Intervertebral hernia of the thoracic region: symptoms and treatment

Intervertebral hernia of the thoracic region: symptoms, treatment and prevention

The thoracic spine has less mobility than the cervical and lumbar spine, because it is in interrelation with the thorax. That is why the hernia of this region is less common, often do not give clinical symptoms.

If a person has any complaints and has a hernia diagnosed, the internal organs of the chest and abdominal cavities, attracting different specialists, because the intervertebral hernia of the thoracic region can mimic various somatic disease.

Anatomy

Each intervertebral disk consists of a nucleus in the form of a jelly-like mass, surrounded by a dense fibrous ring.

If, for any reason (degenerative changes, just the wear and tear of the disc, injury spine) in this ring there is a crack, then under axial pressure the core can go out (prolapse). So there is a hernia.

The most frequent localization of the thoracic hernia is Th8-Th12 segments, which have greater mobility and load bearing capacity.

Symptoms

One of the symptoms of this pathology can be a feeling of numbness in the hands.

Symptoms of a hernia of the thoracic region may not be at all, or they are quite diverse. The clinical picture depends on which nerve root is irritated with protrusion, and whether the spinal cord is involved.

1. The most common complaint is pain in the upper back (thoracalgia). Painful sensations can be constant and intensify with loads, coughing, sneezing, forced inspiration. The pain often continues along the course of certain ribs to the upper abdomen. In addition to hernia, back pain can be a sign of vertebral fracture, traumatic or pathological. It is important to consider that such complaints are possible with the pathology of the heart, organs of the gastrointestinal tract, kidneys.
2. Paresthesia (impaired sensitivity) in the form of crawling, goose fever (numbness), hypersthesia (increased skin sensitivity) in the chest, arms, upper abdominal anterior walls.
3. Intercostal neuralgia - girdle pain along the ribs from one or two sides.
4. Dyspeptic disorders, pancreatic enzyme deficiency, intestinal dyskinesia. These manifestations arise due to innervation of the internal nerves involved by the nerve root.
5. If the spinal cord is involved, such serious neurologic manifestations as paresis of the leg (decrease in muscle strength), deterioration or total absence of sensitivity of the area below the level of damage, disruption of the intestine or urination. In rare cases, limb paralysis is possible (complete disappearance of muscle strength).

Diagnostics

Clinical methods

It is important to question the patient in detail about the possible cause of the appearance of pain, their connection with the time of day, physical activity, the presence of other diseases. The doctor conducts a complete neurologic examination to determine the likely location of the hernia.

Instrumental methods

Instrumental methods help in diagnosis. Radiography of the thoracic region in two projections allows to assess the condition of the vertebrae, their ratio relative to each other, the narrowing of the distance between the vertebral bodies (an indirect sign of pathology disk).

A more accurate method for detecting intervertebral hernias is magnetic resonance imaging, which allows visualize a layered image of the near-vertebral soft tissues and the vertebral column, including intervertebral discs.

If MRI is contraindicated, computer tomography can be performed, this is a layered image of only bone structures.

There is also an additional method of investigation - myelography, when a hard shell of the spinal cord is injected X-ray contrast substance, while it is possible to see the hernial protrusion and the spinal cord, compressed them.

Treatment and prevention

Of great importance in the complex of therapeutic measures are anti-inflammatory / analgesic drugs.

In the vast majority of cases, it is possible to do without surgical intervention, using complex conservative treatment:

1. Orthopedic treatment. It is important to avoid long fixed poses, work in an incline, shock loads, such as jumping, running, lifting weights. Physical exertion is recommended for physical exercises aimed at stabilizing the spinal column and strengthening the muscular corset, swimming, yoga, pilates. These methods are also preventive. At an exacerbation the doctor can recommend special orthopedic corsets, unloading a backbone.
2. With the worsening of the process, first-line drugs are non-steroidal anti-inflammatory drugs. They are given in the form of injections (intramuscular, intravenous), orally in the form of tablets, capsules, powders, there are rectal suppositories, local forms (creams, ointments, gels, patches, sprays). A physician can recommend combining systemic and local forms or stepwise therapy. The group of non-steroidal drugs is quite diverse (Diclofenac, Ibuprofen, Meloxicam, Ketorolac, Naise). In terms of side effects, selective drugs are more preferable (Arkoksia, Celebrex).
3. Together with non-steroidal drugs to relieve muscle spasm should take muscle relaxants (Midokalm, Sirdalud, Baclosan).
4. If the inflammatory process due to a hernia lasts a long time and has acquired a chronic character, glucocorticoid hormones are connected with anesthetics (novocaine, lidocaine). With these preparations, the doctor makes a blockade in the area between the spinous processes along the median line, in the region of the exit of the spinal root or the near-vertebral column into the zone of the most painful and muscular voltage.
5. Physiotherapy procedures help to locally influence the spine and surrounding soft tissues, relieving inflammation, muscle spasm, improving blood flow. This laser magnetotherapy, ultrasound, amplipulse, electromyostimulation and others. Some types can be carried out with the use of drugs (novocaine, lidase, caripain, hydrocortisone), their absorption into the focus of the disease will increase.
6. Massage and manual therapy normalize muscle tone, improve blood circulation. In addition to the classic manual, the doctor can prescribe a vacuum massage with the help of special jars, it increases the flow of blood to the hearth, metabolism is established, which helps to relieve inflammation.
7. Cervical spine unloading on specialized beds, traction tables, in water. Soft stretching of the near-vertebral soft tissues, spastic muscles of the back is carried out.

