Osteochondrosis of the cervicothoracic spine
The content of the article:
- Features:
- Symptoms of osteochondrosis of the cervical and thoracic spine
-
Treatment of osteochondrosis of the cervical and thoracic spine
- Drug therapy
- Exercise therapy and massage
- Physiotherapy
- Surgery
- Video
Osteochondrosis of the cervicothoracic spine is a special type of disease in which dystrophic processes in the intervertebral segment spread to two levels of the spinal column at once. The dominant manifestations in the clinical picture arise mainly due to compression of large vessels and nerves (hemodynamic and neurological disorders), and symptoms directly from the dystrophic-damaged disc and articular surfaces of the vertebrae are in second place (static syndrome).
Cervico-thoracic osteochondrosis is very common in clinical practice
Features:
- It starts with nonspecific symptoms (tinnitus, numbness of the extremities), which somewhat complicates the diagnostic search.
- Clinical symptoms appear in the early stages, but when examining the patient, the doctor may not detect the morphological substrate of the disease (signs of intervertebral hernias, sequestration). For this reason, repeated examinations may be required after a certain period of time.
- This is the second most frequent segment in which osteochondrosis can occur, which is associated with the structural features of this anatomical region (it is important to take this fact into account when making a preliminary diagnosis).
- There is a tendency to transition into a sluggish chronic process.
- Since the main disorders occur due to compression of the vertebral artery disk by sections, prolonged absence of treatment leads to chronic oxygen starvation of the brain (development of cervicogenic headaches).
- At the cervical level, only one nerve is more often compressed on one side (monoradicular syndrome), but if the deformed disc is displaced towards the spinal cord, compression of all structures occurs (biradicular syndrome).
- It occurs more often in women and the elderly.
- Conservative treatment, if properly selected, gives up to 70% of positive results.
Symptoms of osteochondrosis of the cervical and thoracic spine
Signs of cervicothoracic osteochondrosis include clinical manifestations immediately
two sections of the spinal column (presented in the table).
| The Department | Syndromes |
| Cervical |
1. Cervicalgia is a pronounced pain syndrome localized in the neck. It intensifies with minor physical exertion. 2. Cervicobrachialgia (neck and shoulder pain). They arise in the cervical region and gradually capture the arm, the anterior surface of the chest and interscapular region. 3. Violations of autonomic regulation and the occurrence of paresthesias of the extremities, discoloration of the skin of the hand. 4. Syndrome of the anterior scalene muscle - associated with compression of the subclavian artery and the lower trunk of the brachial plexus, which leads to the appearance of aching pulling sensations in the limb. In the area of the supraclavicular fossa, swelling occurs. 5. Cervicocranialgia (vertebral artery syndrome) - associated with headaches that seize one side of the head, dizziness. In addition, various manifestations of cochleo-vestibular disorders (ringing and tinnitus, loss of spatial orientation) occur. Manifestations are significantly enhanced when turning and tilting the head. 6. Cardiological syndrome with the occurrence of specific pain in the heart, which are difficult to respond to classical drug treatment. 7. Stein-Broker syndrome (shoulder-hand syndrome). All structures of the limb (joints and muscles) are affected, which leads to a sharp limitation of the range of motion. Over time, the phenomenon of atrophy of muscle, articular and bone structures is possible. 8. Violation of all types of sensitivity in areas that are directly related to the affected nerve root. |
| Pectoral |
1. Dorsalgia - associated with the occurrence of pain in the interscapular region and intercostal spaces. There is a clear connection with movements. 2. Muscle spasm from the degenerative process. 3. Syndrome of the anterior pectoral muscle - associated with the tension of the muscle group of the anterior surface of the chest. 4. Sternum syndrome - occurs due to the peculiarities of the attachment of the cervical muscles and is characterized by pain in this area. 5. Partial loss of sensitivity in the innervated zone (numbness, goose bumps, impaired temperature perception). |
Radicular syndromes in cervical osteochondrosis, depending on the level of compression:
| Squashed root | Manifestations |
| C1 | Violation of sensitivity in the parietal region. |
| C2 | Loss of sensitivity in the parieto-occipital region. |
| C3 | Neck pain and swelling of the tongue. Partial paresis and hypotrophy of the hyoid muscles. |
| C4 | Pain in the shoulder girdle and collarbone on one side, as well as weakness of the muscles of the scapula, trapezius and longus muscles of the neck. Partial impairment of respiratory function due to the presence of branches to the diaphragm. |
| C5 | The pain covers the shoulder girdle and the outer surface of the shoulder. Deltoid muscle weakness occurs. Loss of sensitivity in these areas. |
| C6 | Pain reaches the thumb (spread over the dermatome). Weakness of muscles all over. |
| C7 | The pain captures the neck, scapula, externo-posterior part of the shoulder, the back surface of the forearm and reaches the II and III fingers. |
| C8 |
The pain is directed from the neck through the elbow edge of the forearm to the little finger. The manifestations of radicular syndromes with lesions of the thoracic region do not have a clear differentiation and are associated with a partial loss of motor and sensory activity, as well as with disruption of the work of internal organs. |
Treatment of osteochondrosis of the cervical and thoracic spine
Treatment for all types of osteochondrosis is standard and includes two broad categories:
- conservative;
- surgical.
