The relationship between the change in digital infrared thermography imaging and preoperative and postoperative pain or disability in HNP patients

Abstract

Surgery is recommended as the best intervention for patients with herniated nucleus pulposus (HNP) who have associated sciatic pain and low back pain. Unfortunately, some patients have poor surgical outcomes and many continue to have low back and leg pain. This study investigated the differences in operative results in HNP patients by comparing preoperative and postoperative conditions such as fluctuation of temperature gradient, pain, or disability level. The study included 40 HNP subjects (20 male and 20 female; 38.7±3.3 years old, body weight 63.7±3.6 kg, and height 166.4±1.7 cm) and 40 healthy matched controls. We used an IRIS-5000 as the digital infrared thermographic imaging (DITI) device. We evaluated all subjects before and after the HNP operation period using a numerical rating scale (NRS), the short form-McGill pain questionnaire (SF-MPQ), and the Oswestry disability questionnaire (ODQ). The temperature of the plantar surface in the control group showed no body side dependent differences, but a lower temperature was seen on the affected side compared with those non-affected side in subjects with HNP. The temperature of the plantar surface was recovered postoperation in HNP patients. The pain scale scores, which included NRS, SF-MPQ (sensory), SF-MPQ (psychological), and ODQ, showed a significant decrease in HNP patients after the operation when compared with the scores of the control subjects. The results suggest that an optimally effective examination for rehabilitation of HNP patients should consist of comparison of biophysical measurements before and after the HNP operation. Future studies may focus on development of a postoperative intervention for a healthy lifestyle that will be acceptable to both surgeons and physiotherapists alike.