What Are the Common Causes of Chest and Upper Back Pain?

Patients with ossification of the posterior longitudinal ligament of the thoracic vertebrae complain of persistent ambiguous back pain, and their history can last from months to years. Kenji Hannai reported that 12 patients who underwent anterior surgery had complained of persistent chest pain or fuzzy back pain.

Persistent chest pain or fuzzy back pain

Patients with ossification of the posterior longitudinal ligament of the thoracic vertebrae complain of persistent ambiguous back pain, and their history can last from months to years. Kenji Hannai reported that 12 patients who underwent anterior surgery had complained of persistent chest pain or fuzzy back pain.

Osteosclerosis of the posterior longitudinal ligament (OPLL) is not a common disease worldwide, but it is not uncommon to see hospitals in some countries in the Far East due to ossification of the posterior longitudinal ligament and paralysis of the limbs.

Affected area

chest

Affiliated Department

Other departments

Related inspections

Thoracic compression sign

(I) Causes of Onset

The cause is unknown.

(Two) pathogenesis

Like other parts of the posterior longitudinal ligament ossification, the pathogenesis of thoracic OPLL is unknown. It is generally thought to be caused by ectopic ossification of chondrocytes, but some scholars believe that it is related to fibrocartilage and internal membrane bone, and some scholars believe that degenerated intervertebral disc can affect the formation of posterior longitudinal ligament ossification.

Clinical manifestations:

1. Back pain: Thoracic lesions caused by OPLL from the onset to complete paralysis can take only a short time. However, some patients only complained of persistent fuzzy back pain when they came to the hospital, and their medical history could last for months to years. Kenji Hannai reported that 12 patients who underwent anterior surgery had complained of persistent chest pain or fuzzy back pain.

2. Paralysis of the lower limbs: It can be completely paralyzed from mild exercise weakness to severe lower limbs, and may be accompanied by different degrees of sensation. The paralysis symptoms of patients with disorders are mostly progressive.

3. Abnormal urination and dysfunction: Depending on the degree of lesions, there may be weakness in urination and incontinence.

4. Instability in walking: weakness in walking on both lower limbs, easy to fall, or stepping on cotton.

Complications: May be accompanied by complete paralysis of the lower limbs.

an examination:

1. X-ray examination: thoracic spine or tomographic X-ray films, often found ossified posterior longitudinal ligament showed a high density shadow, can be continuous or isolated.

2. Myelography: It can display the range of ossification, which is of great significance for determining the range of decompression.

3. CT examination: It has clear diagnostic significance and can measure spinal stenosis rate. CT three-dimensional reconstruction can show both the scope and shape of ossification and the degree of spinal cord compression.

4. MRI examination: can show the extent of spinal cord compression.

Chest pain is a common clinical symptom with many causes, and the location and severity of chest pain are not necessarily consistent with the location and severity of the lesion. Traumatic, inflammation, tumor and tissue damage caused by some physical and chemical factors stimulate intercostal nerves, phrenic nerves, posterior roots of spinal nerves and vagus nerves distributed in the esophagus, bronchi, lung, pleura, nerve endings of the heart and aorta can cause Chest pain.

Overworked, gallbladder inflammation or gallbladder stones, cold and cold, insufficient blood can cause back pain.

Clinical manifestations:

1. Back pain: Thoracic lesions caused by OPLL from the onset to complete paralysis can take only a short time. However, some patients only complained of persistent fuzzy back pain when they came to the hospital, and their medical history could last for months to years. Kenji Hannai reported that 12 patients who underwent anterior surgery had complained of persistent chest pain or fuzzy back pain.

2. Paralysis of the lower limbs: It can be completely paralyzed from mild exercise weakness to severe lower limbs, and may be accompanied by different degrees of sensation. The paralysis symptoms of patients with disorders are mostly progressive.

3. Abnormal urination and dysfunction: Depending on the degree of lesions, there may be weakness in urination and incontinence.

4. Instability in walking: weakness in walking on both lower limbs, easy to fall, or stepping on cotton.

Complications: May be accompanied by complete paralysis of the lower limbs.

an examination:

1. X-ray examination: thoracic spine or tomographic X-ray films, often found ossified posterior longitudinal ligament showed a high density shadow, can be continuous or isolated.

2. Myelography: It can display the range of ossification, which is of great significance for determining the range of decompression.

3. CT examination: It has clear diagnostic significance and can measure spinal stenosis rate. CT three-dimensional reconstruction can show both the scope and shape of ossification and the degree of spinal cord compression.

4. MRI examination: can show the extent of spinal cord compression.

Treatment: Once the thoracic spine OPLL is diagnosed, it usually requires surgery, but for some patients with initial symptoms, conservative treatment can be tried, including rest, braking, physical therapy, oral anti-inflammatory analgesics and neurotrophic drugs. Common surgical methods for thoracic spine OPLL include laminectomy, laminoplasty, anterior or posterior ossification ligament resection, and bone graft fusion.

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Back pain, persistent chest pain or blurred back pain, urinary incontinence, gallbladder stones, inflammation of the spinal cord, compression of the spinal cord, paralysis, weakness, chest pain, easy fall