The doctor determines how to treat a particular patient, as well as the required amount of measures.
Drug therapy
The main groups of drugs used to treat osteochondrosis of the cervicothoracic spine:
- Analgesics - to relieve pain. Use narcotic and non-narcotic pain relievers (acetaminophen).
- Non-steroidal anti-inflammatory drugs - in order to relieve inflammation and partially anesthetize the lesion (Celecoxib, Rofecoxib).
- Tricyclic antidepressants - for analgesic purposes (Amitriptyline, Imipramine).
- Muscle relaxants - with the aim of relieving muscle spasm (Sirdalud, Tolperisone).
- Dehydration therapy - in order to eliminate edema and normalize blood circulation. Facilitates venous outflow at the site of injury (diuretics).
- Chondroprotectors - prevent the destruction of cartilage (Rumalon, Structum). Promote restoration of the affected area of the disc.
- Therapeutic blockades (novocaine and lidocaine) are the most effective method of eliminating pain impulses.
- Local therapy (ointments, gels, creams) - to relieve spasm, minor local irritation.
The therapy regimen is supplemented according to the dominant symptom. For example, in the treatment of vertebral artery syndrome, they supplement with neuroprotectors, vasodilators and antihypertensive drugs.
Exercise therapy and massage
Physiotherapy and massage are suitable as an auxiliary set of measures that allows you to restore physical activity. It is not recommended to start exercises on your own and with severe pain syndrome.
Several exercises:
- In a sitting position, bend and bend the spinal column. The upper limbs can serve as support.
- In the prone position, bend in the cervical and thoracic segment with the head tilted back.
- In a standing position, tilt the body forward / backward and right / left.
Before starting therapy, a thorough examination and consultation with a specialist are indicated.
Massage is often used as one of the main conservative treatment options.
The main point of its application is to create muscle relaxation in the affected area. To achieve the desired effect, several courses of therapy are required (2-3 courses of 5-10 sessions each).
Physiotherapy
The goal of the method is to eliminate a number of symptoms and relieve local spasm. Physical therapy leads to some improvement in local metabolic processes, normalization of blood circulation and lymph flow.
Physiotherapy is one of the most effective methods of treating cervicothoracic osteochondrosis
Types of exposure:
- infrared radiation on the back of the neck;
- UFO of the neck-collar zone;
- ultratonotherapy of the collar zone;
- paravertebral diadynamic currents to the cervical spine;
- ultrasound on the cervical spine;
- CMT on the zones of projection of pain transversely and paravertebrally on the cervical or thoracic spine;
- ultratonotherapy for segmental zones of the spine and pain projection area;
- electrophoresis with anesthetics and ganglion blockers.
Surgery
Surgical treatment is considered when other methods fail and when the disc is severely damaged. The most commonly used surgical procedures:
- Periarterial sympathectomy and decompression of the vertebral arteries to eliminate vertebral artery syndrome.
- Removal of disc herniation by endoscopic or open methods.
- Puncture methods: removal of the disc nucleus with high-intensity laser radiation; dissolution of the disc nucleus with papain; Dereception of a disc with alcohol or ozone.
Video
We offer for viewing a video on the topic of the article.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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