Surgery

The need for an operation is determined by a neurosurgeon in the event that the hernia of the spinal cord is compressed or nerve root, neurological disorders quickly increase or there is no effect from conservative therapy.

In this case, operative treatment is performed in the form of decompression, in which the compressed nerve root or spinal cord is released.

This operation is cavitary. To access the intervertebral disc, the surgeon makes a cut through the thorax in front or behind and on the side.

There is also a minimally invasive technique.

If the appearance of the first symptoms or the presence of the reasons for the onset of a hernia, consult a specialist, pass a diagnosis, to receive complex medical treatment courses, it is quite possible to prevent exacerbations and complications of this pathology.

To which doctor to apply

If chronic back pain occurs, you should consult a neurologist or a vertebrologist (specialist in spine diseases). In addition, consultations are given to a cardiologist, gastroenterologist, physiotherapist.

To confirm the diagnosis, CT or MRI is required. Herniated discs are found in many people without any complaints, so do not immediately start taking medication or think about surgery.

Often in such situations, therapeutic exercises and physiotherapy are helpful.

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A source: https://myfamilydoctor.ru/mezhpozvonochnaya-gryzha-grudnogo-otdela-simptomy-lechenie-i-profilaktika/

Intervertebral hernia of the thoracic spine: symptoms and treatment

Hernia of the thoracic spine, symptoms and treatment - such problems can be faced by people who have not taken effective measures to treat certain vertebral diseases.

This pathology, as a rule, becomes a dangerous complication of osteochondrosis, but it can also develop as an independent disease. Symptoms and treatment of the disease require a very careful and professional attitude.

Hernias of the thoracic spine should be identified at the earliest stages for effective treatment, but this should be done in a timely manner to a specialist.

The essence of pathology

The intervertebral hernia is a complication of the pathology of the spine, expressed in seepage of the central gelatinous nucleus into the spinal canal through damaged sites fibrous disc.

The most common localization of the hernia is the area of ​​the lumbar vertebral part in the thoracic. However, this phenomenon can occur in other places of the thoracic department, and in this department there are 12 intervertebral disks where pathology is possible.

In this case, the manifestation of the disease is largely determined by the localization of the lesion.

Intervertebral hernia of the thoracic region can be of two types:

• degenerate nature, occurs as a result of gradual wear of the disc;
• traumatic variety associated with traumatic injury of the fibrous ring.

The manifestation of pathology depends on the prevailing nature of the lesion: damage to the nerve root or spinal cord disturbance.

The clinical picture of the disease depends on the location of the lesion of the disc. In this direction, the following types of disease are distinguished:

• central protrusion of the disc, causing compression of the spinal cord or nerve roots and capable of leading to paralysis;
• lateral protrusion, due to protrusion on the lateral areas, is expressed by a strong compression of the nerve roots;
• central-lateral protrusion, combining the two previous versions.

Etiological mechanisms

In the etiology of the hernia of the thoracic spine, the following main mechanisms can be distinguished:

1. 1 Degenerative-dystrophic mechanism is associated with natural physiological aging of tissues. The age factor begins to affect after 55-60 years, when degenerative structural changes lead to the fact that even non-critical loads can lead to damage to the intervertebral disk.
2. 2 Degenerative mechanism associated with frequent and prolonged significant physical exertion. This type of pathology develops in people aged 30-55 years, when physical activity is most intense. The destruction of disks is fatigue-prone.
3. 3 The traumatic mechanism is caused by excessive pressure or shock. Common causes of such injuries in the thoracic region: lifting the load with the torso tilting, landing in a sitting position. If the impact is very strong, the disc may be ruptured. Fractures of the spine often lead to posttraumatic hernia in the thoracic region.

