Thermatomal changes in cervical disc herniations

Subjective symptoms of a cool or warm sensation in the arm could be shown objectively by using of thermography with the detection of thermal change in the case of radiculopathy, including cervical disc herniation (CDH). However, the precise location of each thermal change at CDH has not been established in humans. This study used digital infrared thermographic imaging (DITI) for 50 controls and 115 CDH patients, analyzed the data statistically with t-test, and defined the areas of thermatomal change in CDH C3/4, C4/5, C5/6, C6/7 and C7/T1. The temperature of the upper trunk and upper extremities of the control group ranged from 29.8 degrees C to 32.8 degrees C. The minimal abnormal thermal difference in the right and left upper extremities ranged from 0.1 degree C to 0.3 degree C in 99% confidence interval. If delta T was more than 0.1 degree C, the anterior middle shoulder sector was considered abnormal (p < 0.01). If delta T was more than 0.3 degree C, the medial upper aspect of the forearm and dorsal aspect of the arm, some areas of the palm and anterior part of the fourth finger, and their opposite side sectors and all dorsal aspects of fingers were considered abnormal (p < 0.01). Other areas except those mentioned above were considered abnormal if delta T was more than 0.2 degree C (p < 0.01). In p < 0.05, thermal change in CDH C3/4 included the posterior upper back and shoulder and the anterior shoulder. Thermal change in CDH C4/5 included the middle and lateral aspect of the triceps muscle, proximal radial region, the posterior medial aspect of the forearm and distal lateral forearm. Thermal change in CDH C5/6 included the anterior aspects of the thenar, thumb and second finger and the anterior aspects of the radial region and posterior aspects of the pararadial region. Thermal change in CDH C6/7 included the posterior aspect of the ulnar and palmar region and the anterior aspects of the ulnar region and some fingers. Thermal change in CDH C7/T1 included the scapula and posterior medial aspect of the arm and the anterior medial aspect of the arm. The areas of thermal change in each CDH included wider sensory dermatome and sympathetic dermatome. There was a statistically significant change of temperature in the areas of thermal change in all CDH patients. In conclusion, the areas of thermal change in CDH can be helpful in diagnosing the level of disc protrusion and in detecting the symptomatic level in multiple CDH patients.

Thermatomes of the Lumbosacral Nerve Roots

Thermography shows the skin temperature changes in various conditions of the body. The skin temperature varies according to subcutaneous blood flow under the control of autonomic nervous system. Lumbar radiculopathy due to disc hernation makes difference in the temperature of lower extremities caused by the changes in general functions and autonomic functions of the nerve root. Digital infrared thermographic imaging(DITI) system has been used to diagnose radiculopathy without any hazards or discomforts and shows the pain due to LDH by objective change of temperature. This study has used DITIs of 55 control cases and 217 cases of LDH patients and analysed it statistically. In the room the temperature stable at 20 degrees C, the temperature distribution of the lower extremities of the control cases ranged from 24.9 degrees C to 29.9 degrees C. The significant minimal temperature difference between right and left lower extremities range from 0.1 degrees C to 0.4 degrees C. The more distal, the greater the temperature difference was. The thermatome of L4, L5 and S1 was drawn in radiating type and spot type. The thermatome showed larger area than the sensory dermatome and sympathetic dermatome. There was significant increase or decrease of temperature in thermatome in LDH patients. In conclusion, preoperative DITI of the LDH patient can be helpful for diagnosing the level of LDH and the areas of pain.

Digital Infrared Thermographic Imaging(D.I.T.I.) in Herniated Lumbar Disc Patients

Thermography is a sensitive and reliable method for diagnosis of radiculopathy. Skin temperature alterations of the involved dermatome named thermatone are diagnostic for sensory root involvement in radiculopathy which can be demonstrated by thermography. Digital infrared thermographic imaging system using computer is development and could measure thermal difference more exactly without hazards or discomforts to patient. Authors present 186 cases of thermographic evaluation in herniated lumbar disc disease by digital infrared thermographic imging system and the results are evaluated with literature review.