Osteosarcoma is one of the common diseases of the spine. It is believed that it develops mainly in the neck or lower back. After all, it is in these places that the spine is very mobile and under great pressure. But the sedentary lifestyle of most people and prolonged sitting at the table has resulted in thoracic spondylolisthesis starting to occur more and more frequently. Although in many cases this pathology is not diagnosed immediately. After all, the peculiarity of thoracic osteonecrosis is that its symptoms are nonspecific and resemble many other pathologies.
General features
This degenerative-dystrophic disease affects the discs of the thoracic spine. This is due to a violation of metabolism, which leads to thin and dry cartilage tissue. As a result, under the influence of physical exertion, the discs begin to collapse and lose their depreciating function. The vertebrae, ligaments and joints in the spine are gradually affected. Nerve fibers and blood vessels may be impaired.
This process develops slowly, making the diagnosis difficult. Moreover, not everyone immediately goes to see a doctor, because they do not know how dangerous the thoracic osteonecrosis is. But if left untreated, the disease can lead to serious complications. Since this part of the spine is responsible for the blood supply and nourishment of the internal organs, with an advanced form of osteochondrosis of the thoracic spine various pathologies can develop. Intestinal motility, the work of the heart, liver, gastrointestinal tract is disturbed. Pancreatitis, cholecystitis, biliary dyskinesia may appear. But most of the complications usually appear in the spine. In addition to herniated discs and intercostal neuralgia, spinal cord compression, spondylolisthesis, sciatica, and postural disturbances can develop.
Tumors of the thoracic spine are equally common in men and women. Its occurrence does not even depend on age, although it was previously believed that degenerative-dystrophic diseases are characteristic only of the elderly. But modern youth are increasingly suffering from bone necrosis due to improper diet and sedentary lifestyle.
It is believed that the most common osteonecrosis is cervical. Often, the pathology also appears in the lumbar region. It is due to the special structure of the skeleton. In the thoracic region, the spine is less mobile, as it is connected to the ribs and sternum.
The discs here are thinner, and the vertebrae are closer together. But this part is less susceptible to trauma and other external influences, since part of the load is assumed by the ribs and ribcage.
Bone tumors appear usually at the level of 7-11 vertebrae. In this case, the discs are mainly affected. Usually, 1-2 segments of the spine are affected. But sometimes multifocal osteonecrosis develops, in which several discs are destroyed at once. Rarely, pathology in this part occurs independently, often in association with a lesion of the cervical or lumbar spine. In this case, the symptoms are more obvious so the diagnosis becomes easier.
The peculiarity of thoracic osteosarcoma is that it rarely presents with back pain after exertion, as is the case when it is localized to the cervical or lumbar spine. Early-stage disease is easily confused with heart or lung disease. Finally, the pain is usually localized to the chest, shortness of breath, nausea, and chills appear. But the manifestations of thoracic bone tumor are not very bright, so patients do not always go to the doctor at the first stage. Because of this, the pathology progresses.
Disease develops
The danger of thoracic osteonecrosis is that it is "disguised" as other diseases. The pathology develops slowly, rarely the patient sees a doctor in the early stages. Osteoarthritis begins with the gradual thinning of the discs. Its core flattened, the crust cracked and dried, and the vertebrae drew closer together. At this stage there is usually no major discomfort, only mild muscle tension. If the disease can be detected, then it can be completely cured by restoring the condition of the disc.
But usually the progression of osteonecrosis continues. In the surrounding soft tissues, an inflammatory process may begin, the joint capsule is affected. The mobility of the spine is reduced, the vertebrae can be displaced. If you continue to increase physical activity, due to the friction of the vertebrae against each other, small cracks will appear on them. There is a feeling of tightness in the chest, pain that accompanies any movement in the upper body.
In the third stage of osteonecrosis, the discs become very thin, protrusions and herniations appear. The mobility of the spine is almost completely limited. Bone cells begin to form on the vertebrae. This stage is characterized by pronounced lens syndrome, due to impaired nerve fibers. In this case, the work of internal organs is severely disrupted. In most cases, that's when the patient goes to the doctor and begins treatment. If this is not done, complications can lead to disability, and when the spinal cord is compressed, to complete immobility.
