A Study on Subjective Symptoms and Plantar Temperature Imbalance in Lumbar Spinal Stenosis: A Preliminary Study

Background Symptoms of lumbar spinal stenosis (LSS) are associated with changes in blood flow to lower limbs. These changes in blood flow can be perceived as temperature variations, which can be visualized using thermography. We compared the relationship between the subjective symptoms of LSS and temperature variations before and after surgical intervention and investigated the associated patient factors. Methods Patients who underwent laminectomy for LSS were included. Plantar temperature was measured preoperatively and postoperatively using thermography. Subjective symptoms and patient backgrounds were assessed through interviews and medical records. Temperature differences were evaluated using the parameter ΔT, defined as the temperature of the limb with stronger symptoms minus the temperature of the limb with weaker symptoms. The analyses were performed based on these parameters. Results The symptoms improved following laminectomy, and ΔT showed a significant increase. Pain and ΔT were positively correlated preoperatively, whereas ΔT and numbness and neuropathic pain scores were negatively correlated postoperatively. Cauda equina symptoms were associated with a decrease in ΔT both preoperatively and postoperatively, whereas age and disease duration were associated with a postoperative decrease in ΔT. Conclusion The postoperative increase in ΔT, resulting from the alleviation of nerve compression, suggests a relationship between nerve dysfunction and decreased temperature. The preoperative correlation between pain and ΔT may be attributed to vasodilation mediated by calcitonin gene-related peptide. The postoperative correlation between ΔT and neurological symptoms may reflect an association between the extent of nerve damage and reduced blood flow. In particular, cauda equina symptoms may lead to decreased blood flow through dysfunction of the S region, causing a relatively sympathetic-dominant state due to impaired parasympathetic function. Our findings suggest the potential of using temperature measurements to visualize and objectively evaluate subjective symptoms.