Evaluation of Long-Term Follow-Up Efficacy of Patients with Lumbar Myofasciitis by Infrared Thermal Imaging

Evaluation of Long-Term Follow-Up Efficacy of Patients with Lumbar Myofasciitis by Infrared Thermal Imaging

   Lumbar myofasciitis refers to a series of symptoms such as edema, exudation, and degeneration of myofascial soft tissue and muscles of the lumbar region, resulting in pain and movement disorders. It is often caused by pain points caused by trauma or overwork. The course of the disease is repeated. Due to changes in modern lifestyles, behaviors such as prolonged sitting and standing have increased the incidence of lumbar myofasciitis and the probability of acute attacks. Pain worsens and waist function is limited during acute attacks, which affects the quality of life. At present, the treatment of patients with lumbar fasciitis is mainly based on non-surgical methods, such as rest, physical therapy and traditional Chinese medicine. Extracorporeal shock wave is a non-invasive treatment method between drugs and surgery. It has definite curative effect and good patient compliance. It is mainly used in myofasciitis, tennis elbow and Achilles tendinitis and other muscle fascia and tendinopathy. Acute and chronic pain has a certain definite effect.

   Infrared thermal imaging technology uses different colors to display the intuitive image of the body surface temperature to reflect the distribution of the body surface temperature. It has the advantages of high sensitivity, safety and easy operation and other functional imaging advantages. It can assist in the diagnosis of inflammation, tumor, pain and other diseases, Therapeutic evaluation and follow-up provide new ideas, and have been applied in many diseases in recent years. As far as lumbar myofasciitis is concerned, the current domestic infrared thermal imaging technology is used to locate the main pathogenic parts of myofasciitis to guide shock wave therapy to improve the efficacy of extracorporeal shock wave therapy. However, there is no literature report on the use of infrared thermal imaging technology for long-term follow-up evaluation of its efficacy. The purpose of this study is to explore the use of the average temperature of infrared thermograms to evaluate the long-term follow-up efficacy of patients after extracorporeal shock wave treatment of patients with acute lumbar myofasciitis, so as to assist in the evaluation of the clinical treatment of patients with lumbar myofasciitis.

Figure 1. Infrared thermal imaging inspection.

   Infrared thermal imaging inspection method: use a medical infrared thermal imaging camera to examine the patient. The room temperature of the inspection room is maintained at 22-24°C, and the air has no convection and direct sunlight. The subject is prohibited from smoking, drinking, etc. the night before. The scanning area is located after full exposure before the examination, and the examination is performed after a 15-minute rest in a quiet state to detect the average temperature of the local body surface in the localized area. All included patients underwent infrared thermal imaging examinations after admission and 1 week, 1 month, and 6 months after the last treatment.

   Extracorporeal shock wave therapy: Use shock wave therapy device and choose red therapy gun. The patient takes the supine position, relaxes the waist muscles, locates the trigger point by infrared thermal imaging method, marks the trigger point with a marker, smears the coupling agent, and treats the trigger point with a shock wave therapy gun. The handle pressure is moderate, the impact frequency is 5 Hz, the pressure is between 1.5 and 2.5 bar, the pressure is gradually increased, and the impact is 2000 to 4000 pulses, once every 5 days, for a total of 5 treatments.

   Infrared thermal image image analysis and evaluation: the waist and back image data of all enrolled patients obtained by the infrared thermal imager camera are converted into gray-scale digital images with the supporting analysis software, and the average temperature of the infrared thermal image is obtained and statistically analyzed.

   The patient's curative effect was evaluated by the modified MacNab standard. It was found that the total excellent and good rates of patients with acute lumbar myofasciitis after extracorporeal shock wave treatment reached 80.2%, 86.8%, and 88.1% respectively. After treatment, the average temperature difference between the patient's VAS and the infrared thermal image of the healthy side was lower than before treatment, and the difference was statistically significant.

   Correlation analysis between the average temperature difference of the infrared thermal image of the patient's healthy side and VAS at different examination time points. The correlation analysis between the temperature difference of the infrared thermal image of the patient's healthy side and VAS at different time points before and after the treatment is carried out for correlation analysis. It can be found that the average temperature difference of the patient's infrared thermal image before and after treatment at different time points is significantly positively correlated with VAS.

   Correlation analysis between the change of the average temperature difference of the infrared thermal image of the patient's healthy side and the change of VAS before and after treatment The correlation between the change of the average temperature difference of the infrared thermal image of the patient's healthy side at different time points after treatment and the change of the VAS before and after treatment Analysis shows that there is a significant positive correlation between the two indicators at three time points after surgery.