Comparative analysis of dynamics in thermal pain sensitivity after correction of severe and mild spine deformities in patients with idiopathic scoliosis

Shchurova T.N., Prudnikova O.G., Ryabykh S.O., Lipin S.A.

Abstract


Introduction
Despite a great number of researches on idiopathic scoliosis reported there is still no instrumentation assessment of sensitivity before and after surgical correction of the curve found in literature. The purpose of the work was to explore dynamics in thermal pain sensitivity following correction of severe and mild spinal curves in patients with idiopathic scoliosis.
Material and methods
The work included results of examination of 25 patients with idiopathic scoliosis. Sampling population was divided into two groups depending on the extent of preoperative curve in major arch: Group I included patients with the curve of ≤ 60º (15 cases); Group II consisted of patients with the curve of > 60º (10 patients). Preoperative neurological examination showed no motor, reflex and sensory impairments. Acute deformity correction and spine stabilization with transpedicular systems were produced in all the cases. Thermal pain sensitivity was explored preoperatively and postoperatively at Th1-S2 dermatomes using electric esthesiometer.
Results
Disturbed thermal pain sensitivity of various extent was observed preoperatively in the study dermatomes of all patients with idiopathic scoliosis and was not shown to be dependent on the amount of the curve. Positive dynamics in thermal pain sensitivity revealed itself in reduced pain and heat thresholds and restored heat sensitivity and was observed in 41.5 to 54.1 % of the cases Group I following spine deformity correction. Deterioration was seen in 29.2 to 34.7 % of the cases. Group II showed negative dynamics in thermal pain sensitivity in 35.4 to 50 % of the cases with either increased or decreased pain threshold, enhanced heat threshold and loss of heat sensitivity. Sensitivity improved in 29.4 to 31.8 % of the patients. No changes in neurological status were noted in both groups after surgical correction with subclinical changes in thermal pain sensitivity to be considered.
Conclusion
Positive dynamics in thermal pain sensitivity prevailed in patients with idiopathic scoliosis following baseline curve correction of ≤ 60º. Negative dynamics in thermal pain sensitivity was seen in patients with baseline curve correction of > 60º with a greater risk of neurological complications.

Keywords


idiopathic scoliosis, thermal pain sensitivity, spinal deformity correction

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