Thoracic vertebral disease

　　13. 1. Congenital malformation of the spine; strain and trauma of the back muscles; hyperplasia and malalignment of the vertebral body and small joints; prolapse of the thoracic intervertebral disc; calcification of the posterior longitudinal ligament of the thoracic vertebra.

　　12. Most of them have a history of strain or cold, a history of trauma, recurrence after surgery or residual symptoms after surgery, and some patients have cervical, thoracic, and lumbar diseases at the same time.

　　11. The increase in age and the disorder and decline of metabolic function are the basic factors for its occurrence. Long-term carrying of heavy loads on the shoulders and back, such as loaders; long-term sedentary work, such as seamstresses, teachers, typists, etc.; long-term bad entertainment habits, such as long-term internet surfing, playing cards, lying down to watch TV and read newspapers, and other factors lead to chronic strain of the thoracic vertebrae and vertebral spines; injury, is the main factor that promotes the degenerative changes of the thoracic intervertebral disc, vertebral bone, and surrounding fibrous soft tissue, and leads to the occurrence of thoracic vertebral disease.

　　10. The main pathological changes include prolapse of the thoracic intervertebral disc, micro-subluxation of the intervertebral disc causing narrowing of the intervertebral space and intervertebral foramen, pseudo-spondylolisthesis, osteophytes at the edge of the vertebral body and joint hyperplasia, and thickening of the yellow ligament. Among them, the most common is the narrowing of the intervertebral space and intervertebral foramen, especially the formation of lip-like osteophytes at the anterior and lateral edges of the vertebral body, which are often extensive and often affect several thoracic vertebrae. As for the prolapse of the thoracic intervertebral disc, it is extremely rare in clinical practice and only occasionally occurs in the lowest three thoracic vertebrae.

　　9. The above changes, or the reactive changes such as adhesions and hardening of the adjacent spinal meninges, fibrosis, external tissues, and the sheath of the nerve roots, can cause compression or ischemia of the thoracic spinal cord, nerve roots, and sympathetic nerves, and produce corresponding clinical symptoms.

　　6. Abdominal pain is often accompanied by severe heartburn and constipation, but there is no regurgitation.

　　5. When there is damage to the lower thoracic vertebra, there may be occasional pain resembling renal colic, difficulty in urination, and phenomena such as decreased libido and impotence in men.

　　3. Currently, it is very similar to the symptoms caused by spinal cord tumors or localized adhesive arachnoiditis of the spinal cord. The main symptoms include typical intercostal neuralgia or zoster-like abdominal pain, weakness and numbness in the lower limbs, as well as sphincter and sexual dysfunction.

　　Generally, it is chronic low back pain, chest pain, intercostal neuralgia, numbness and pain in the arms, numbness and tingling in the shoulder and back, sweating or no sweating, chest tightness, palpitations, dizziness, insomnia, poor digestion, and in severe cases, instability when standing, difficulty in walking, a feeling of being bound in the chest and abdomen, abnormal urination and defecation, paraplegia, and so on.

　　1. The common main manifestations of thoracic vertebral disease are back and chest pain and kyphosis, with chest pain being severe when bending and sitting.

　　2. Pain caused by degeneration of the upper thoracic vertebrae may radiate to the anterior chest.

　　3. When the lower thoracic vertebral lesions, pain may radiate to the abdominal wall, and sometimes it is mistaken for angina pectoris.

　　4. If the osteophytes stimulate the sympathetic nerves located around the spine, it can produce autonomic symptoms such as circulatory disorders.

　　5. Patients may develop kyphosis due to narrowing of the vertebral interspaces, causing back pain.

　　6. Due to limited movement of the ribs, the amplitude of respiration is reduced.

　　7. In severe degeneration, if there is compression of the spinal cord, numbness in the lower limbs and cord signs may occur.

　　The prevention of thoracic vertebral disease mainly involves developing good living habits and behaviors, such as: 1. Maintain correct posture when sitting. 2. Maintain correct sleeping posture. 3. Strengthen reasonable exercise methods and appropriate exercise.

　　1. X-ray examination

　　The lateral view of the thoracic vertebral side film shows marginal spurring of the vertebral body, and the anteroposterior view shows subluxation of the head of the rib. Most show a relatively wide narrowing of the thoracic vertebral interspaces, ossification of the cartilage plates, and marginal osteophytes on the anterior or lateral margins of the vertebral bodies. Some cases show shadows of Schmorl's nodes, changes such as lateral curvature of the thoracic spine and deepening of physiological curvature. Occasionally, marginal osteophytes can be seen at the posterior margin of the thoracic vertebral body, and it is believed that this symptom has a significant diagnostic meaning, often suggesting the possibility of intervertebral disc herniation.

　　2. Laboratory tests

　　HLA-B27, ESR, ASO, and RF should be checked to exclude rheumatic diseases or ankylosing spondylitis.

　　1. Rest: Often change posture to relieve muscle spasm in the back.

　　2. Orthopedic massage and physical therapy: Can promote blood circulation, remove blood stasis, unblock meridians, and straighten tendons.

　　3. Strengthen reasonable exercise methods.

　　1. Rest: Often change posture to relieve muscle spasm in the back.

　　2. Orthopedic massage and physical therapy: Can promote blood circulation, remove blood stasis, unblock meridians, and straighten tendons.

　　3. Treatment drugs for thoracic vertebral disease: Use drugs for relaxing tendons, promoting blood circulation, and relieving pain.

　　4. Manual reduction treatment for cervical-thoracic vertebral joint subluxation.