Mobility of the thoracic vertebrae
Forward and backward tilting is mainly performed via the BWS. The body can be bent about 45° forward and 26° backward. Lateral inclination of the thoracic vertebrae can be between 25° and 35°. In addition, the thoracic spine can be rotated around its own axis. The circumference is about 33°.
Clinical examination
In general, an anamnesis, a conversation, is conducted first, followed by a detailed physical examination. During this examination, the scope of movement is to be evaluated. There are two important tests for this.
The Ott sign: A measuring tape is taken from the seventh cervical vertebra in a standing patient and a line is marked 30 cm below. Now the patient must bend forward. The stretching of the vertebrae should be about 3-4 cm. For lateral flexion, the finger-knee distance is measured.
Injuries of the thoracic vertebrae
Pain in the thoracic spine occurs frequently and can have different pain characteristics. They are often described as dull between the shoulder blades or as belt-like pain in the thoracic region. The reasons for chest pain are many and varied; it can affect the skeleton, as well as muscles, ligaments or internal organs, which is why a doctor should be consulted.
One cause of pain can be a herniated disc in the thoracic vertebrae. However, they are very rare and can be treated with appropriate pain therapy, as well as anti-inflammatory and muscle-relaxing medication. In most cases, a physiotherapeutic treatment also brings an improvement of the symptoms.
In rare cases, surgical measures are performed and only if the herniated disc presses on the spinal cord or nerves or if there is a risk of paraplegia. Often in older people, especially women, small traumas due to osteoporosis are sufficient to trigger a vertebral fracture. Pain and immobility are frequent consequences.
As a therapeutic measure, the fractured vertebra is straightened and filled with bone cement. This operation is called balloon kyphoplasty. Sometimes this type of surgery is not possible and a stiffening of the vertebrae must be performed (spondylodesis).
In young people, adequate trauma must be applied to cause a fracture. In the first instance, balloon kyphoplasty is also performed here and only in the case of unstable fractures or significant kyphosis does stiffening surgery become necessary. About 15% of all spinal fractures affect the thoracic spine.
They are mostly caused by high speed traumas. The consequences are mainly compression fractures. Since the spinal canal at the level of the thoracic vertebrae generally has little reserve space, a narrowing of 20% is sufficient to cause complete paralysis.
The spinal cord is affected in 2/3 of all injuries. The extent of the injury is recorded by means of various imaging techniques (e.g. MRI of the thoracic spinal cord) and individually treated. Conservative treatment is sufficient for stable fractures, but unstable fractures require immediate surgery to restore the axes and stability and to relieve the spinal cord.
In addition to open surgical procedures, minimally invasive and thoracoscopic techniques are available today. However, the type of surgical treatment depends on the type of fracture and the experience of the surgeon. Scoliosis is another important clinical picture, as it is particularly pronounced in the thoracic vertebrae. This is an extreme sideways inclination of the spine, which can lead to some problems.
