Usage of local infrared thermometry to objectify local and regional somatic dysfunctions in patients with cervical dorsopathy

Introduction. The specific object of osteopathic physician’s work is somatic dysfunction (SD). It is generally accepted, based on the basic concepts of anatomy and physiology, to distinguish three components in SD: biomechanical, hydrodynamic and neurodynamic. These disturbances in the body can be defined at different levels — local, regional and global. However, there are very few studies aimed at objectifying SD, revealing the pathophysiological mechanisms of their formation, and substantiating the separation of disorders at different levels. Recently, the notion of «non-infectious epidemic» in relation to dorsopathies and related pain syndromes has been heard. At the same time, despite the variety of diagnostic methods, a multitude of existing drugs and conventional medicine techniques, as well as advances in the field of spinal neurosurgery, many issues of treatment and rehabilitation of patients with neurological manifestations of degenerative spinal diseases remain unresolved. The aim of the study : to compare local temperature indices in areas of local and regional SD in patients with cervical dorsopathy. Materials and methods. In the cross-sectional study, 462 patients diagnosed with cervical spine dorsopathy were examined. All patients were assessed for osteopathic status based on clinical guidelines. Local temperature was also measured using a portable infrared thermometer along the posterior surface of the neck with calculation of mean values and thermoasymmetry. Results. The vast majority of the examined patients — 408 (88 per 100 examined) were diagnosed with regional biomechanical disorders: regions of the thoracic and pelvis, structural and visceral components; regions of the dura mater, neck, structural component. SDs of local level were detected in all examined patients. The most frequently identified dysfunctions were: spinal motor segments (SMS) of the cervical, thoracic and lumbar spine, visceral, individual sutures of the skull, joints of the lower extremities. Patients with regional biomechanical disturbance at the neck level are characterized by statistically significantly ( p <0,05) lower average temperature values in this area compared to patients with local dysfunctions and without dysfunctions of this area. From the physiological point of view it is more important not just average temperature indices in this or that area, but the presence of functionally significant (>0,4 °C) thermoasymmetry. It turned out that in patients with regional SD (neck region, structural component) the values of thermoasymmetry are statistically significantly higher ( p <0,05) compared to patients without SD or with local SD at the neck level. Conclusion. According to the results of local infrared thermometry in the area of regional biomechanical disturbance at the neck level, patients with dorsopathy have a decrease in local temperature, as well as the presence of functionally significant (>0,4 °С) thermoasymmetry in comparison with patients in whom at this level either local level SDs were diagnosed or no dysfunction was detected at all. The obtained data allow us to speak about the validity of differentiation of dysfunctions of different levels, as well as objectify the hydrodynamic component of SD.