To clarify the relationship of skin temperature changes to clinical, radiologic, and electrophysiological findings in unilateral lumbosacral radiculopathy and to delineate the possible temperature-change mechanisms involved.
One hundred and one patients who had clinical symptoms and for whom there were physical findings suggestive or indicative of unilateral lumbosacral radiculopathy, along with 27 normal controls, were selected for the study, and the thermal-pattern results of digital infrared thermographic imaging (DITI) performed on the back and lower extremities were analyzed. Local temperatures were assessed by comparing the mean temperature differences (ΔT) in 30 regions of interest (ROIs), and abnormal thermal patterns were divided into seven regions. To aid the diagnosis of radiculopathy, magnetic resonance imaging (MRI) and electrophysiological tests were also carried out.
The incidence of disc herniation on MRI was 86%; 43% of patients showed electrophysiological abnormalities. On DITI, 97% of the patients showed abnormal ΔT in at least one of the 30 ROIs, and 79% showed hypothermia on the involved side. Seventy-eight percent of the patients also showed abnormal thermal patterns in at least one of the seven regions. Patients who had motor weakness or lateral-type disc herniation showed some correlations with abnormal DITI findings. However, neither pain severity nor other physical or electrophysiological findings were related to the DITI findings.
Skin temperature change following lumbosacral radiculopathy was related to some clinical and MRI findings, suggesting muscle atrophy. DITI, despite its limitations, might be useful as a complementary tool in the diagnosis of unilateral lumbosacral radiculopathy.
Citations
The present study was designed to investigate the effects and action mechanism of electrical stimulation on functional recovery following spinal cord injury in Sprague-Dawley rats. Electrical stimulation with 0.2 ms, 20 Hz, 1-3 V was applied to the sciatic nerve for 4 hours/day during 6 days following dorsal hemisection of the T10 spinal cord. After 7 days of spinal cord injury, mechanical properties of muscle contraction including contraction time, half relaxation time, maximum twitch tension, maximum tetanic tension, and fatigue index were measured in the soleus and medial gastrocnemius muscles, and the number of c-fos immunoreactive cells was counted in the upper lumbar cord. In mechanical properties of muscle contraction of normal rats, contraction time and half relaxation time of the soleus muscle were 1.5 times and 2 times as long as those of the medial gastrocnemius muscle, respectively. And fatigue index of the soleus muscle was 0.19⁑0.4 and the medial gastrocnemius muscle was 0.82⁑0.03. According to the above characteristics, the soleus muscle was mainly composed of slow muscle fibers and the medial gastrocnemius muscle was composed of fast muscle fibers. Maximum twitch tension, maximum tetanic tension, and fatigue index of both muscles following spinal cord injury were decreased significantly compared to the control group (p<0.01). In electrically stimulated rats following spinal cord injury, maximum twitch tension, maximum tetanic tension, and fatigue index were significantly increased compared to spinal cord injured rats. The number of c-Fos immunoreactive cells was increased markedly at the upper lumbar cord in electrically stimulated rats.
These results may suggest that electrical stimulation not only prevents from muscle atrophy in slow and fast muscles through efferent nerve fibers, but also promotes functional plasticity through afferent nerve fibers by activating silent synapse and regulation of receptors for neurotransmitters.
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