The thoracic region of the back is not the most vulnerable to injury, as it is less mobile. However, due to constant sedentary work, weakened muscles and injuries, displacement of the thoracic vertebrae . This is a violation of the normal structure of the back, when individual parts of the spinal column move to the side.
What it is?
Vertebral displacement in the thoracic spine is a process of vertebral deformation in which the intervertebral discs deviate forward or backward relative to the remaining vertebrae.
Such deformations lead to a reduction in the diameter of the spinal canal and the appearance of diseases such as renal failure, bronchial asthma, ulcerative lesions of the gastrointestinal tract and duodenum, etc.
Picture of the course of the disease
Small deviations (especially at a young age) are almost impossible to notice. Symptoms in such cases are practically not expressed, and the presence of pathology can only be determined during a random examination or during fluorography.
The more the degree of displacement increases, the more often patients notice pain in the sacrum, lower back, and between the shoulder blades . Typically, such symptoms are mild and periodic in nature and rarely cause the need to consult a specialist.
As the disease progresses, neurological changes . Pinching of the spinal canal leads to increased pain, which becomes noticeable and bothers the patient.
Ischemic processes appear , which lead to a deterioration in blood supply (due to the fact that blood vessels are pinched). The patient begins to feel numbness in the upper extremities, tingling in the fingers, and limited mobility.
Displacement of the vertebrae in the thoracic region leads to ischemic processes
Advanced pathology triggers the process of skeletal deformation (this is especially important for those patients who have long-standing problems with the spine: kyphosis, lordosis, scoliosis). Partial paralysis (paresis), changes in sensitivity and tendon reflexes are observed.
Degrees and classification
First of all, displacement of the thoracic vertebrae is divided into stable and unstable. With stable displacement, the position of the vertebra does not change, even if the patient moves. With unstable displacement, the vertebra moves when the body position changes.
There are also several main subtypes of thoracic displacements:
- Congenital subspecies. Occurs under the influence of intrauterine factors or due to birth trauma;
- Isthmic subspecies. Most often diagnosed in professional athletes. This subtype is characterized by defects in the interarticular areas of the thoracic vertebrae;
- Degenerative subspecies. With this form, arthritic lesions develop. This subtype is typical for older patients;
- Traumatic subtype. Everything is obvious here - the process of displacement develops against the background of injury or fracture;
- Pathological subspecies. The displacement occurs under the pressure of tumors and other neoplasms.
Displacement of the thoracic vertebrae is also characterized by its severity. In total, there are 5 degrees of development of the pathology , where 1 degree is a practically asymptomatic manifestation of the disease, and 5 degree is a severe form, in which the vertebra is completely displaced forward.
ICD 10 code
The pathology is included in the group of diseases M51 .
Prevalence
Spondylolisthesis is not particularly common among patients. Most often, displacement of the vertebrae occurs due to severe injuries and fractures, and it manifests itself only after a certain period of time.
Causes of spondylolisthesis
Due to the occurrence of the disease, spondylolisthesis is divided into five types:
- dysplastic spondylolisthesis (the rarest type of congenital pathology) is a malformation of the base of the sacral vertebrae and the fifth lumbar vertebra (defect of the arch, vertebral pedicle);
- isthmic or spondylolytic spondylolisthesis (spondylolysis) – provoked by the growth of connective scar tissue at the site of an ununited stress fracture of the pedicle or vertebral arch (fracture due to prolonged excessive loads, movements with overextension during sports);
- degenerative (involutive) spondylolisthesis - arthritic changes in the joints of the vertebrae, stretching, thinning, degeneration of the intervertebral disc (osteochondrosis), usually in old age;
- traumatic spondylolisthesis - direct injury to the spine, fracture of the pedicle, lamina of the vertebral arch or facet joint;
- pathological spondylolisthesis is a defect in the bone caused by a tumor.
