Pellegrini Andrea, Pegreffi Francesco, Paladini Paolo, Verdano Michele Arcangelo, Ceccarelli Francesco, Porcellini Giuseppe
Unit of Shoulder and Elbow surgery, D. Cervesi Hospital, Cattolica (Italy); 2 Orthopedic Clinic, University of Parma, Parma, Italy.
Acta Biomed. 2012 Dec;83(3):177-82.
The annual incidence of acute spinal cord injury, as reported in the National Spinal Cord Injury Statistical Center, was estimated to be approximately 40 cases per million, or approximately 11.000 new cases in the United States each year (1). In subjects with spinal cord injury, overstress of the upper extremities occurs not only during daily life activities, but also utilizing wheelchair. The aim of this study is to determine the prevalence of shoulder discomfort in subjects affected by paraplegia living in our country area and evaluate the associated risk factors negatively affecting the shoulder function.
A computerized database search for paraplegic patients was performed at the Department of Orthopedic Surgery, Trauma Surgery and Rehabilitation Medicine. Among the 54 selected paraplegic patients, 47 accepted to participate at the study. Once the patients were contacted, the medical records were reviewed to obtain information regarding shoulder, elbow and spine region pain and discomfort.
The 60% of all the patients who answered to the questionnaire complain shoulder pain, 90% bilaterally, and the 30% referred elbow pain, 20% bilaterally. 77% complains back pain, involving particularly lumbar region. Only 2% of this population undergoes a shoulder surgery treatment for cuff tear and shoulder disability.
The present study is the first in our country that gives an overview of prevalence of upper limb discomfort in paraplegic patients. We have shown the interplay between shoulder elbow and spine with pain, age of patients and type of wheel chair utilized. The previous factors can be corrected and upper limb discomfort relieved.
据国家脊髓损伤统计中心报告,急性脊髓损伤的年发病率估计约为每百万人口40例,即美国每年约有11000例新发病例(1)。在脊髓损伤患者中,上肢过度用力不仅发生在日常生活活动中,也发生在使用轮椅时。本研究的目的是确定我国农村地区截瘫患者肩部不适的患病率,并评估对肩部功能产生负面影响的相关危险因素。
在骨科、创伤外科和康复医学科对截瘫患者进行计算机数据库检索。在选定的54例截瘫患者中,47例同意参与研究。与患者取得联系后,查阅病历以获取有关肩部、肘部和脊柱区域疼痛及不适的信息。
回答问卷的所有患者中,60%主诉肩部疼痛,90%为双侧疼痛,30%主诉肘部疼痛,20%为双侧疼痛。77%主诉背部疼痛,尤其涉及腰椎区域。该人群中只有2%因肩袖撕裂和肩部功能障碍接受肩部手术治疗。
本研究是我国首次对截瘫患者上肢不适患病率进行概述的研究。我们已经表明了肩部、肘部和脊柱之间与疼痛、患者年龄和使用的轮椅类型之间的相互作用。上述因素可以得到纠正,上肢不适也可以得到缓解。