The final stage of osteonecrosis is characterized by complete destruction of the intervertebral discs and loss of their function. The bone tissue of the vertebrae begins to collapse, so the mobility of the spine is completely reduced. All vegetative and lenticular symptoms of thoracic osteonecrosis are evident.
The development of thoracic osteonecrosis is undulating. This is usually a chronic, slow process that causes little discomfort. May increase fatigue, weakness. And when exposed to external factors, exacerbations will appear accompanied by sharp pain. In this case, the patient is usually hospitalized, as the attack may be accompanied by a feeling of lack of air, shortness of breath, chest tightness or abdominal pain.
Reason
The main cause of thoracic osteonecrosis, as well as its other forms, is a violation of mineral metabolism. As a result of the degenerative-dystrophic process, condyle or herniated discs appear, they become thinner and can no longer perform their functions, the vertebrae gradually collapse, the vertebrae develop. . This is usually due to an unbalanced diet, leading to a lack of essential nutrients, or due to age changes in the composition of cartilage tissue. Degenerative discs can also lead to poor circulation in the spine, bad habits or genetics.
But mineral deficiency does not always lead to osteonecrosis. This requires stimulating factors that affect the spine itself.
Therefore, the following reasons for this pathology are also distinguished:
- frequent static loads on the spine;
- sitting for a long time in an uncomfortable position at the table;
- lift the weight;
- fat;
- trauma to the spine or surrounding tissue;
- participate in strength sports;
- rachiocampsis;
- weakness of the corset;
- congenital malformations of the skeleton;
- severe hypothermia;
- excessive stress.
It turns out that people who stay for a long time in an uncomfortable position at a table or drive a car, as well as people who do heavy physical work, are most susceptible to the disease. Indeed, both an increased load and their complete absence are equally harmful to the disc.
In addition, osteonecrosis often develops in young people with degenerative bone disease. This pathology usually develops in the lower thoracic region in adolescents. It is characterized by necrosis of the spongy tissue of the vertebrae, spinal deformity, and the appearance of neurological symptoms. With the progression of the pathology, it is complicated by osteonecrosis.
Manifestations of disease
The main symptoms of osteonecrosis of the thoracic spine are pain, lens syndrome and dysfunction of internal organs. The pain in this pathology can be sharp, paroxysmal or sharp, continuous, increasing with movement. Occasionally patients are hospitalized with suspicion of acute pancreatitis, cholecystitis, or urolithiasis. After all, the pain is not always localized to the area of the affected vertebra. Therefore, osteonecrosis of the chest is often confused with pathologies of other organs.
In addition, the degenerative process in the spine in this pathology is almost always accompanied by vascular disorders or intercostal neuralgia. This is due to the special structure of the spine in this part - a small gap between the vertebrae and a large number of nerves and blood vessels.
Thoracic osteonecrosis may be suspected due to limited upper body mobility, increased stooping. Intercostal neuralgia occurs frequently. Acute pain can last several hours or longer. It can be activated by lifting weights, maintaining a static position for long periods of time, and lowering body temperature.
If the vessels are affected, it means a violation of the skin's blood supply and nutrition. As a result, nails are more brittle, dry and flaky. Often observed cold skin and cold limbs.
Characteristics of pain
Pain in thoracic osteonecrosis can vary in intensity and locality. Pain usually occurs in the chest or between the shoulder blades. This condition is aggravated by raising the arm, turning or bending the body, or coughing or sneezing. The pain can be sharp, dramatic, aching.
Usually, such sensations are divided into two groups: back pain and back pain. Dorsago is an acute pain between the shoulder blades. It is also known as "chest pain". The pain is so severe that the patient cannot move. A back attack usually occurs after a long period of being in a stationary position during the first move. Accompanied by muscle spasms, respiratory function is reduced. The sensation extends to the shoulder blades, between the ribs to the chest. Chest pain with osteonecrosis resembles an angina attack, but unlike it, it is not eliminated by Nitroglycerin. In addition, pain increases when pressing on the vertebrae.
Back pain is a chronic, mild pain. It usually begins gradually, with mild discomfort in the thoracic spine. In this case, the pain may increase when bending, turning, raising the arm, and even walking. This severely limits the patient's mobility. In addition, the pain may increase with deep breathing, after a long time in a sitting position, or at night. Back pain can last from 2 weeks to a month. Chest tightness and shortness of breath may mimic pneumonia, but the patient does not have a cough or fever.
