Lederman R J
Department of Neurology, Cleveland Clinic Foundation, OH 44195.
Ann Neurol. 1989 Nov;26(5):640-6. doi: 10.1002/ana.410260509.
I evaluated 226 instrumentalists for playing-related symptoms. There were 103 players (46%) of string instruments, 7 keyboard instrumentalists (32%), 44 players (19%) of wind instruments, and 6 percussionists (3%). The mean age was 32 years; 58% were women. Sixty-five patients (29%) had a peripheral nerve disorder; 27 had symptoms of thoracic outlet syndrome; 12 had median neuropathies (carpal tunnel syndrome in 9); 9 had ulnar neuropathies; 6 had cervical radiculopathy; 5 had digital neuropathies; 3 had cranial neuropathies; and 3 had other peripheral nerve disorders. Treatment consisted of modification of playing schedules and technique, plus physical and occupational therapy in 51 and surgical procedures in 9 patients; 5 were not treated. Follow-up at 1 to 8 years showed 74% had a satisfactory result, 14% had slight or minimal improvement, and 12% had no improvement. At the time of writing, all but 4 patients remained in the music profession. It is concluded that playing-related symptoms among instrumentalists are frequently neurological in origin and that the large majority can be helped by conservative or, on occasion, surgical means.
我评估了226名乐器演奏者的演奏相关症状。其中有103名弦乐器演奏者（46%）、7名键盘乐器演奏者（32%）、44名管乐器演奏者（19%）和6名打击乐手（3%）。平均年龄为32岁；58%为女性。65名患者（29%）患有周围神经疾病；27名有胸廓出口综合征症状；12名有正中神经病变（9名患有腕管综合征）；9名有尺神经病变；6名有颈椎病神经根病；5名有指神经病变；3名有颅神经病变；3名有其他周围神经疾病。治疗包括调整演奏时间表和技巧，51名患者还接受了物理和职业治疗，9名患者接受了外科手术；5名未接受治疗。1至8年的随访显示，74%的患者结果满意，14%的患者有轻微或极小改善，12%的患者无改善。在撰写本文时，除4名患者外，所有患者仍在从事音乐职业。结论是，乐器演奏者的演奏相关症状通常源于神经方面，并且绝大多数患者可通过保守治疗或偶尔的手术治疗得到帮助。