Symptomatic manifestations of the disease

The problem of diagnosing a hernia in the thoracic spine is related to the fact that the symptoms intervertebral hernia is well masked for other diseases of the chest, especially early stage.

Often, the pain syndrome is attributed to cardiac manifestations, and pain in the lower part of the trunk - peptic ulcer, gastritis, pancreatitis.

Such errors sometimes lead to incorrect treatment, especially when self-treatment at home.

Symptoms of the thoracic hernia depend on the location and area of ​​the lesion, but there are some common signs:

• pain syndrome in the chest region;
• a feeling of numbness and tingling (tingling) in the chest, on the back, upper limbs, at the top of the abdomen;
• muscle weakness in the arms;
• paralysis (partial or complete);
• the appearance of dysfunction of the pelvic organs (urogenital system, rectum).

As a result of lesions in the thoracic spine, such manifestations are possible: incontinence, urinary retention, male impotence.

The most characteristic symptom of the hernia of the thoracic region is painful, the intensity and manifestation of which depends on the localization of the pathology and the degree of compression of nerve fibers or the spinal cord. We can distinguish the following characteristics of the pain syndrome, depending on the localization of the lesion:

1. 1Fractionation of the upper thoracic part. The main pain syndrome is felt in the upper region of the back and between the shoulder blades. It is possible to spread pain to the entire thorax, incl. resembling diseases of the heart. Neurological signs include paresthesia and numbness in the upper limbs.
2. 2Problemy in the middle zone of the thoracic region. Pain syndrome resembles the manifestation of intercostal neuralgia: pain along the chest circling type with strengthening during coughing, sneezing, deep breathing, body rotations.
3. 3Introduction of the lower thoracic part. Pain syndrome, as a rule, is felt at the bottom of the back (below the scapula) and in the lower thoracic zones. Irradiation of pain is recorded in the upper abdomen, which is associated with kidney and stomach diseases. There may be respiratory problems, shortness of breath.

Severe consequences include such complications: curvature of the spine, loss of sensitivity of the skin, paralysis of the part of the body located below the site of the lesion of the spine.

How is the disease

Primary diagnosis is carried out by studying the anamnesis, examination and questioning of the patient, incl. neurologic examination for the presence of numbness and paresthesia. Clarifying research is carried out by the following methods:

• Radiography: this method does not determine the presence of a hernia, but allows you to assess the presence of a traumatic factor and the degree of damage to the vertebrae;
• MRI: the most informative method, which allows to accurately diagnose pathology, localization and degree of lesion;
• computed tomography: performed in the absence of an MRI;
• myelography: an improved method of radiography using contrast medium, which allows to see structural changes.

When identifying the hernia of the thoracic region, it is important to correctly differentiate pathology from a number of diseases that give similar symptoms.

In particular, it is necessary to differentiate from such diseases: stenocardia, peptic ulcer, pyelonephritis, cholecystitis, pulmonary pathologies (pleurisy, pneumonia, tuberculosis), shingles of the shingles, problems with the spine (osteoporosis), oncology.

Principles of treatment of ailment

Treatment of the hernia of the thoracic spine depends on the degree of damage, the stage of the disease and the individual characteristics of the organism. At the initial stages only conservative treatment is carried out.

Such treatment implies drug therapy, physiotherapy, exercise therapy.

In exceptional cases, when conservative methods do not bring relief or protrusion of the hernia has become alarming, surgery is performed.

Conservative treatment is conducted in the home and outpatient settings. At the same time one should not allow uncontrolled self-medication.

The use of any remedies or methods (even medicinal herbs) should be agreed with the doctor.

In general, the treatment of pathology is carried out by a complex method with long courses.

Methods of conservative therapy

The purpose of drug treatment is to eliminate inflammatory processes, remove pain syndrome and other symptoms, regeneration of bone and cartilaginous tissue, normalization of metabolic processes, blood supply and innervation reactions, restoration of muscle tone. The following groups of medicines are used for complex treatment:

1. 1 Non-steroidal anti-inflammatory drugs: Celecoxib, Piroxicam, Pyatyrchatka - anesthesia and elimination of inflammatory reactions. The course of admission is from 6-7 to 25-30 days, depending on the degree of injury.
2. 2 Miorelaxants: Midokalm, Liorasal - reduction of muscle tone and load on the intervertebral disc, anesthesia and help in tissue regeneration. The course of therapy is approximately 30 days.
3. 3Corticosteroids: Metipred, Belosalik - have anti-edematous, anti-inflammatory and analgesic effect, normalize metabolic processes.
4. 4Biologicheskie stimuljatory: FIBS, Plazmol - are intended for activization of a metabolism, stimulation of regenerating processes.
5. 5Condroprotectors: Arthra, Elbona, Glucosamine - restoration of cartilage and stopping the process of their destruction. The course of treatment is 8-50 days.

