Osteochondrosis of the cervicothoracic spine is a special type of disease in which dystrophic processes in the intervertebral segment immediately spread to two levels of the spinal column. The dominant manifestations in the clinical picture arise mainly due to compression of large vessels and nerves (hemodynamic and neurological disorders), and the symptoms directly from the dystrophic-damaged disc and articular surfaces of the vertebrae are in second place (static syndrome), according to the Internet publication for. net Cervical-thoracic osteochondrosis in clinical practice is very common.

Features 1. Begins with non-specific symptoms (tinnitus, numbness of the extremities), which somewhat complicates the diagnostic search.

Clinical symptoms appear in the early stages, but when examining a patient, the doctor may not detect the morphological substrate of the disease (signs of intervertebral hernia, sequestration). For this reason, repeated examinations after a certain period of time may be required..

This is the second most common 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 to a sluggish chronic process.

Since the main disorders occur as a result of compression of the vertebral artery disk by sections, prolonged lack of treatment leads to chronic oxygen starvation of the brain (development of cervicogenic headaches).

At the cervical level, there is more often compression of only one nerve on one side (monoradicular syndrome), but if the deformed disc is displaced towards the spinal cord, compression of all structures occurs (biradicular syndrome).

More common in women and the elderly.

Conservative treatment with its correct selection gives up to 70% of positive results..

Symptoms of osteochondrosis of the cervical and thoracic spine.

Department.

Syndromes.

Cervical.

Cervicalgia is a severe pain syndrome localized in the neck. Increases with minor physical exertion.

Cervicobrachialgia (neck and shoulder pain). Arise in the cervical region and gradually capture the arm, the anterior surface of the chest and the interscapular region.

Violations of autonomic regulation and the occurrence of paresthesia of the limbs, discoloration of the skin of the hand.

Anterior scalene syndrome - 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. Swelling occurs in the supraclavicular fossa.

Cervicocranialgia (vertebral artery syndrome) - associated with headaches that capture one side of the head, dizziness. In addition, there are various manifestations of cochleo-vestibular disorders (ringing and noise in the ears, loss of spatial orientation). Manifestations are greatly enhanced by turning and tilting the head..

Cardiac syndrome with the occurrence of specific pains in the heart, which are difficult to respond to classical drug treatment.

Stein-Broker syndrome (shoulder-hand syndrome). All structures of the limb (joints and muscles) are affected, which leads to a sharp limitation of range of motion. Over time, the phenomenon of atrophy of muscle, articular and bone structures is possible..

Violation of all types of sensitivity in areas that are directly related to the affected nerve root.

thoracic.

Dorsalgia - associated with the occurrence of pain in the interscapular region and intercostal spaces. There is a clear connection with the movements.

Muscle spasm from the degenerative process.

Syndrome of the anterior pectoral muscle - associated with the tension of the muscle group of the anterior surface of the chest.

Sternum syndrome - occurs due to the peculiarities of the attachment of the neck muscles and is characterized by pain in this area.

Partial loss of sensation in the innervated zone (numbness, goosebumps, impaired temperature perception).

Radicular syndromes in cervical osteochondrosis, depending on the level of compression:.

Squeezed spine.

Manifestations.

C1.

Loss of sensation in the parietal region.

C2.

Loss of sensation 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 longest muscles of the neck. Partial impairment of respiratory function due to the presence of branches to the diaphragm.

C5.

Pain captures the shoulder girdle and the outer surface of the shoulder. Weakness of the deltoid muscle. Loss of sensation in these areas.

C6.

Pain extends to the thumb (spread through the dermatome). Muscle weakness throughout.

C7.

The pain captures the neck, scapula, external-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 ulnar edge of the forearm to the little finger.

Manifestations of radicular syndromes in 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 a violation of the internal organs.

When collecting an anamnesis, it is almost impossible to find a classic clinical picture of cervicothoracic osteochondrosis, the manifestations of the disease are mixed.

Treatment of osteochondrosis of the cervical and thoracic spine Treatment for all types of osteochondrosis is standard and includes two broad categories:.

conservative;

surgical.

How exactly to treat a particular patient, as well as the required amount of measures, is determined by the doctor..

Drug therapy The main groups of drugs used to treat osteochondrosis of the cervicothoracic spine:.

Analgesics - to relieve pain. Use of narcotic and non-narcotic painkillers (acetaminophen).

Non-steroidal anti-inflammatory drugs - to relieve inflammation and partially anesthetize the lesion (Celecoxib, Rofecoxib).

Tricyclic antidepressants - with analgesic purpose (Amitriptyline, Imipramine).

Muscle relaxants - to relieve muscle spasm (Sirdalud, Tolperisone).

Dehydration therapy - to eliminate edema and normalize blood circulation. Facilitates venous outflow at the site of injury (diuretics).

Chondroprotectors - prevent the destruction of cartilage (Rumalon, Structum). Contribute to the restoration of the affected area of \u200b\u200bthe disc.

Therapeutic blockades (novocaine and lidocaine) are the most effective method for 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 are supplemented with neuroprotectors, vasodilators and antihypertensive drugs..

Exercise therapy and massageTherapeutic exercise and massage are suitable as an auxiliary set of activities that allows you to restore motor activity. It is not recommended to start exercises on your own and with severe pain syndrome..

A few exercises:.

In a sitting position, arching and bending the spinal column. The upper limbs can serve as a support.

In the supine position, make a deflection in the cervical and thoracic segments 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 is indicated..

Massage is often used as one of the main conservative treatment options..

The main point of its use 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).

PhysiotherapyThe purpose 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 effective methods of treating cervicothoracic osteochondrosis..

infrared radiation to the back of the neck;

UVR of the cervical-collar zone;

ultratonotherapy of the collar zone;

diadynamic currents paravertebral to the cervical spine;

ultrasound on the cervical spine;

SMT on the areas of pain projection transversely and paravertebral to the cervical or thoracic spine;

ultratonotherapy on segmental zones of the spine and the area of \u200b\u200bpain projection;

electrophoresis with anesthetics and ganglion blockers.

Surgical treatmentSurgical treatment is considered when other methods fail and when there is severe disc destruction. The most commonly used surgical procedures:.

Periarterial sympathectomy and decompression of the vertebral arteries to eliminate vertebral artery syndrome.

Removal of a herniated disc by endoscopic or open methods.

Puncture methods: removal of the disc nucleus with high-intensity laser radiation; dissolution of the disc nucleus with papain; disc deception with alcohol or ozone.

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