Primena infracrvene termovizijske kamere u dijagnostici i proceni terapijskog efekta fizikalnih agenasa kod lumbosakralne radikulopatije

Abstract

Introduction: Lumbosacral radiculopathy (LSR) occurs due to the dysfunction of the spinal nerve root in the lumbosacral region of the spine. Temperature asymmetry of the lower extremities caused by vasomotor dysfunction can be visualized and accurately detected by infrared thermovision camera. Objective: To examine the importance of infrared thermovision camera in diagnosis of LSR and assess therapeutic effect of physical modalities by evaluation of thermographic, clinical and functional parameters. Method: The study included 75 patients with unilateral LSR, which was diagnosed by clinical and electromioneurographic examinations. The patients were divided into three groups. Group A was treated by low level laser and kinesitherapy. Group B was treated by transcutaneous electrical nerve stimulation (TENS) and kinesitherapy. Group C was treated only by kinesitherapy. The tested parameters included: pain intensity at rest and during active movement (visual analogue scale), lumbar movement (finger-floor test, Schober test) and functional disability (Oswestry Disability Index). Infrared thermovision camera recorded the regions of interest (ROIs) in lower extremities.The quantitative analysis of the obtained thermograms determined ROIs with maximum values of the thermal deficit (maxΔТ), then max ΔТ correlation with each tested parameter was examined. Results: There was significant correlation of max ΔТ with the degree of spinal roots`lesion as well as with parameters of clinical and functional examinations. The therapeutic effect of physical modalities was assessed by comparative analysis of parameters of thermographic, clinical and functional examinations obtained before and after treatment. The applied therapy protocols achieved a good therapeutic effect in LSR but combined application of low level laser and kinesytherapy achieved significantly better therapeutic effect than combined application of TENS and kinesitherapy with respect to all tested parameters. Conclusion: The results showed that infrared thermography can be used in diagnosis and assessment of therapeutic effect of physical modalities in unilateral LSR. Laser therapy was proved to be superior compared to TENS in LSR.