In the article, we consider the signs and symptoms of a bruise of the thoracic spine. After all, this is a topic that requires attention and can to some extent save a person’s life.
So, the spine plays an important role in the structure of the human skeleton, it is not in vain that its name is translated from Latin as “supporting pillar”. But, unfortunately, it has very poor protection, as it is surrounded by a thin layer of soft tissue. Bruising it is a serious damage requiring qualified and immediate assistance from a specialist. Such injuries can lead to serious complications in case of improper and untimely treatment. Further, in detail about the injury of the thoracic spine.
Statistics
The frequency of bruises of the spine (thoracic, cervical and lumbar) is about one hundred people per one million of the population annually. Of these, seventy percent accounted for damage to the subject. About three percent of patients remain disabled.
Description of the disease
A contusion of the thoracic spine (ICD 10 S20-S29) is a trauma to the support column, in which the soft tissue surrounding its core suffers. Most lesions are mild, and neurological symptoms are not detected as a result of their receipt. But in severe forms, people may experience concussion along with spinal cord injury. Which is often accompanied by transient neurological disorders.
Bruises of the thoracic spine can be received by persons of any age, and this happens regardless of gender. But more often young people who lead an active lifestyle suffer, and, in addition, men of working age.
Description of the anatomical structure
The thoracic section consists of twelve vertebrae. From them, on each side of the person, ribs extend that connect in front of the sternum. This part of the spinal column is the least mobile in comparison with the lumbar and cervical sectors. Below is the lumbar region, which consists of five vertebrae bearing the greatest load. In that case, if you look at the support pillar from the side, it will be seen that in its shape it resembles a certain spring, whose bends smoothly pass from one to another. Such a structure is required to maintain equilibrium, and at the same time, to evenly distribute the loads.
In the thoracolumbar sector, between the eleventh and second vertebra, kyphosis passes into lordosis, and the load axis passes through the bodies of this section. Therefore, with bruises and injuries of the spine, injuries most often occur in this zone. The lower sections suffer much less frequently.
Symptoms
In most cases, with a bruise of the thoracic spine, patients remain alive. The following symptoms can be attributed to the main manifestations of the ailment:
- The presence of a violation of the sensitivity of the skin below the affected area of ​​the spine.
- The presence of pain in the region of the heart.
- The appearance of certain respiratory disorders like shortness of breath, pain on inhalation and exhalation.
- The presence of weakness, paresis or paralysis in the area of ​​the legs of the victim can also be attributed to signs of contusion of the thoracic spine.
- The presence of involuntary urination and bowel movements (that is, there may be a violation of the functions of the pelvic organs).
- The occurrence of sexual disorders in the form of impotence, frigidity, etc.
- Decreased tendon and muscle reflex.
- The appearance of pain discomfort in the thoracic spine.
Causes
A bruise of the thoracic spine (ICD 10 S20-S29) can be obtained in an industrial or living environment. Such damage is likely to occur as a result of a fall on ice, and, in addition, in the event of a traffic accident. Thus, the main cause of such an injury is usually an indirect or direct mechanical effect on the spine. Contusion of soft tissues of the thoracic region is most often caused by:
- Getting hit with a blunt heavy object.
- The consequence of an unsuccessful landing during a jump (in particular, this is dangerous because of the possibility of obtaining a compression vertebral fracture).
- A flat impact on the water (this is perhaps one of the most common causes that cause a bruise in the chest area). This effect is called a diver injury.
- Whiplash damage to the support column due to a sharp bending-extension of the body, which is typical when falling into a traffic accident.
There are also factors that affect the severity of the resulting bruise, we are talking about:
- The age of the affected person and his body weight.
- The degree of strength, intensity and duration of mechanical action on the thoracic region of the spine.
- The presence of a human anatomical pathology or chronic disease of the supporting column.
Effects
Complications as a result of a bruise are conditions that doctors can’t eliminate during the treatment of patients after they receive the appropriate injury. These include the following negative consequences:
- Partial or complete paralysis.
- The presence of constant incontinence of urine and feces.
- The occurrence of impotence or frigidity.
- The presence of curvature of the spine.
- Loss of skin sensitivity in the chest area.
- Coma.
Classification
Contusion of the thoracic region of the spine is classified according to the severity of the disease:
- With light damage, the recovery period, as a rule, takes up to one and a half months. At the same time, small neurological changes are noted in the condition of the victim.
- In the case of moderate severity, the recovery period usually takes up to four months. Against this background, there is an absolute violation of the innervation of the affected area of ​​the spine.
- As a result of a severe injury, the recovery period of time takes more than six months, but, unfortunately, it is not possible to fully restore the previous functioning of the body.
