Hecht J S
Patricia Neal Rehabilitation Center, Fort Sanders Regional Medical Center, Knoxville, TN 37916.
Arch Phys Med Rehabil. 1992 Nov;73(11):1036-9.
Shoulder pain frequently superimposes substantial disability on a limb already limited by hemiplegia. The subscapularis muscle is a major internal rotator of the shoulder and, therefore, plays a role in the flexor synergy pattern commonly seen in spastic hemiplegia. Thirteen patients with spastic hemiplegia, limited range of motion, and painful shoulders underwent percutaneous phenol blocks to the nerves to the subscapularis. Patients' ages ranged from 22 to 76 (x 46 years) and the duration of hemiplegia from two to 13 months. Immediate and significant (p < 0.01) improvements in range of motion were observed in abduction (21 degrees), flexion (40 degrees), and external rotation (38 degrees). Relief of pain was also noted with the previously painful movement. Subscapularis nerve block is a new and potentially useful technique in the management of the painful hemiplegic shoulder.
肩部疼痛常常给已因偏瘫而活动受限的肢体带来严重残疾。肩胛下肌是肩部主要的内旋肌，因此在痉挛性偏瘫常见的屈肌协同模式中发挥作用。13例患有痉挛性偏瘫、活动范围受限且肩部疼痛的患者接受了肩胛下肌神经的经皮酚阻滞。患者年龄在22至76岁之间（平均46岁），偏瘫持续时间为2至13个月。在外展（21度）、屈曲（40度）和外旋（38度）方面，观察到活动范围立即且显著（p < 0.01）改善。之前疼痛的动作也出现了疼痛缓解。肩胛下肌神经阻滞是治疗疼痛性偏瘫肩部的一种新的且可能有用的技术。
