Hill Larisa J N, Jelsing Elena J, Terry Marisa J, Strommen Jeffrey A
Mayo Medical School, Mayo Clinic College of Medicine, Rochester, MN(∗).
Department of Rehabilitation Medicine, University of Washington, Seattle, WA(†).
PM R. 2014 Sep;6(9):774-80. doi: 10.1016/j.pmrj.2014.02.003. Epub 2014 Feb 14.
To report our diagnostic and treatment experiences, and patient outcomes, in patients with suprascapular neuropathy (SSN).
Retrospective cohort study.
A tertiary medical center.
65 patients with electromyographically (EMG)-confirmed SSN.
A 5-year retrospective chart review of patients with EMG-confirmed SSN.
Descriptive statistics were used to summarize demographics, risk factors, causes, EMG findings, diagnostic evaluation, treatments, and self-reported outcomes. Exact Mantel-Haenszel χ(2) tests and Fisher exact tests were used to assess correlation between these measures.
The 3 most common causes of SSN were trauma (32 patients), an inflammatory process (ie, brachial neuritis) (14), and the presence of a cyst (13). Remaining cases were related to a rotator cuff tear or were due to overuse. No cases were attributed to notch abnormalities. At the time of follow-up (a mean of 50 months [range, 15-84 months] after EMG), 50% of subjects returned to activity with no restrictions (excellent outcome) and 40% returned to activity with restrictions (good outcome), regardless of cause and treatment. EMG findings, specifically the presence/absence of fibrillation potentials, did not predict recovery.
SSN should be considered in patients with shoulder pain and weakness. Magnetic resonance imaging and ultrasound help to exclude a structural process. Identifying a structural cause, specifically a cyst or rotator cuff tear, is important because it appears that these patients have improved recovery with return to normal activities when treated surgically. Although EMG data did not have prognostic value in this study, the data were limited and further study is warranted. Regardless of cause or treatment, most patients with SSN returned to activities in some capacity.
报告我们在肩胛上神经病变（SSN）患者中的诊断和治疗经验以及患者预后情况。
回顾性队列研究。
一家三级医疗中心。
65例经肌电图（EMG）确诊的SSN患者。
对经EMG确诊的SSN患者进行为期5年的回顾性病历审查。
采用描述性统计方法总结人口统计学、危险因素、病因、EMG检查结果、诊断评估、治疗方法及自我报告的预后情况。使用精确Mantel-Haenszel χ(2)检验和Fisher精确检验评估这些指标之间的相关性。
SSN最常见的3个病因是创伤（32例患者）、炎症过程（即臂丛神经炎）（14例）和囊肿存在（13例）。其余病例与肩袖撕裂有关或因过度使用所致。无病例归因于切迹异常。在随访时（EMG后平均50个月[范围，15 - 84个月]），50%的受试者恢复活动且无限制（预后良好），40%的受试者恢复活动但有一定限制（预后较好），无论病因和治疗方法如何。EMG检查结果，特别是纤颤电位的有无，并不能预测恢复情况。
对于有肩部疼痛和无力的患者应考虑SSN。磁共振成像和超声有助于排除结构性病变。识别结构性病因，特别是囊肿或肩袖撕裂，很重要，因为似乎这些患者手术治疗后恢复正常活动时恢复情况较好。尽管本研究中EMG数据没有预后价值，但数据有限，有必要进一步研究。无论病因或治疗方法如何，大多数SSN患者都能在一定程度上恢复活动。
