A hernia of the thoracic spine is a protrusion of a deformed intervertebral disc into the extra-articular space. Most often, the protrusion occurs anterior to the axis of the vertebrae.. In the pathogenesis lies compression of the surrounding nerve roots by the elements of the disk. They can be located directly in the spinal canal, as well as exit the spinal cord at different levels, often a hernial protrusion leads to compression of two roots, as reported by the online publication for girls and women from 14 to 35 years old Pannochka. net Hernia in the thoracic spine hernias are less common than in other departments Characteristics of the disease 1. Refers to rare diseases and occurs in no more than 1-4% of patients.

It can occur in areas Th8-Th9, Th9-Th10, Th10-Th11, Th11-Th12 (Th is the designation of the thoracic vertebrae).

More common in middle-aged men.

The main symptom is pain of varying intensity and localization..

The first signs may occur in organs and tissues that are innervated by a compressed nerve (numbness of the hand, tingling of the fingers).

Pathology can occur at the border of different parts of the spinal column, which leads to an increase in the volume of the lesion (cervical zone, lumbar zone).

Intervertebral hernia of the thoracic region, like any other hernial formation of the spine, has several periods of development:.

Period.

Characteristic.

Peculiarities.

Protrusion.

Initial phase, or pre-hernia.

Associated with the destruction of the inner component of the annulus, while the outer shell is preserved. Due to partial subsidence of the nucleus, the intervertebral disc may protrude by 2-4 mm.

Extrusion.

Intermediate stage (the probability of recognizing a hernia in the images is 70%).

The fibrous ring remains intact, but becomes brittle and deformed throughout. Partial elements of the disc can shift into the extra-articular space. Possible occurrence of clinical symptoms due to compression of the nerve roots.

Sequestration (before this stage, one more can be distinguished - prolapse. Difficulties in diagnosis make it possible to combine these stages).

A typical formed hernia with all the characteristic clinical and diagnostic features.

Pronounced destruction of the disc with the release of its elements directly into the cavity of the spinal canal. This often leads to disability (80-90% of cases), as irreversible damage to the nervous tissue occurs..

Depending on the effect on the spinal canal:.

narrowing by no more than 10% (the clinic occurs relatively rarely);

narrowing by 10-20% (the clinic is predominantly local);

narrowing of more than 20% (serious disorder with the occurrence of radicular symptoms).

Classification of the process depending on the direction of growth:.

lateral - growth to the right or left side relative to the center (occurs in 57-65% of cases);

front - growth forward relative to the center (the safest option);

median - growth strictly in the center (the most dangerous type of hernia, since growth occurs in the spinal canal);

paramedian - growth somewhat sideways relative to the center.

Detailed classifications are given in order to understand the occurrence of certain symptoms of the disease..

If an intervertebral hernia is suspected, a consultation with a neurologist or neurosurgeon is indicated, the main diagnostic method is MRI (magnetic resonance imaging).

Causes There are two main causes that directly lead to the occurrence of hernias:.

Degenerative-dystrophic diseases of the spine. First of all, we are talking about advanced forms of osteochondrosis.. With this disease, serious metabolic changes occur in the interarticular space, which leads to fragility of the intervertebral disc. As the disc progresses, it finally collapses and a hernial protrusion forms..

Traumatic injuries. When hitting or falling, fractures, ruptures of ligaments occur, which lead to a violation of integrity in any part of the spinal column. In this case, the vertebrae are displaced along the axis and lead to the formation of a non-classical hernia..

Predisposing factors:.

Prolonged and pronounced load on the spine. This category includes professional athletes, as well as people whose profession is associated with muscle tension and the musculoskeletal system (loaders).

Orthopedic diseases. Scoliosis of 3-4 degrees leads to pronounced changes in the axis of the spinal column and displacement of the vertebrae by more than 60%. In addition, there is a stretching of the supporting frame of the spine and intervertebral space, which includes muscles and ligaments..

Obesity 3-4 degrees. Provides a total load on the entire musculoskeletal system.

Chest deformities. They do not have a direct connection with the spine, but cause deformation of the entire chest and ribs - the angle of inclination changes, at which attachment to the vertebrae is carried out.

The risk group, in addition to the already mentioned categories, includes:.

patients over 60 years of age, as natural processes of bone tissue degeneration occur;

programmers, accountants and other persons whose professional activities involve prolonged sitting.

Symptoms of a hernia of the thoracic spineSymptoms are directly related to the characteristics of the innervation of this zone. The list of innervated organs and tissues (the most significant are given):.

upper limbs;

respiratory system;

chest wall;

elements of the digestive system (esophagus, liver, duodenum, part of the small intestine);

partially some elements of the urinary system;

spleen;

pelvic components (fallopian tubes).

Innervation is carried out not only by branches emerging from the thoracic spine, but also by a number of other nerve branches, which provides a single nervous network (if any department is damaged, nerve impulses are redirected from another department).

All symptoms can be divided into two groups.

From the nervous system:.

Pain. In the initial stages, it is of a moderate short-term nature and is localized only in the thoracic region of the back.. Becomes acute as it progresses and may radiate to adjacent structures (ribs, lower back, may become herpes zoster).

Spasm and muscle tension in the affected area (back, chest). This is a reflex defense of the body..

Vertebral thoracalgia. Manifested by bouts of painful spasms in different areas.

Paresthesia (tingling, numbness), which are localized in different areas (hands, forearms, back).

Muscular weakness of the upper limbs.

Rarely, with severe disc destruction, total paralysis can occur (thorax and below).

From the innervated organs:.

Swallowing disorder (choking).

Respiratory failure.

Total or partial loss of all types of sensitivity in the lower part of the body, as well as the perineum, genitals, lower abdomen.

Sexual dysfunction (impotence in men and infertility in women).

Rarely in advanced cases of dysfunction of the pelvic organs (urinary and fecal incontinence).

These signs are always associated with a pronounced destruction of the structure of the intervertebral discs; they do not occur at the initial stage..

As a rule, symptoms appear gradually and a person finds an opportunity to seek help before all possible manifestations develop..

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