Infrarotanalyse der regionalen Temperaturänderungen durch Rückenmarkelektrostimulation: Eine Observationsstudie
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Electrical spinal cord stimulation is an established procedure that can be used for therapy-refractory chronic neuropathic pain. One challenge is the patient selection for therapy with spinal cord stimulation. With our study, we wanted to find out whether measuring the change in skin temperature caused by this therapy procedure could be an objective indicator to document the effectiveness of this treatment. An increase in the temperature of the skin could be among other things associated with sympatholysis and associated dilation.
An infrared camera offers the possibility of detecting regional temperature differences on the body surface of patients in a non-invasive way and with reasonable effort. This procedure was used in this study on 25 patients with an implanted spinal cord stimulator. The camera was used to document the temperature of a region assigned to the pain localization over a period of 60 minutes.
The results of our study provide a statistically significant confirmation of our hypothesis. By rejecting the null hypothesis (H0), we were able to rule out the possibility of no temperature increase with an error probability of 5%. These findings confirm the assumption that a temperature increase is indeed taking place. The study design of an observational study does not test two alternative hypotheses, but presents an analysis of the current situation. In our study, we noticed a dispersion of temperature. To investigate this observation in more detail, we conducted a post-hoc analysis. We found out that there are some patients who have reliably experienced an increase in temperature, while others have not.
We suspect that these contradictory results are due to the fact that the neuropathies of our patients are associated with varying degrees of sympathetic nerve dysfunction. Symphaticolysis is only to be expected, if the autonomic nervous system is intact. In conclusion, it can be stated, that the temperature increase is not an objective parameter for testing the indication of spinal cord electrical stimulation for chronic neuropathic pain. Nevertheless, it is important that future studies focus on researching objective parameters in order to optimize the treatment.
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This item has been published with the following license: In Copyright