Conservative treatment of the thoracic hernia is based on medical therapy, but its effectiveness significantly increases the physiotherapy measures.

The most actively used electrophoresis and thermal therapy with the help of appliques.

A wide application is provided by such procedures as reflexotherapy, therapeutic massage, exercise therapy.

Operational activities

Surgical treatment in the form of surgical intervention is performed in acute need to eliminate the compression of nerve roots and spinal cord. Traditional methods of surgical treatment are laminotomy and discectomy.

Laminotomy consists in the excision of vertebral arches, and the discectomy involves removing the site or the entire body of the disc.

To reduce the traumatization during the operation, methods such as microdiscectomy (all procedures are conducted through a small incision) are used and endoscopic discectomy (operating with a special instrument - an endoscope with the introduction of a microchamber for visual monitoring process). When carrying out a discectomy with a complete removal of the intervertebral disc, a transplant is inserted instead of it.

A source: http://LechenieGryzhi.ru/gryzha-grudnogo-otdela-pozvonochnika-simptomy-i-lechenie/

Intervertebral hernia of the thoracic region: symptoms, treatment

Probably none of the existing varieties of hernia of the spine has such a wide range of symptoms.

And although this type of pathology is much less common than similar in other departments, the seriousness of its consequences is such, that prevention and timely treatment of this disease become the first and extremely important condition for preventing these consequences. This is a hernia of the thoracic spine.

Intervertebral hernia of thoraxdevelops from the first small protrusion into 1 - 3 mm and passes the well-known and inevitable stages through which passes hernial protrusion of the spine of any department, dropping out of the disk in the form of separate necrotic fragments (sequestration). Because of the involvement of pairs of nerve roots (only 24 - two for each of the 12 segments of the thoracic region) and the spinal cord, and also because of the wide zones of innervation, there are:

• a variety of neuralgic symptoms
• Myelopathy syndromes
• reactions from internal organs

Causes of intervertebral hernia of the thoracic region

The causes of the appearance of thoracic protrusion of the intervertebral disc also do not deviate from the general pattern of cause-effect relationships:

1. The first reason is osteochondrosis
2. A complex of various diseases: hereditary, congenital, destructive, infectious - all those that contribute to the destruction of the intervertebral disc
3. Traumatic injuries leading to deformities of the disc, especially with compression compression
4. Intra-metabolic disturbances, mineral and electrolyte imbalance
5. Uneven distribution of the load on the thoracic part: a sharp rise in gravity with an unsuccessful tilt or turn
6. Constant small physical exertion, leading to a gradual wear of the intervertebral disc: the intervertebral hernia of the thoracic region in this case develops in sufficiently mature age: usually after 50 years

This video will remind you how the formation of the intervertebral hernia occurs

Why is not always effective treatment of hernia of the thoracic department?

The patient, for example, may have pain during breathing, heart pain, girdle - like pancreatitis or cholecystitis, etc.

Symptoms of a hernia of the thoracic spine

Symptoms and treatment of the thoracic hernia is very important in its size and location:

• Anterior or anterolateral herniate formations of even large dimensions are almost asymptomatic, but this results to the fact that it can be noticed when there is a loss of sequestration and destruction of the intervertebral disk
• Dorsal hernia, foraminous (with access to the lateral opening, where the spinal nerve leaves) manifested in the early stages due to the fact that under their pressure the nerve enters, and in some cases, spinal cord

Especially acute symptoms in the foraminal intervertebral hernia, when even a small primary protrusion causes pain with the slightest movement and even breathing. Pain during breathing occurs due to the involvement of the thoracic region in the respiratory movements of the chest, the ribs of which are attached to its vertebrae from behind.

