Before talking about protrusion of the thoracic vertebral region, one must have a general idea of the intervertebral discs in general. They are located between the vertebrae and are elastic cartilage tissue, acting as shock absorbers with vertical loads on the spine column. Any disk has a pulp - a semi-liquid core, which is surrounded and fixed by a fibrous ring. There are many layers in the fibrous ring. They are spirally intertwined, very powerful and durable.
The thoracic section is protected more than other sections, and the vertebrae are fixed here with strong back muscles and 12 ribs. It also has fibro-cartilaginous thoracic intervertebral discs, which play the role of shock absorbers.
Ribs are attached to the lateral part of the vertebrae, creating the chest frame. It protects the most important organs of man - the lungs, heart, liver. The integrity of this entire system is provided by the muscles and ligaments.
Nature of the problem
Thoracic protrusion can occur for a variety of reasons. What is spinal disc protrusion? This is a displacement of the vertebrae and protrusion of the disc. Protrusion (from lat. Protrusión) means "extension". The pathology is aggravated by a power failure of the vertebrae, which occurs as a result of increased loads and age-related changes.
Causes of protrusion
The main reasons for the development of protrusion:
- Injury to the middle part of the spine due to a fall, heavy labor, surgical interventions, etc.
- Age-related destructive tissue changes that weaken muscles, bones and cartilage.
- Intense physical activity increases pressure on each vertebra and cartilage. It should be noted that regular sports do not protect against the disease.
- Protrusion of the thoracic spine becomes an almost professional pathology of builders and loaders. The risk group includes wrestlers, as they are often thrown.
- An unbalanced diet, calcium and vitamin D deficiency is also a risk factor.
- Congenital pathologies such as cerebral palsy.
- Chronic inflammation of a rheumatoid nature.
- Spinal curvature - kyphosis and scoliosis.
- Frequent back strain in case of irregular and prolonged posture.
- Inconvenient position during sleep or breastfeeding, etc.
- Genetic factor.
- Hypodynamia and increased weight.
If some reasons are combined, and this happens often, protrusion occurs several times faster.
Pathogenesis
Cartilage tissue does not have its own microcirculation, and receives nutrition only from surrounding tissues. With age, it worsens. Elastin elasticity is lost, its gradual replacement with scar tissue begins. The level of proteoglycans, which provided hydrophilicity of tissues, decreases. Cartilage begins to deform, their height decreases, the elasticity of the disc is noticeably lost, as is the ability to cushion. But the fibrous ring, being very strong, also has the ability to stretch without breaks to 5-12 mm. Stretches his shifting pulp. The fibrous ring is thinning noticeably, and its malnutrition leads to the appearance of cracks on the surface, where the pulp willingly moves out.
The process of exit of the disk from the cartilaginous tissue without rupture of the still fibrous ring progresses, protrusion of the spinal disc appears. What it is? This is not an independent pathology, but the stage of osteochondrosis, i.e., if protrusion is diagnosed, osteochondrosis caused it. It is followed by an intervertebral hernia, which is characterized by a rupture of the fibrous ring.
Thus, protrusion is a kind of border zone between health and hernia. In practice, this is much more common than a hernia.
Thoracic spinal disc protrusion is rare because it does not experience stresses such as the cervical and lumbar.
Classification of protrusions
They are divided by size:
- The level of 1-2 mm - is considered a small deformation. Small chips are formed inside the soft tissue of the base of the spine. The elasticity and height of the disc are reduced.
- The average protrusion is 3-5 mm. The distance between adjacent disks is reduced, nerve processes begin to squeeze, acute pain occurs. An inflammatory reaction begins in the tissues.
- Large protrusion - deformation at the level of 6-8 mm. There is a risk of rupture of the ring with the formation of a hernia.
In addition, protrusions are divided into cervical, thoracic and lumbar - at the place of localization.
It is also customary to classify protrusion based on the direction of the protrusions:
- With lateral protrusion (lateral), the intervertebral ring protrudes to either side from the left or right. It makes up 10% of all cases of the disease.
- With posterolateral protrusion, posterolateral protrusion of the disc occurs. If the nerve roots are intact, then there are no symptoms or they appear as short-term, slightly pronounced pains.
- Back protrusion (dorsal) - directed posteriorly, towards the spinal cord. This species is the most dangerous. The pain is severe, the frequency is rare.
- Anterior protrusion (ventral) is one of the rarest. There are no symptoms with it.
- Foraminal protrusion - the disc protrudes in the direction of the foraminal holes. Dangerous protrusion.
- Circular protrusion (circular) - uniform protrusion of the disk in all directions. It occurs most often and threatens with pinched nerves.
- Diffuse protrusion is a periodic output of the disc in several vertebral segments. Older men and physically untrained people often suffer from this form.
Symptomatic manifestations
The main symptoms of protrusion of the thoracic spine are not immediately apparent. Back pain behind the sternum, inability to deeply breathe air, limited mobility of the shoulder blades, tingling when turning the body or lifting a load are the first signs of the disease.