Risk factors, causes
Since displacement of the vertebrae in the thoracic region is a fairly rare phenomenon, there are also few reasons why this could happen:
- The main reason is defectiveness of one of the vertebrae. This problem can be congenital or acquired. This defect leads to fracture
The vertebrae begin to shift if there is any injury or defect in the vertebral pedicle during stress on the spinal column. Gradually, the fracture will heal, but a scar will remain at the site of the injury, which will prevent the vertebra from assuming its usual position. Because of this, the vertebral body will begin to protrude forward; - The second common cause of deformation is injury or fall . When falling on your back, in almost all cases, the vertebrae are displaced due to the appearance of fractures or cracks;
- Another risk factor is surgical interventions . Any operations on the spinal column can lead to complications, which over time develop into displacement of the vertebrae;
- The presence of degenerative diseases increases the risk of vertebral body displacement;
- Age-related changes that lead to weakening of bone structures can also lead to deformation of the vertebrae.
Symptoms of spondylolisthesis and diagnosis
Damage to the vertebrae of this kind, which is observed with spondylolisthesis, does not make itself felt immediately. It may take days or even years for the patient to feel that something is wrong. And at this time, ulcers, gastritis, pancreatitis and other complicated situations relating to the digestive system or pathologies of other systems and organs will begin to develop.
Important! Symptoms noticed as early as possible will lead the patient to a doctor for examination, allowing the disease to be diagnosed at an uncomplicated stage and severe complications to be avoided.
Symptoms of the disease
Symptoms can be pronounced, but not often, mostly the symptoms are weak and subtle.
- Pain in the thoracic region, which is chronic, but not a cause for severe concern.
- Mechanical pain is mild, only at the moment of a vertebra slipping from its usual position and the resulting instability of the motor spinal segment. It is felt in the thoracic area and radiates (but not necessarily) to the lumbar area.
- Radicular pain - observed when the nerve root is compressed, can be more severe than mechanical pain. The pain covers the entire sternum (girdles), can be burning and intensifies if the patient moves his arms back, sits for a long time or lifts weights.
- Gastrointestinal disorders, which are expressed by heartburn, indigestion and lead to gastritis and ulcers, are also a symptom of spondylolisthesis.
Radicular pain
The pathology is characterized by stage-by-stage changes in the spinal column.
Consequences
Compared to displacement of the vertebrae in the cervical region, deformation of the vertebrae in the thoracic region does not lead to problems with the vertebral arteries. The danger in this case is different - the risk of paralysis of the upper limbs increases. However, restoration of lost functions is not possible.
An undoubted danger is also the involvement of the lungs and heart in the pathological process. A lethal outcome, of course, will not happen, but chronic diseases of these organs will definitely be ensured (hyperventilation, chronic cough, sinus tachycardia, arrhythmia)
General characteristics of the disease
The disease is a displacement of one vertebra relative to the underlying one. In this case, it can move:
- to the right or left side - in this case, the diagnosis will indicate “laterolisthesis”;
- forward – anterolisthesis;
- back – retrolisthesis.
In addition, it is important to understand that pathology does not appear immediately, but develops over time. The more attentive you are to your health, the earlier the disease can be detected. If a neurologist
determines that the vertebra has shifted by 25%, then you have the first degree of spondylolisthesis, 50% - the second, 75% - the third, from 75% to 100% - the fourth. The fifth occurs when the vertebra completely “leaves” from its place, a phenomenon called “spondyloptosis”.
Symptoms
The symptoms of diseases depend on how far the pathology has gone in its progression. In the early stages, symptoms may be mild or absent altogether. Sometimes they may be absent even in the last stages.
Early symptoms:
- Discomfort and mild pain in the affected area of the spinal column;
- The pain syndrome intensifies when bending, turning the body, as well as during physical activity of varying degrees of severity;
- Slight limitation of mobility in the thoracic spine (especially after waking up).
At the next stage of deformation development, the following reactions begin to appear:
- Constant burning pain in the deformation area, aggravated by physical activity;
- Increased pain after a long stay in a static position;
- Numbness, “goosebumps” in the fingers of the upper extremities.