Segmental hernia symptoms

C7-T1:

• Pain in the chest in the area of ​​the scapula
• Angina pectoris
• Limitation of hand movements
• Paresthesia of the upper extremities (numbness, the appearance of goosebumps)

Th2 - Th3:

• Back pain, sometimes girdling, giving in the heart
• Symptom Lasega and Neri - increased pain when trying to touch the chin breasts

Th3 - Th4:

• Chronic back pain with the effect of strengthening with coughing, laughing, sneezing
• Intercostal neuralgia
• Diseases masking for pleurisy and heart disease

Th4 - Th5, Th5 - Th6, Th6 - Th7

• Pain in chest and back
• The phenomena of paresthesia
• Labored breathing
• Imitation of diseases of the digestive tract (cholecystitis, gastric ulcer, pancreatitis): This is due to falling into the innervation zone of the gastrointestinal tract

Th7 - Th8:
To the above symptoms, false signs of a duodenal ulcer are added

Th9 - Th10:
Symptoms masking under illness are added:

• pyelonephritis
• diseases of the thick and small intestine

Th11 - Th12:

• Pain in the back of a constant nature, (intensified when the elongated leg is raised in the supine position and under the test of Lasega and Neri)
• Wide range of innervation:
  • abdominal organs
  • intestines (thick and thin)
• The organs of excretory system and small pelvis

Th12 - L1

• Back pain with lumbar lumbar symptoms
• Deterioration of motor ability of lower extremities
• Appearance of reflexive severe pain in the leg during the tapping of the affected area of ​​the spine
• As a result of innervation of the large intestine and appendix, the appearance of false symptoms of colitis and appendicitis

• The intervertebral hernia, localized between segments C7 and Th11, most often occurs due to osteochondrosis, involuntary low mobility of the spine, or long-term presence in the same posture.
• The intervertebral protrusion located in the lower segments Th11 - Th12 and Th12 - L1, is more often provoked by traumas and activity of extensor movements.

Treatment of a hernia of thoracal department

Treatment of the hernia of the thoracic spine will be introduced in accordance with the severity of clinical symptoms.

Surgical treatment is conducted:

1. If there are serious signs of myelopathy in the form of: unceasing pain, motor damage with loss sensitivity, increasing respiratory and heart failure, disorders of the abdominal cavity and pelvis
2. If, despite repeated conservative treatment, the intervertebral hernia still progresses
3. With a large hernia size (over 10 mm), the threat of her prolapse and destruction of the disc

Main types of operations:

Cavity open surgery:

• Discectomy - removal of the entire disk of the spine or part of it
• Laminectomy - removal of a part of an arch of a vertebra

Minimally invasive neurosurgical operations, using a small incision:

• Endoscopic surgery - removal of small posterolateral and foraminal hernias with a spinal endoscope and instruments
• Microdisectomy - surgery with a precision microscope and micro instruments
• Laser hernia removal - using a high-energy laser beam

However, surgical intervention is still very rare, and the main method of treating the thoracic hernia of the spine is conservative.

Conservative treatment of a hernia of the thoracic spine

1. After examining and talking with a doctor, signs of a hernia are revealed, they need to be confirmed with the help of a survey:
   X-ray, MRI or myelography
2. The main problem of thoracic hernia is pain, which literally does not allow a person not only to live, but even to breathe. Arsenal of analgesic and anti-inflammatory drugs: Analgesics, Novocain, Non-steroidal and steroid drugs, Epidural anesthesia - if nothing helps
3. The decisive role in the rehabilitation of a hernia is played by: stretching exercises, which include in complexes LFK, manual therapy, massage, wearing hard corsets, methods of hardware physiotherapy
4. It is very important to try to change your life: Go in for sports.
   . Adjust the balanced power. Lose weight. Fill life with movement, fresh air and joyful mood

Health and good luck!

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A source: https://ZaSpiny.ru/gryzha/grudnoy-otdel.html

Intervertebral hernia of the thoracic spine: symptoms and treatment, signs, photo

The health of the ridge largely determines the general condition of a person. The thoracic department has the greatest duration - it consists of twelve vertebrae and is the least mobile.

The disks are low in height. This creates an additional condition for reducing the mobility of the vertebrae. In this zone, the ribs are attached to the vertebrae. With their help a rigid frame is created.

The vertebral canal is endowed with a relatively narrow lumen. The design of the chest zone provides protection against accidental factors leading to deformities.

That is why in the thoracic spine are observed two percent of the cases of the formation of hernias from the general statistics. If a pathology has occurred, it can deliver a sick person a lot of problems.

How does a hernia appear in the thoracic spine?

Disks are located between the vertebrae, they create cushioning and flexible connection. Disks consist of a gelatinous soft core and a protective shell.

https://www.youtube.com/watc? = wnDhFcskZ4I

Gaps between the vertebrae with time and under the influence of adverse factors sag and lose structure.