Due to the lack of mobility during protrusion of the thoracic spine, pain is a common occurrence. Temporary numbness and paresthesia of the hands may occur (usually with central protrusions). Lack of coordination occurs, especially in the elderly, shortness of breath and sharp pain with a deep breath are observed. Possible increase in pressure and migraine due to overstrain of blood vessels. On palpation or pressing on the vertebra, sharp pain is felt.
Symptoms of protrusion of the thoracic spine, appearing, progress. Very often, doctors find it difficult to differentiate, because by signs they are similar to heart attack, pancreatitis, and gastric ulcer. A full examination and consultation of a cardiologist and neuropathologist is advisable.
With nerve infringement, the following symptoms of protrusion of the thoracic spine occur:
- Pain at the site of a damaged vertebra.
- Morning stiffness in the back due to swelling of the tissues.
- Dependence of pain on movement.
- Intercostal neuralgia and tingling in the chest.
A neurological symptom of protrusion of the thoracic spine is a symmetrical paresis of the hands, which is expressed in the restriction of mobility.
Along with the above signs of protrusion of the thoracic spine, neuropathologists often observe muscle-tonic syndrome of intercostal muscles.
Diagnostic measures
The most effective research method is MRI, which gives complete information about changes in the spine. This is the standard for diagnosing spinal pathologies. But due to the high cost of such an examination in a regular clinic, a spine x-ray is performed in 2 projections.
Effects
Protrusion can be considered the initial stage of development of the intervertebral hernia. If timely treatment is not started, a hernia will appear. The result is disability.
Also, over time, restrained nerves begin to die. There is a risk of complete paralysis of the upper shoulder girdle. It is necessary to remember about the severe pains that protrusion causes. This is especially true of the defeat of the seventh and eighth thoracic vertebrae.
Treatment tactics
When choosing treatment, the goal is to restore the functionality of the affected department, eliminate the causative factor and the lesion itself. Comprehensive treatment of protrusion of the thoracic spine includes:
- drug treatment - general and local;
- physiotherapy;
- Exercise therapy;
- massage and manual therapy.
Massage improves trophic tissue, can relieve muscle spasm and reduce pain. It is recommended to use the usual classic surface option, which is quite applicable for moderate protrusion.
Manual therapy is aimed at strengthening the muscle corset, which will not allow the vertebrae to move.
Physiotherapy improves blood circulation, relieves inflammation and pain. Exercise therapy is useful for strengthening the muscular-ligamentous apparatus of the spine.
Drug therapy:
- Restorative stimulants - these include biostimulants such as aloe, vitreous, etc.
- For muscle building during dystrophy - anabolics such as "Retabolil", "Nerobol", "Potassium orotate".
- Compression syndrome is better treated in a hospital setting: they also prescribe successfully therapeutic spinal traction (traction therapy), stimulation of immunity, a course of diuretics to relieve puffiness, and manual exposure.
At the time of treatment and in future in such cases, physical activity is first completely excluded, and after treatment, only dosed are included. During therapy, it is advisable to observe bed rest and wear a special corset.
Symptomatic treatment of protrusion
Such therapy includes taking the following drugs:
- decongestant dehydration drugs - diuretics for a week;
- two weeks antihistamines to desensitize the body;
- non-steroidal anti-inflammatory drugs.
With the latter, any treatment of the spine begins.
To preserve cartilage, Vitamin C is a good help. To relieve muscle spasms and reduce pain, Midokalm and topical anti-inflammatory ointments and gels are prescribed.
Physiotherapy
When protrusion of the thoracic spine is shown:
- pressure therapy;
- magnetotherapy;
- ultrasound therapy;
- exposure to infrared radiation;
- electrophoresis with novocaine and ganglioblockers - to reduce pain during pinching of roots;
- acupuncture.
Physiotherapy is used only for remissions. If protrusion of the intervertebral discs of the thoracic region is detected at an early stage of development, and the patient complies with all the doctor's prescriptions, the result will be quick and positive.
Exercise therapy for protrusion
Physical moderate activity is always useful for protrusion of the thoracic spine, but subject to proper selection and control.
You can use the following exercises for protrusion of the thoracic spine:
- Take the starting position while standing, arms down. On exhalation, raise your hands up, and on a deep breath, bend back. Lower your arms with leaning forward on the exhale.
- Sit on a chair with a back. Fold hands behind head while inhaling. Bending back to back, lean your shoulders on the back of the chair, exhale.
- “Kitty” - standing on all fours, smoothly round and arch your back.
- “Swallow” - lie on your stomach, stretch your arms forward, raise your chest and straight legs above the floor by 5-10 cm.
A complete set of exercise therapy can be recommended only by a doctor. The exercises are repeated several times.
Preventive actions
How to cure protrusion of the thoracic spine? This is possible only with early diagnosis and an integrated approach to treatment.
For prevention, it is necessary to dose, moderate, but constantly engage in sports. The goal should be to strengthen the muscles of the back. With loads on the spine, do not overdo it. When walking and sitting at the table, one should not forget about direct posture. It is necessary to normalize body weight, establish nutrition - it should be balanced not only in diet, but also in the regimen of admission.