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颈椎神经根病中与受累神经根相对应的肩胛部疼痛。

Corresponding scapular pain with the nerve root involved in cervical radiculopathy.

作者信息

Mizutamari Masaya, Sei Akira, Tokiyoshi Akinari, Fujimoto Toru, Taniwaki Takuya, Togami Wakana, Mizuta Hiroshi

机构信息

Department of Orthopaedic and Neuro-Musculoskeltal Surgery, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan.

出版信息

J Orthop Surg (Hong Kong). 2010 Dec;18(3):356-60. doi: 10.1177/230949901001800320.

Abstract

PURPOSE

To correspond scapular pain with the nerve root involved in cervical radiculopathy.

METHODS

In the anatomic study, 11 Japanese adult cadavers were dissected to examine the numbers and courses of the cutaneous nerves from C3 to C8 dorsal rami. In the clinical study, 14 men and 11 women aged 34 to 77 years who presented with scapular pain as well as pain, numbness or motor weakness in the upper limbs secondary to cervical radiculopathy were assessed. The involved nerve roots were identified based on the symptoms and signs in the arm and/ or fingers, the radiological diagnosis, and the pain response to cervical nerve root blocks. The sites and characteristics of radicular pain were assessed.

RESULTS

In the anatomic study of 22 cutaneous nerves from medial branches of dorsal rami, 18 involved the C5 nerve root, 0 the C6 root, one the C7 root, and 8 the C8 root. In the clinical study, the radicular pain often occurred in the suprascapular region involving the C5 root, in the suprascapular to posterior deltoid region involving the C6 root, in the interscapular region involving the C7 root, and in the interscapular and scapular regions involving the C8 root. All patients with C5 or C8 radiculopathy had both superficial and deep pain, whereas almost all patients with C6 or C7 radiculopathy had deep pain only. No patient had superficial pain only.

CONCLUSION

Cervical radiculopathy can cause scapular pain. Pain sites and characteristics are related to the affected nerve root.

摘要

目的

将肩胛部疼痛与神经根型颈椎病中受累的神经根相对应。

方法

在解剖学研究中,解剖了11具日本成年尸体,以检查从C3至C8背侧支发出的皮神经的数量和走行。在临床研究中,对14名男性和11名女性进行了评估,这些患者年龄在34至77岁之间,表现为肩胛部疼痛以及继发于神经根型颈椎病的上肢疼痛、麻木或运动无力。根据手臂和/或手指的症状和体征、放射学诊断以及对颈神经根阻滞的疼痛反应来确定受累神经根。评估神经根性疼痛的部位和特征。

结果

在对背侧支内侧支发出的22条皮神经进行的解剖学研究中,18条涉及C5神经根,0条涉及C6神经根,1条涉及C7神经根,8条涉及C8神经根。在临床研究中,神经根性疼痛常发生于肩胛上区,累及C5神经根;发生于肩胛上区至三角肌后部区域,累及C6神经根;发生于肩胛间区,累及C7神经根;发生于肩胛间区和肩胛区,累及C8神经根。所有C5或C8神经根型颈椎病患者均有浅部和深部疼痛,而几乎所有C6或C7神经根型颈椎病患者仅有深部疼痛。没有患者仅有浅部疼痛。

结论

神经根型颈椎病可引起肩胛部疼痛。疼痛部位和特征与受累神经根有关。

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