The formation of the intervertebral hernia has three stages:

1. The core protrudes, stretching part of the shell. The integrity of it is still preserved, but the protrusion that looks outside the vertebrae creates compression in the surrounding tissues.
2. The dense shell in the place of the greatest stress is cracked and a gelatinous nucleus is visible in the lumens. The beginning of the destructive processes in the disk.
3. If the negative circumstances that cause the continuation of the development of the pathological process are not stopped, then a breakthrough of the fibrous membrane and the loss of a part of the soft core are possible.

Photo MRI diagnostic, which shows the hernia of the thoracic spine

The direction of protrusion of the hernia is important. It can have the name on this basis:

• foraminal - affects the location of the exit of the radicular nerve,
• back,
• front,
• right-sided,
• left-sided.

Symptoms and signs of illness

Hernias can remain in places of dislocation of the problem asymptomatically. Pain occurs if the bulging part of the disc presses the radicular nerve.

Nature of pain:

• The discomfort that changes to pain syndrome increases after a long time in the body in a frozen posture. This happens when performing professional duties, for example:
  • hairdressers,
  • surgeons,
  • dentists
  • and others.
• Localization of persistent pain in the lower back (in its upper region).
• Perhaps a sense of pain in the chest zone.
• Discomfort in the abdomen, upper zone.
• A feeling of pain between the shoulder blades.
• When you change from lying to a sitting posture, pain intensifies.
• In this department is characterized by a girdle of pain.

In connection with the fact that the nerve endings, emerging from the spinal cord of this department, are responsible for the functions of internal organs, there is a failure in their vital activity.

• Deterioration of the work of intestinal peristalsis, which is manifested by constipation, alternating diarrhea.
• Problems in the genital area in men.
• Violation of urination: rare or frequent.
• During physical exertion, the muscles of the arms and legs quickly become tired.
• Symptoms similar to the disease:
  • gastropathy,
  • angina pectoris,
  • pancreatitis,
  • cholecystitis,
  • heart problems,
  • renal colic.
• Discomfort in the pelvic area.
• Numbness, feeling like crawling creeps, tingling in the area:
  • back,
  • upper abdomen,
  • upper extremities.

  The localization of symptoms depends on where the hernia happened.

• Paralysis of the part of the body, the control of which is located beneath the place of harboring of the spinal cord, may occur.
  With partial paralysis, the lower part of the trunk and legs are immobilized.
• If the hernia is localized at the top of the thoracic zone, then complete paralysis can occur. In such a situation, only the head can move.
• In the presence of a hernia in the thoracic part, there may be an increased contraction of muscles related to reflex actions.

Causes

The status of discs may deteriorate with age. Their thinning, loss of fluid can give the prerequisites for the disease of the spine.

Pathology of the spine - a hernia is provoked by such circumstances:

1. Disturbance of the structure of the disc due to its poor nutrition. This situation can arise if:
   • the metabolism is broken,
   • a man eats poorly,
   • the patient leads an immobile lifestyle. The disc is not provided with blood vessels. The food he receives diffusively from the surrounding tissues. In order for this process to occur fully, it is necessary to move in this zone.
2. The habit of smoking creates the prerequisites for a weakening of the metabolism. The smoker at himself reduces the oxygen content in the blood.
3. Hereditary predisposition to dystrophic processes in discs.
4. A sharp rise in gravity in an inclined position. The ridge can withstand heavy loads, if you follow simple rules. The spine should be kept vertically. The vector of the load force applied to the spine should be directed downward, but not obliquely.
5. Scoliosis, osteochondrosis predispose the ridge to the appearance of a hernia.
6. Weak muscular corset back.
7. Professions, where there is a need to be long in frozen postures, contribute to the creation of pathology. It:
   • at the machine tool in a factory or factory,
   • on the production line,
   • jewelers,
   • hairdressers,
   • office staff,
   • and other professions.

   Statistics show that the thoracic hernia usually occurs in middle age among the working population.

8. Traumatic situations with the spine.
9. The increased weight adds to the load on the disks.
10. Incorrect posture regularly creates disharmonious loads.
11. Overcooling worsens the condition of the discs.

Than the disease is dangerous

If the corrupted part of the disk core does not touch the nerve end, then there will be no pain signal. A person can be careless and miss the time.

The earlier to take action for the prevention and treatment of this pathology, the greater the chance of complete disposal of the problem.

The thoracic area is protected from unwanted traumatic circumstances leading to protrusions. But, if the hernia did happen, it poses a serious threat to health.

