic facet joint disorder Thoracic facet joint disorder refers to the change of anatomical position under the action of external force of thoracic facet joint, which is characterized by incomplete dislocation of inseparable joint capsule synovial membrane, and the symptoms of pain and function limitation caused by self-reset a condition. Clinically, it is also called thoracic spine staggering, thoracic facet joint dislocation, thoracic facet joint dislocation, thoracic facet joint synovial incarceration, thoracic facet joint disorder. basic knowledge The proportion of sickness: 0.01%-0.018% Susceptible people: no specific population Mode of infection: non-infectious Complications: joint dislocation
Cause
Causes of thoracic facet joint disorder
1, acute trauma
There is a significant history of trauma, which is caused by the torsion or impact of the object, which causes the posterior joint of the thoracic spine to be dislocated, resulting in joints, ligaments, nerves, blood vessels, etc., which are stimulated by incarceration, stretching, etc. Hey.
2, chronic strain
(1) Because the thoracic intervertebral disc is degenerated and thinned, the intervertebral space is narrowed, and the joint capsule and ligament of Guanzhou in the post-thoracic spine are loose, and the posterior thoracic joint is misaligned.
(2) Working and learning in an uncoordinated position for a long time, so that the soft tissue of the back is often over-contracted, pulled, twisted, and chronic strain occurs. Due to the tension of these soft tissues, the imbalance of the external balance such as sputum causes the internal balance to be uncoordinated, and the posterior thoracic joints are misaligned.
(3) After the trauma, without timely treatment, the wind, cold and dampness invade the meridians and muscles of the back, and cause muscle spasm, qi stagnation and blood stasis. The internal and external balance of the thoracic spine is imbalanced, and the posterior joints are misplaced. Due to local external factors or long-term work, or degenerative changes with age, the ligaments around the joints are relaxed, the joints are unstable, and the anatomical position of such micro-joints changes, and the joints are interlocked in abnormal or reversed. A series of lesions caused by the position. Usually, the ribs of the ribs are moved backwards and the ribs of the corresponding thoracic vertebrae are staggered, and the ribs can be moved backwards; or the upper (lower) articular surface of the facet joints is laterally displaced and staggered, the joint gap is changed, and the intra-articular pressure is also Corresponding changes, or the synovial membrane is incarcerated, the structural mechanics of the surrounding structure changes, and the corresponding symptoms, signs and functions are stimulated accordingly.
Prevention
Thoracic facet joint disorder prevention
1. Avoid sedentary, long standing, and overworked.
2, maintain a good sitting position, sleeping position, correct bad posture.
3. Participate in sports more.
Complication
Thoracic facet joint disorder complications Complications, joint dislocation
Thoracic facet joint disorders often cause joint dislocation.
Symptom
Thoracic facet joint disorder symptoms common symptoms sternal tenderness rib pain chest tightness turning over difficulty
In the normal physiological breathing movement of the human body, the thoracic facet joint (posterior joint) has a small range of motion, but the squeezing or improperly applied contusion, even coughing, sneezing, etc. can also cause joint dislocation.
In the onset of a typical patient, it is often audible and the "squeaky" sound of the thoracic facet joints in the sudden dislocation. Light joints cause joint strain, localized pain and discomfort in the dislocated segments; severe cases can cause ligament tears, posterior joints Dislocation, manifested as "suffocation", suffering from neck and shoulder pain, and feeling rib pain, discomfort, chest tightness, chest compression, dysfunction, difficulty in turning over at night, and the sensory and motor dysfunction of the corresponding spinal nerve innervation. Acute thoracic facet joint disorder, patients with painful face, head and neck tilting, turning side difficult, often maintain a fixed position (mostly forward tilt), can not rotate freely; damaged thoracic spine segment spine has tenderness, sputum pain and vertebra Side tenderness, deep inhalation pain is even worse, the spinous process deviates from the central axis of the spine, kyphosis or depression. The paraspinal soft tissue of the damaged thoracic vertebra can be seen with tenderness, painful nodules or cords.
Examine
Examination of thoracic facet joint disorder
1, CT examination.
2. MRI MRI.
3. X-ray inspection.
Diagnosis
Diagnosis and diagnosis of thoracic facet joint disorder
1. History of trauma or long-term adverse posture history. (Suddenly lifting, turning side, long-term desk, twisting, etc.)
2, clinical symptoms and signs.
3, palpation: dislocation of the thoracic spinous process has obvious tenderness, sputum pain or hemiplegia (more than 1mm). The soft tissue around the spinous process (about 1.5cm) can have different ranges and degrees of tension, and even sputum, often feels like a cord, pressure pain.
4, X-ray film, CT image: Because the thoracic facet joint disorder is a subtle change in the anatomical position of the facet joint, X-ray film is often difficult to display. (But some people think that the positive rate of the difference between the lesions of the spinous processes and the asymmetry of the small joints is 1%.) X-ray plain film and CT imaging examination can exclude thoracic tuberculosis, tumor, fracture, rheumatoid and other diseases.
5, classification
According to the incidence of the disease, divided into simple type and complex type: simple type with back pain as the main syndrome; complex type often has intercostal neuralgia and chest and abdominal organs related symptoms. According to the lesion segment, it is divided into upper thoracic (T1-5), middle thoracic (T6-9) and lower thoracic (T10-12). The upper thoracic spine injury of the disease mainly manifested as sensory abnormalities and dysfunction of the head, neck, chest organs and upper limbs, while the middle and lower thoracic spine mainly showed symptoms of digestive tract dysfunction before the abdominal parenchyma and the spleen of the colon.
