Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, 10444, Goyang, Republic of Korea.
Department of Rehabilitation Medicine, Pohang Stroke and Spine Hospital, 37659, Pohang, Republic of Korea.
BMC Musculoskelet Disord. 2023 Jan 31;24(1):79. doi: 10.1186/s12891-023-06193-4.
Digital infrared thermal imaging (DITI), which detects infrared rays emitted from body surface to create a body heat map, has been utilized at various musculocutaneous conditions. Notably, DITI can demonstrate autonomic vasomotor activity in the nerve-innervated area, and thus may be of use in carpal tunnel syndrome (CTS). In this study, we compared DITI findings before and after carpal tunnel release (CTR) surgery in patients with unilateral CTS to investigate the corresponding neurophysiological changes.
In this retrospective cohort study, DITI parameters such as the temperature differences between the median and ulnar nerve territories and median nerve-innervated digital anisometry were measured. Subjective symptom duration, pain scale, and ultrasonographic findings were also compared before and after CTR. Patients were evaluated before and 6 weeks after CTR, respectively.
A total of 27 patients aged 59.0 ± 11.2 years were finally included. After CTR, median nerve-innervated thermal anisometry was improved (2.55 ± 0.96 °C to 1.64 ± 1.34 °C; p = 0.003). The temperature differences between the median and ulnar nerve territories were not significantly changed. Subjective pain, the Simovic Weinberg Clinical Scale, and palmar bowing of the flexor retinaculum were also significantly improved (p < 0.001 for all comparisons).
Our results demonstrated that DITI findings could reflect an improvement in autonomic function after CTR. Therefore, DITI can be an objective method to assess pre- and post-operative neurophysiologic changes in CTS.
数字红外热成像(DITI)通过检测人体表面发射的红外线来创建体温图,已应用于各种肌肉皮肤疾病。值得注意的是,DITI 可以显示神经支配区域的自主血管运动活动,因此可能对腕管综合征(CTS)有用。在这项研究中,我们比较了单侧 CTS 患者腕管松解(CTR)前后的 DITI 结果,以研究相应的神经生理变化。
在这项回顾性队列研究中,测量了 DITI 参数,如正中神经和尺神经区域之间的温差以及正中神经支配的手指各向异性。还比较了 CTR 前后的主观症状持续时间、疼痛量表和超声检查结果。患者分别在 CTR 前和 6 周后进行评估。
共有 27 名年龄 59.0±11.2 岁的患者最终纳入研究。在 CTR 后,正中神经支配的热各向异性得到改善(2.55±0.96°C 至 1.64±1.34°C;p=0.003)。正中神经和尺神经区域之间的温差没有明显变化。主观疼痛、Simovic Weinberg 临床量表和屈肌支持带的掌弓也明显改善(所有比较均 p<0.001)。
我们的结果表明,DITI 结果可以反映 CTR 后自主功能的改善。因此,DITI 可以成为评估 CTS 术前和术后神经生理变化的客观方法。