Anatomy & Background
The thoracic spine, or mid back, is the largest section of the back and includes 12 vertebrae, with an intervertebral disc in-between each. The vertebrae are the bony building blocks of the back and spine. They are designed to protect the spinal cord, provide support and structure to the spine, and carry the weight of the head, neck and trunk. The vertebrae of each section of the spine are slightly different and specific to the function of that area.
Spinal and Facet Joints
All thoracic vertebral levels consist of three joints. There is one joint consisting of the intervertebral discs which connect the bodies of the vertebra. There are also two posterior and lateral joints with one on each side called facet joints. The facet joints provide support, stability and facilitate motion of the thoracic spine.
Facet joints are synovial joints, which means they have smooth shiny contact surfaces called articular cartilage. The articular cartilage allows the bones to slide freely over each other with reduced friction and stress. Each joint is also surrounded by a protective sleeve called a capsule, and is lubricated by synovial fluid. The facet joints can become irritated and inflamed producing pain and dysfunction.
Each thoracic vertebra has a pair of ribs, one on each side. The twelve ribs form the thoracic cage and serve to protect the vital organs of the body (lungs, heart, liver, kidneys, etc.) The nerves of the thoracic spine provide sensory and muscle innervations to the trunk and part of each arm. Additionally, the internal organs of the body supply these nerves.
The thoracic spine has less movement than the cervical and lumbar spine. The greatest amount of movement is forward bending. The ribs limit side bending and rotational, or turning, motions of the mid back.
Degenerative joint disease
Arthritis is a non-infectious, progressive disorder of the joints. The normal articular joint cartilage is smooth, white, and translucent. In early arthritis or joint degeneration, the cartilage becomes yellow and opaque with localized areas of softening and roughening of the surfaces. As degeneration progresses, the soft areas become cracked and worn, exposing bone under the cartilage. Eventually, osteophytes (spurs of new bone) covered by cartilage, form at the edge of the joint. As mechanical wear increases, the cartilage cells are unable to repair themselves.
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