The last stage by the following manifestations:
- Pronounced pain syndrome (sharp shooting pains during physical activity);
- Numbness of the limbs;
- Breathing disorders, tachycardia;
- Partial or complete paralysis of the upper limbs.
At the first noticeable symptoms, you should consult a doctor to clarify the diagnosis. The sooner you detect the problem and begin to treat it, the higher the likelihood of a full recovery.
Diagnostic methods
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Next fact
Spondylolisthesis can be diagnosed through a routine examination of the patient. First of all, of course, the doctor will visually assess your condition. Using palpation, he will examine the spine and identify initial problems.
If such an examination does not give a sane clinical picture, then the doctor will send you for additional studies: MRI and.
A computer examination will help not only determine the level of neglect of the pathology, but also the specific location, the level of impact on internal organs and tissues, and the rate of development of the disease.
After receiving a complete picture of the course of the disease, the doctor will prescribe appropriate therapeutic measures for you.
Video: “How to detect vertebral displacement?”
Find out how degenerative changes in the spine develop:
- Degenerative-dystrophic changes in the cervical spine
- Degenerative-dystrophic changes in the thoracic region
- Degenerative-dystrophic changes in the lumbar region
Diagnosis of vertebral displacement
In order to correctly diagnose vertebral displacement, you need the help of a neurologist.
At the initial appointment, the neurologist conducts:
- conversation with the patient (to identify painful areas and determine the nature of pain);
- taking anamnesis;
- reflex diagnostics;
- comprehensive examination to determine:
- muscle conditions (hypertonicity, hypotonicity);
- presence/absence of sensory impairment.
- presence/absence of decreased mobility of the spine and joints
In addition, the doctor may prescribe additional examination methods, such as:
- MRI
- Ultrasound
- X-ray
- Lab tests
Treatment
To treat displacement of the vertebrae in the thoracic region, both conservative and surgical methods are used.
Drug therapy
Drug therapy is aimed primarily at relieving acute pain symptoms and relieving spasms.
Standard groups of drugs for the treatment of vertebral displacement in the thoracic region:
- NSAIDs and analgesics;
- Novocaine blockades (especially for those who have intervertebral hernias);
- Chondroprotectors (to restore cartilage tissue and prevent chondrosis);
- Muscle relaxants (to relieve muscle spasms);
- Vascular medications (to improve metabolic processes in inflamed tissues)
Surgical intervention
In this situation, the help of a surgeon is resorted to only if the patient experiences rapid progression of the disease, damage to nerve fibers that threatens the normal functioning of the nervous system, or a form of pathology that is not amenable to conservative treatment. After the operation, the patient will need to be under constant medical supervision and undergo rehabilitation measures .
Massage
Massage is one of the priority methods of conservative treatment (along with exercise therapy). Regular therapeutic massage sessions will help return the vertebra to the correct position and secure it there.
In addition, massage will improve blood flow in damaged and inflamed tissues and speed up their healing.
Video: “Technique for realigning displaced vertebrae”
Physiotherapy
Therapeutic gymnastics works well to combat these types of deformities. But it will be effective only if the set of exercises is selected strictly individually and performed under the supervision of a specialist. Therapeutic exercises should definitely be combined with massage sessions to avoid muscle overload and pinching.
Treatment at home
If vertebrae are displaced in any part of the spinal column, treatment with folk recipes at home will be ineffective . Such deformities require medical intervention and a special treatment course.
Prevention
Prevention of vertebral displacement is to reduce the load on the spine. Prevention is important if you have prerequisites for vertebral displacement (in the past there were severe back injuries, surgical interventions or third-party diseases of the spine).
In such cases, it is worth reducing the load on the spinal column, reducing the time spent in a static position, keep your back straight, and do not make sudden movements.
If you experience exacerbations, then during this time you need to limit physical activity.
It is advisable to use special orthopedic corsets. At the first symptoms, you should contact a specialist who will help you create an individual treatment course.