Application—Infrared Thermal Imaging To Evaluate Lumbar Disc Herniation

Infrared Thermal Imaging To Evaluate Lumbar Disc Herniation

   Lumbar intervertebral disc herniation (LDH) is a common clinical spine disease, mainly manifested as low back pain and radiating pain in the lower limbs of the related nerve distribution area, which can seriously affect the patient's quality of life. Studies have shown that 80% of people in the world will be affected by LDH at a certain stage of their lives, and 1% to 3% of the population may be unable to live and work normally due to LDH, causing a considerable economic burden on individuals and the medical security system. In the past ten years, the technology of spinal endoscopy has matured nationwide, but some patients are discouraged due to economic reasons, resulting in poor efficacy. Therefore, in clinical treatment, it is necessary to find some relatively simple and economical treatment methods.

   Foraminal ligament lysis is a new method for the treatment of LDH and lumbar spinal stenosis. There is evidence that foraminal ligament lysis can relieve neuralgia caused by LDH and lumbar spinal stenosis, and can be used as an effective treatment for LDH select. The advantage of this operation is that the operation damage is minimal under local anesthesia, and the normal spine structure is not damaged, but the target point is reached, the internal and external ligaments of the intervertebral foramina are loosened, and the nerve root is decompressed to a certain extent. During the operation, the special blunt release kit can be used to safely dissect the dural sac and nerves without damaging the dural sac and nerves. At the same time, the operation only takes about half an hour, which is suitable for patients who cannot tolerate prolonged prone positions, especially elderly patients It is more suitable; no consumables are needed during the operation, and the operation cost is low; for the surgeon, the learning curve is short and the operation technique is easy to master.

Figure 1. Infrared thermal image before and after surgery.

   Medical infrared thermal imaging technology can measure human body surface temperature non-destructively and conveniently and provide objective quantitative data. Symmetrical parts of the body of healthy people have a high degree of thermal symmetry, and the inconsistency of skin temperature often indicates certain inflammation and musculoskeletal pathological changes. Studies have shown that there is a correlation between the results of magnetic resonance imaging and infrared thermal imaging data. The skin temperature of the infrared thermal imaging of the side of the MRI nerve root in LDH patients is lower, and the temperature difference and VAS of the corresponding distribution area of the lower extremity nerves of LDH patients. , JOA score correlation. Compared with VAS and JOA scores, infrared thermal imaging images are more intuitive and sensitive, and can reflect earlier whether the nerve roots of the corresponding segment are involved, and provide a reference for evaluating the recovery of nerve root decompression. Because it is easily affected by the ambient temperature, a special temperature-controlled infrared thermal imaging room should be set up to be checked by a dedicated person. The temperature difference between the lower limbs is used as the observation index to avoid the interference of external factors and the influence of its own temperature fluctuation.

   In the study, a short focal length uncooled far-infrared thermal imaging camera was used to detect the temperature of both lower extremities of the patient before and after the operation, and to compare the ΔT of the corresponding distribution areas of the lower extremities before and after the operation. The ΔT of the corresponding distribution area of the nerves in the lower extremities of the patient's infrared thermography 7 days after the release of the foraminal ligament was significantly lower than that before the operation (P <0.01). The Pearson correlation coefficient analysis of the postoperative patient’s VAS score and the infrared thermography ΔT showed that the r value was 0.82, P <0.01, and the two showed a significant positive correlation. The Pearson correlation coefficient analysis of postoperative patient JOA score and infrared thermography ΔT showed that the r value was -0.83, P<0.01, and there was a significant negative correlation between the two.

   In summary, the treatment of LDH by intervertebral foraminal ligament lysis has a positive effect, is safe and simple, has a good clinical application prospect, and is worthy of promotion. Infrared thermal imaging can provide an objective basis for the diagnosis and efficacy evaluation of LDH, and can be used as an auxiliary evaluation method to help clinicians better grasp the development and outcome of the disease. The number of samples in this study is small, and the cases have not been followed up for a long time. Due to the geographical characteristics of patients, most of the patients come from suburbs and counties and other places. The infrared thermography of patients after 1 month of surgery is less effective for follow-up. The long-term effects of infrared thermal imaging data need to be further explored, and we look forward to future large-sample prospective controlled studies.