Diagnostics
It should be remembered that improper treatment of a bruise of the thoracic spine (ICD code S20-S29) is dangerous for serious disorders in the body. Before proceeding with treatment, it is required to determine the nature of the injury, making the correct diagnosis. The following types of diagnosis help this doctor:
- Interviewing a patient. In the course of this, information should be obtained on the conditions of the injury, as well as on the specifics of the symptoms.
- Performing a patient examination. Search for externally noticeable deformation and accurate determination of the boundaries of the damage area.
- Verification of a nervous reaction. It is produced manually or using medical special tools. Due to this, the presence of any problems with tactile sensations and reflexes is determined in the patient.
- Palpation of the back. Thanks to this procedure, tense muscle areas are determined along with painful foci and hidden spinal deformities.
- Blood and urine tests. The results show the general condition of the body and identify the ongoing inflammatory process. What else involves the diagnosis of a bruised thoracic spine?
- Performing radiography. Such a procedure is necessary in order to most accurately determine the location of damage and its nature.
- Magnetic resonance imaging and computed tomography help to obtain the most detailed picture of the bruised area and assess the degree of deformation of the vertebrae, as well as of the intervertebral discs.
- Carrying out a lumbar puncture. Its purpose is to confirm or refute the fact that the patient has hemorrhage in the spinal cord.
Treatment of a bruised thoracic spine
What to do with such a pathology? The main thing in this matter is to begin competent treatment of the resulting injury as soon as possible. First aid for an injured person should be a set of measures:
- First of all, immediate provision of the patient with complete immobility will be required.
- In the event that there is no breathing or it is difficult, then it is necessary to perform procedures aimed at artificial ventilation of the lungs, without violating the patient's stationary position.
- A cold item is applied to the bruised area.
- During transportation, it is necessary to maintain complete immobility of the affected area of ​​the spine. The injured patient should be on his back.
The patient, regardless of the nature of his bruise, is prescribed anti-inflammatory and analgesic drugs that do not contain steroids. A set of other pharmaceuticals, as well as a set of therapeutic procedures, is prescribed after the doctor determines the symptoms and nature of the damage.
With a mild form of the disease
In the presence of a slight bruise, when the structure of the internal organs and spinal cord is not damaged, radical therapy is not prescribed, they are limited to bed rest, and, in addition, a temporary ban on any physical activity. The bruised place can be rubbed with ointments, for example, “Troxevasin” or “Lyoton”. In the event that the condition of the injured patient does not improve within a week, then it is worth performing a re-examination in order to search for complications that have not been identified previously.
In severe form
With severe bruises of the spinal cord of the thoracic spine, for example, doctors carry out complex drug treatment in a hospital. In the framework of which combined combinations of such drugs as, for example, anticoagulants along with angioprotectors and anabolics are used. In certain cases, the doctor prescribes the wearing of an orthopedic collar or hard corset.
To avoid complications from a bruise of the thoracic spine, the patient needs a long bed rest. But such treatment, in turn, can lead to pressure sores. For their elimination use drugs like "Chlorhexidine", "Levomekol" and "Solcoseryl".
Rehabilitation
Ten to twelve days after the bruise occurred, (if complications do not develop), a rehabilitation period begins, which includes such measures:
- Occupation by physiotherapy exercises. The set of various exercises individually selected by the doctor should help the patient to restore his spinal motor functions.
- Conducting medical massage. In this case, apply its classic varieties (for example, manual action), or hardware (the effect of vibration, water, air flow).
- Perform body myostimulation. This procedure (it is carried out using modern equipment), helps in restoring the activity of muscle groups that have suffered paralysis or paresis.
Prevention
Most of the injuries that are associated with a bruise of the thoracic spine occur due to various accidents, and therefore their prevention, first of all, consists in observing the basics of industrial and domestic safety. Do not neglect and faithfully following the rules of the road. To avoid such damage during exercise, you need to correctly calculate the physical activity. In this, experienced trainers supervising the process of sports activities will help any person.
Thus, a stable injury to the column with preservation of the integrity of the support and the spinal cord is considered a bruised spine. But such injuries cannot be called light, since when they are received, people develop foci of hematomas and hemorrhages, necrosis (tissue death) can form, and there is a violation of the movement of cerebrospinal fluid along the spinal canal.
The frequency of injuries of the support column among all injuries of the motor system today is from three to ten percent. Mostly, patients who have received such injuries are men up to forty to fifty years old. Injuries of the thoracic spine in the elderly and children are quite rare, and women are injured with the same frequency as the stronger sex.
About thirty-nine percent of all injuries, according to statistics, occur in the thoracic lower vertebrae. But in many cases, the cervical region also suffers. The main cause of bruising in the chest area are car accidents, which make up about sixty-five percent of all causes of such injuries.