ASSESSMENTOFTHERMALPAINSENSITIVITYVALUESIN PATIENTS WITH CONSEQUENCES OF THORACOLUMBAR SPINE INJURY

Abstract

Studying the sensitive sphere is not unimportant in determining the degree of injuring the spinal cord and its structures, the nervous system plasticity, and the processes of recovering after injury.However, little attention has been paid in the literature to the instrumental assessment of sensitivity in patients with the consequences of the thoracolumbar spine injury. Purpose of the Work. To study the features of the state of thermal pain sensitivity in patients with long-term consequences of the thoracolumbar spine injury with partial damage to the spinal cord and its structures (type B and C according to ASIA scale). Material and Мethods. A total of 22 patients with long-term consequences of the spinal cord injury in the thoracolumbar spine (type B and C, ASIA) was examined.Clinical analysis of sensory disorders was carried out according to ISNCSCI and ASIA scales. An electric esthesiometer was used to study thermal pain sensitivity in Th10-S2 dermatomes on the right and left. Results. Regardless of the type of injuries (B/C), the similar disorders were determined: hypoesthesia of thermal pain sensitivity; hyperesthesia of pain sensitivity; thermanesthesia; thermanalgesia. However, the degree and level of disordering varied. In the group of patients with type B, significant changes in thermal pain sensitivity were recorded from L1dermatome,in patients with type C – from L4. In the group of patients with type C, in comparison with the values of patients with type B, there was a decrease in the number of cases of thermanesthesia (by 38%, p=0.033) and thermanalgesia (by 64.3%, p=0.004), an increase in the proportion of dermatomes with normal pain sensitivity thresholds (by 443%, p =0.036) and with hypoesthesia of thermal sensitivity (by 52%, p=0.037). Conclusion. In patients with long-term consequences of the thoracolumbar spine injury the level of significant disorders of thermal pain sensitivity depends on the degree of traumatization of the spinal cord. In the group of patients with type B, significant changes in temperature and pain sensitivity are recorded from the dermatome L1, in patients with type C — from L4.