Thermatomal changes in cervical disc herniations. Zhang HY, Kim YS, Cho YE;
Department of Neurosurgery, Yongdong Severance Hospital, Yonsei College of Medicine, Seoul, Korea.
hyzhang@unitel.co.kr
Subjective symptoms of a cool or warm sensation in the arm could be shown objectively by using of
thermography with the detection of thermal change in the case of radiculopathy, including cervical disc
herniation (CDH). However, the precise location of each thermal change at CDH has not been
established in humans. This study used digital infrared thermographic imaging (DITI) for 50 controls and
115 CDH patients, analyzed the data statistically with t-test, and defined the areas of thermatomal change
in CDH C3/4, C4/5, C5/6, C6/7 and C7/T1. The temperature of the upper trunk and upper extremities 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 extremities ranged from 0.1 degree C to 0.3 degree C in 99%
confidence interval. If delta T was more than 0.1 degree C, the anterior middle shoulder sector was
considered abnormal (p < 0.01). If delta T was more than 0.3 degree 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 opposite 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 degree C (p
< 0.01). In p < 0.05, thermal change in CDH C3/4 included the posterior upper back and shoulder and the
anterior shoulder. Thermal change in CDH C4/5 included the middle and lateral aspect of the triceps
muscle, proximal radial region, the posterior medial aspect of the forearm and distal lateral forearm.
Thermal change in CDH C5/6 included the anterior aspects of the thenar, thumb and second finger and
the anterior aspects of the radial region and posterior aspects of the pararadial region. Thermal change
in CDH C6/7 included the posterior aspect of the ulnar and palmar region and the anterior aspects of the
ulnar region and some fingers. Thermal change in CDH C7/T1 included the scapula and posterior medial
aspect of the arm and the anterior medial aspect of the arm. The areas of thermal change in each CDH
included wider sensory dermatome and sympathetic dermatome There was a statistically significant
change of temperature in the areas of thermal change in all CDH patients. In conclusion, the areas of
thermal change in CDH can be helpful in diagnosing the level of disc protrusion and in detecting the
symptomatic level in multiple CDH patients.
www.spectronir.com