This is due to the fact that the spinal canal of this site is relatively narrow. Oppression of the spinal cord with bulging hernia is fraught with dangerous consequences.

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That's why experienced experts advise with persistent pain in the heart, abdomen without an obvious pathology in them to make a spine examination.

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The danger of the formation of a hernia in the thoracic zone is fraught with consequences from a slight discomfort to paralysis.

Diagnostics

If you find any symptoms similar to the presence of a hernia, you should seek help from a specialist and have a checkup.

1. A magnetic resonance imaging study can give a complete and detailed picture of the problems of the spine. The device will present the picture in any plane. He can make cuts with a small step, if you need to clarify and expand the survey area. Among the important advantages of this method is that it does not have harmful radiation.
2. Rarely, computer diagnostics is used to study the problem. It can show what situation in the surveyed area, only have to use a contrast medium. This circumstance creates, to some extent, the possibility of complications for the patient.

How to treat the pathology of discs

Specialists suggest conservative treatment. The operation is provided if nothing else brings relief.

In the first days of treatment, the patient should be given a spinal rest.Acute condition is facilitated by drug therapy:

After the transition of the course of the disease to the stage of remission, the specialist appoints a rehabilitation complex, which may include:

Laminotomy is done with dissection in several vertebrae of their arches. Discectomy involves removing the problem disk or part of it.

The most sparing surgical method is microdiscectomy. The procedure is carried out with microtools under the supervision of a microscope.

A source: http://OsteoHondroza.net/oslozhneniya/gryzha/grudnogo-otdela-pozvonochnika.html

Intervertebral hernia of thorax

Intervertebral hernia of thorax- prolapse of the thoracic intervertebral disc, normally not leaving the vertebral bodies beyond the boundaries.

Is manifested by pain and a disorder of chest sensitivity, weakness in the lower extremities with pelvic dysfunction, various functional changes from the somatic organs.

Diagnosed according to the MRI of the spine with the mandatory exception of the pathology of internal organs.

Conservative treatment includes medical and physiotherapy methods, manual therapy or stretching of the spine, exercise therapy, massage. The operation involves removing the disk.

The intervertebral hernia of the thoracic region is much less common than the intervertebral hernia of the lumbar region and the hernia of the cervical region.

By some estimates, hernias of thoracic localization account for no more than 1% of all intervertebral hernias, although accurate there is no data on their prevalence, since in some cases they are characterized by asymptomatic subclinical flow.

Mostly people of young and middle age are affected. The most common lesion is the intervertebral disc of the lower thoracic spine (Th8-Th12).

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Depending on the location, clinical manifestations of the thoracic hernia can mimic the symptoms of various pathologies of the chest and upper abdominal cavity.

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In this regard, their differential diagnosis should cause particular caution in the neurologist and be conducted with the involvement of specialists of other profiles: gastroenterologist, cardiologist, nephrologist, pulmonologist.

Causes of a thoracic hernia

The main etiofactors of intervertebral hernia of thoracic localization are spinal trauma and osteochondrosis.

In young patients, the formation of a hernia is caused either by trauma or by an early development of degenerative changes in intervertebral discs.

In patients older than 40 years, hernia, as a rule, is a complication of osteochondrosis.

Traumatic injuries of the discs of the thoracic region can occur with a bruise of the spine, subluxation of the vertebrae, fracture thoracic spine, excessive stress on the thoracic area during exercise or lifting weights. Chronic injury to the discs, leading to their premature degeneration and wear, is usually due to work in an uncomfortable position (for example, surgeons, car repair workers, welders, tailors). Early development of osteochondrosis in the thoracic spine is often associated with an uneven load on the vertebral column when violation of posture or curvature of the spine (kyphosis, scoliosis), dismetabolic processes in the body (diabetes, early climax).

As a result of tearing of the fibrous ring, the disc ceases to be held strictly between the vertebral bodies, part of it prolaps from the intervertebral space. There is a protrusion of the disc, which, with progression, grows into a herniated disk.

The main clinical manifestations of the latter are associated with its effect on the spine nerve root and / or on the substance itself of the spinal cord.

In neurology, the intervertebral hernia of the thoracic department is classified into the central and lateral. In the first case, the hernia manifests symptoms of compression of the spinal cord - compression myelopathy with the development of lower mono- or paraparesis, pelvic disorders.

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In view of the fact that discogenic myelopathy in the thoracic region is caused by compression of the conduction motor ways, pareses are central (spastic) in nature.

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The lateral hernia debuts with signs of irritation and compression of the corresponding spinal root - pain syndrome (radiculitis) and sensitive disorders in the chest area.