Lens syndrome
When the vertebrae or the spasmodic muscles of the nerve roots are compressed, the signs of bone degeneration in the thoracic region are more pronounced. After all, the spinal nerves located in this position of the spine are responsible for the development of the skin, motor functions of the limbs and the functioning of internal organs.
In addition to pain in the back, chest or abdomen, nerve compression is also accompanied by the following symptoms:
- paralysis or partial paralysis of the limbs;
- violation of skin sensitivity;
- numbness, burning, tingling, "goosebumps" running sensation;
- violation of tendon reflexes;
- muscle contraction reflex;
- nutritional changes in the skin - hair loss, discoloration, dryness and flaking.
The intensity of these symptoms increases with exertion, deep inhalation, prolonged sitting, after hypothermia or stress.
Nutritional disorders
In the thoracic spine there are many nerves and blood vessels that ensure the normal functioning of internal organs. Therefore, with osteonecrosis, various autonomic disorders are necessarily observed. They depend on the localization of the affected vertebrae, as well as on the stage of the pathology.
With lesions of the spine in the upper thoracic region, there is discomfort in the esophagus, there is a feeling of coma in the pharynx. Difficulty swallowing, voice changes may appear. The middle thoracic vertebrae are responsible for the liver, gallbladder, stomach, and pancreas. Therefore, when they are destroyed, symptoms often appear similar to pancreatitis, cholecystitis, or gastritis. If degenerative changes have affected the lower thoracic vertebrae, there may be problems with the intestines and genitals.
Patients who come to the doctor often have abdominal pain. They often get worse in the evening or after physical work. Furthermore, the pain was not related to the characteristics of the patient's diet. This gastric syndrome is characteristic of thoracic osteonecrosis. But despite abdominal pain, intestinal disorders, nausea and flatulence, problems with the work of the gastrointestinal tract were not found. These sensations arise from damage to the nerves and blood vessels in the spine.
Diagnose
Because the signs of thoracic osteonecrosis are nonspecific, only a thorough examination can reveal the pathology. At the same time, it is important to distinguish it from other diseases. X-ray or computed tomography of the spine helps to rule out degenerative spondylitis, rheumatoid arthritis, and ankylosing spondylitis.
But other methods of examination are also needed. This is a urinalysis, general blood and biochemical tests, fluorography, ECG, MRI or ultrasound of internal organs. Such an examination can rule out such conditions as pancreatitis, gastritis, peptic ulcer, heart attack, pneumonia, and urolithiasis.
Treatment
Comprehensive treatment of osteonecrosis of the right thoracic spine. Since the cause of the pathology is degenerative processes, it cannot be completely cured. Only in the early stages, when the structure of the vertebrae has not been disturbed and the discs are only slightly reduced in size, this process can be stopped and the functions of the spine restored.
But usually the treatment of osteonecrosis in the chest is aimed at slowing tissue destruction, reducing pain and neurological symptoms, and restoring mobility. The choice of treatment method depends on the stage of the pathology, the location of the degenerative processes, the manifested symptoms. Treatment should be initiated as soon as possible, the greater the chance that complications will be avoided.
It is especially important to see a doctor when back pain is severe and the pain radiates to the chest or shoulder blades. Such aggravation can be eliminated by special methods. Most often these are drugs that are used in the form of tablets or injections, various ointments or compresses, physiotherapeutic procedures. It is also necessary to immobilize the spine: the patient is bed rested and restricted in movement for several days.
After the exacerbation, the treatment does not go away. But now its main goal is to stop degenerative processes and restore tissue nutrition. Among the drugs for this, chord protectors, vitamins and means to improve metabolism are used. In addition, massage and physiotherapy courses, as well as physiotherapeutic exercises, are necessarily prescribed. Moreover, the performance of special exercises should be constant. To prevent complications, it is necessary to monitor the diet to provide the body with all the necessary vitamins and minerals. Lifestyle is also important: choosing the right mattress and pillow for sleep, office chair, rest and physical activity.
Breast cancer is a rather dangerous disease that, if not treated in time, can lead to dangerous complications. But diagnostic difficulties lead to the fact that the disease is often advanced. Therefore, it is important to lead a right lifestyle and avoid the factors that trigger disc destruction. This will help prevent the development of osteonecrosis and keep the spine healthy.