Thermatomal changes in cervical disc herniations

Subjective symptoms of a cool or warm sensation in the arm could be shown o bjectively by using of thermography with the detection of thermal change in the case of radiculopathy, including cervical disc herniation (CDH). Howev er, the precise location of each thermal change at CDH has not been establi shed in humans. This study used digital infrared thermographic imaging (DIT I) for 50 controls and 115 CDH patients, analyzed the dat a statistically w ith t-test, and defined the areas of thermatomal change in CDH C-3/4, C-4/5 , C-5/6, C-6/7 and C-7/T1. The temperature of the upper trunk and upper ext remities of the control group ranged from 29.8 degrees C to 32.8 degrees C. The minimal abnormal thermal difference in the right and left upper extrem ities ranged from 0.1 degrees C to 0.3 degrees C in 99% confidence interval . If Delta T was more than 0.1 degrees C, the anterior middle shoulder sect or was considered abnormal (p<0.01). If Delta T was more than 0.3 degrees C , the medial upper aspect of the forearm and dorsal aspect of the arm, some areas of the palm and anterior part of the fourth finger, and their opposi te side sectors and all dorsal aspects of fingers were considered abnormal (p<0.01). Other areas except those mentioned above were considered abnormal if Delta T was more than 0.2 degrees C (p<0.01). In p<0.05, thermal change in CDH C-3/4 included the posterior upper back and shoulder and the anteri or shoulder. Thermal change in CDH Cia included the middle and lateral aspe ct of the triceps muscle, proximal radial region, the posterior medial aspe ct of the forearm and distal lateral forearm. Thermal change in CDH C-5/6 i ncluded the anterior aspects of the thenar, thumb and second finger and the anterior aspects of the radial region and posterior aspects of the pararad ial region. Thermal change in CDH Gn included the posterior aspect of the u lnar and palmar region and the anterior aspects of the ulnar region and som e fingers. Thermal change in CDH C-7/T1 included the scapula and posterior medial aspect of the arm and the anterior medial aspect of the arm. The are as of thermal change in each CDH included wider sensory dermatome and sympa thetic dermatome. There was a statistically significant change of temperatu re in the areas of thermal change in all CDH patients. In conclusion, the a reas of thermal change in CDH can be helpful in diagnosing the level of dis c protrusion and in detecting the symptomatic level in multiple CDH patient s.