In the spinal nerves of the thoracic region there are visceral branches to many internal organs: trachea, lung, bronchi, esophagus, liver, duodenum, gall bladder, kidneys.

Therefore, the thoracic hernia can be accompanied by functional disorders of the corresponding visceral organs. The localization of these symptoms depends on the level of the location of the hernia, which is why the division of the thoracic hernia into upper, middle and lower ones is accepted.

Hernia of upper thoracic region(Th1-Th4) is manifested by pains (thoracalgia) and paresthesias in the upper parts of the thorax, the interblade area.

Possible disorder of peristalsis of the esophagus, difficulty swallowing.

Hernia of middle chest(Th5-Th8) often occurs with symptoms of intercostal neuralgia - one- or two-sided girdling pains along the intercostal spaces, resembling herpes zoster, but not accompanied by bubble rashes. Such pains can limit the respiratory excursion of the chest with the formation of a more shallow and rapid breathing. Possible pain in the stomach. In some cases, breast hernia can cause dyspepsia, enzyme deficiency of the pancreas, insulin secretion disorder, disorders in carbohydrate metabolism.

Hernia of lower thoracic region(Th9-Th12) occurs with pain localized in the kidneys, under the ribs, in the upper abdomen, sometimes simulating the "sharp abdomen".

Right-sided pains in the hypochondrium can be taken for manifestations of liver pathology, acute cholecystitis or appendicitis, surrounding intense pains - for acute pancreatitis.

A hernia at the level of Th11-Th12 can provoke dyskinesia of the intestine.

Depending on the location and the clinic of the thoracic hernia, patients often turn first to the therapist, cardiologist, gastroenterologist, urologist.

However, an attentive clinician on the nature of the pain syndrome (strengthening with movement, soreness with palpation of the thoracic spine, tension of the paravertebral muscles) may be suspected pathology the spine.

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In such cases, lung radiography can completely eliminate pneumonia, pleurisy, swelling; ECG and UZDG coronary vessels - ischemic disease heart; esophagogastroduodenoscopy and ultrasound of the abdominal cavity - pathology of the gastrointestinal tract; urine analysis, kidney ultrasound and urography - glomerulonephritis, urolithiasis, pyelonephritis.

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Radiography of the spine allows diagnosing osteochondrosis, deformities, post-traumatic changes.

CT of the spine visualizes a hernial protrusion, but does not give an opportunity to correctly estimate its size and the degree of spinal compression. Therefore, the optimal diagnostic method is MRI of the spine in the thoracic region.

MRI more accurately determines the localization and volume of hernia, allows you to assess the degree of inflammatory changes and spinal compression, to identify / exclude other diseases of the spine (tumor of the spinal cord, hematoma, neurin spinal root, thoracic spondylosis and other). If MRI studies are contraindicated to the patient, then use of CT with myelography.

Treatment of a hernia of thoracal department

Conservative treatment is aimed at arresting inflammation and pain syndrome, stopping the increase in the size of the hernia, restoring the lost neurological functions.

Anti-inflammatory drugs are prescribed (naproxen, ibuprofen, ketoprofen, carprofen, etc.). Local injection of anesthetics and corticosteroid drugs in the form of paravertebral blockades is performed.

In the presence of a spastic syndrome, muscle relaxants (tolperisone) are shown. The positive effect has a course of treatment with vitamins B1 and B6.

Increase the distance between the vertebrae and thereby ease the pressure on the affected disc assist manual therapy and traction therapy.

The patient should observe a special regimen that is more severe in the acute period and excludes excessive stress on the spine in the future.

If the results of conservative measures are positive so that the hernia symptoms do not return again, it is necessary to regularly perform a special complex of exercise therapy, aimed at creating a muscle holding the spine corset.

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Surgical treatment is indicated if the intervertebral hernia of the thoracic region does not lend itself to conservative therapy, symptoms of myelopathy arise, the compression of the spinal root progresses. Urgent decompression of the spinal canal is carried out by means of a laminectomy.

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Depending on the size of the hernial protrusion, endoscopic microdiscectomy, microdiscectomy, discectomy can be performed. After the removal of the disk, its place is occupied by connective tissue growths that form the fusion of two vertebrae (ankylosis).

It is necessary to approach the decision of the need for surgery as carefully as possible, since it can have a number of serious complications: bleeding, damage to the spinal nerves, infection with myelitis, spinal arachnoiditis, trauma to the dura mater.

A source: http://www.krasotaimedicina.ru/diseases/zabolevanija_neurology/thoracic-herniated-disc