Effects of Stenosis in the Thoracic Spine
Where stenosis (narrowing) of these foramina occurs the nerves can become trapped and pain, altered sensation, motor difficulties and even organ dysfunction may arise as a result. Thoracic spinal stenosis can cause breathing difficulties in some patients and, whilst rare, may require immediate attention to decompress the spine. Even minor trauma to the back can cause spinal cord injury (SCI) in those with spinal stenosis and an SCI at the thoracic level could lead to paralysis of the intercostal muscles and other muscles involved in breathing.
Symptoms of Thoracic Spinal Stenosis
Nerves which exit the thoracic spine are not just responsible for innervating respiratory muscles, however, they also extend far into the body to organs and other muscles. As such, injury at the mid-level of the spine, causing thoracic spinal stenosis and nerve or spinal cord compression can have an effect at any level below the site of injury, even into the legs. Total loss of sensation may occur or patients may experience intermittent numbness and paraesthesia with progressive weakness if this ‘pins and needles’ sensation is not adequately addressed.
Muscle Atrophy, Paralysis and Breathing Problems
Thoracic spinal stenosis that goes untreated can lead to irreversible neurological injury and atrophy of the muscles as they are no longer receiving signals from motor neurons. Respiratory difficulties and weakness in the legs are two possible symptoms of thoracic spinal stenosis that has led to muscle weakness or paralysis. This may begin as muscle spasms, cramps, and uncontrollable movements or gait disturbances. Continued spasms of the muscles may trigger muscle fatigue and pain, followed by weakness. Where these symptoms are severe it is sometimes necessary to undergo back surgery to decompress the thoracic spine in an attempt to restore functional gait and mobility.
Diagnosing Thoracic Spinal Stenosis
Another possible sign of thoracic spinal stenosis is an acute issue of orthostatic hypotension. This is a condition involving low blood pressure when changing position, such as when standing suddenly after sitting or lying down. Blood pressure disturbances are connected to thoracic spinal stenosis in some cases due to damage to the nerves that control the muscle tone of blood vessels. Dizziness may not seem an obvious sign of spinal stenosis but it may be an important diagnostic sign in those with intermittent and disparate symptoms.
Causes of Thoracic Spinal Stenosis
Thoracic spinal stenosis may be a result of back trauma, congenital defect, wear and tear, or even the knock-on effects from back surgery in the lumbar or cervical spine. Generally, thoracic spinal stenosis is less common than stenosis in the other spinal sections due to its relative stability and, thus, reduced wear and tear. However, where it does arise, the symptoms of stenosis in the thoracic spine can be quite different from those expected from stenosis in the neck or lower back. The usual culprits of degenerative disc disease, bone spurs, arthritis, and disc herniation can all cause thoracic spinal stenosis, as can ligament calcification and adjacent segment syndrome after back surgery.
Treating Thoracic Spinal Stenosis
Treatment for thoracic spinal stenosis depends on the severity and progression of the condition and may involve physical therapy, pain medications and other conservative options for several months before back surgery is suggested. In some cases it may simply be a matter of time and rest or limited activity that is needed to allow the spine to heal after incurring some trauma. A back brace could be helpful for some patients but may actually hinder the healing process and lead to further muscle atrophy in others so it is important to consult a qualified physician before applying any treatments for thoracic spinal stenosis.