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General Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Spinal nerve impingement from intervertebral disc protrusion or single-level foraminal stenosis does not cause dermatomal thermographically visible areas. The thermal finding of increased local warmth due to loss of sympathetic tone comes from the sympathetic trunks, not the spinal cord. The sympathetic trunks communicate both upward and downward across the dermatomes, thus compensating for and obscuring any sympathetic deficit caused by a single spinal nerve root compression. Paraspinal heat conducted from local muscle spasm caused by the pain of spinal nerve impingement may be present, however. Skin warmth along a strictly dermatomal pattern should suggest nerve damage at or distal to the sympathetic trunks and proximal to the brachial or lumbar nerve plexuses. Due to stimulation of the corresponding sympathetic segment by the compressed nerve root causing increased vasoconstriction, the involved limb may have a cool area that corresponds roughly to the distribution of that nerve root.178
Computer-Aided Diagnosis of Spinal Abnormalities
Published in de Azevedo-Marques Paulo Mazzoncini, Mencattini Arianna, Salmeri Marcello, Rangayyan Rangaraj M., Medical Image Analysis and Informatics: Computer-Aided Diagnosis and Therapy, 2018
Marcello H. Nogueira-Barbosa, Paulo Mazzoncini de Azevedo-Marques
Ruiz-España et al. (2015) also described a computer-aided approach to classify degenerative lumbar spinal disease based on the classification of Pfirrmann et al. (2001). They used a set of 52 lumbar intervertebral discs from 14 patients for training and a set of 243 lumbar intervertebral discs from 53 patients for testing. The authors used T2-weighted sagittal and axial 1.5T lumbar spine MRI. The same radiologist performed classification according to Pfirrmann et al. (2001) for disc degeneration and also classified each intervertebral disc morphology as normal, bulging disc or herniated disc (protrusion or extrusion). Semiautomatic analyses were performed by the same engineer blinded to the radiologist’s classifications. The manual tasks were limited to placing a seed point in the intervertebral disc. A signal intensity method was used for segmentation and to detect spinal stenosis. They used the gradient vector flow algorithm to extract disc shape features and to detect contour abnormalities. The authors reported high reproducibility in the diagnosis of intervertebral disc herniation and spinal canal stenosis. The method was not adequate to identify correctly disc bulging. The CAD system presented was able to detect and also quantify spinal canal narrowing.
Associations between lower back pain and job types in South Korean male firefighters
Published in International Journal of Occupational Safety and Ergonomics, 2021
MRI has opened up new possibilities for refined diagnostic classification of mechanical LBP in epidemiological research. Various abnormalities can be identified on spinal MRI, including disc herniation and nerve root impingement [28]. Endean et al. [28] reported that disc protrusion is the MRI abnormality most strongly associated with LBP, followed by disc degeneration, high-intensity zone/annular tear and nerve root displacement or compression (canal stenosis). However, even disc protrusion did not help to predict the occurrence of back pain [28]. While the prevalence of LBP in firefighters was associated with more than disc protrusion, it was associated with central canal stenosis in controls. Lumbar disc herniation, where the most common site is toward the bottom of the spine at L4–L5 or L5–S1, makes up the vast majority of spinal disc herniation cases (95%) [29]. Foraminal stenosis more frequently involves the L5 nerve root, as the L5–S1 foramen has a smaller foramen/root area ratio [29]. Considering the low LBP prediction rate of MRI findings, it is difficult to explain the difference in MRI findings significant for LBP in the firefighters and controls. However, we suggest that the MRI findings may be meaningful to compensate for the effect of spine abnormalities.