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全层肩袖撕裂的磁共振成像特征与睡眠障碍相关吗?

Do Magnetic Resonance Imaging Characteristics of Full-Thickness Rotator Cuff Tears Correlate With Sleep Disturbance?

作者信息

Reyes Bryan A, Hull Brandon R, Kurth Alexander B, Kukowski Nathan R, Mulligan Edward P, Khazzam Michael S

机构信息

Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

出版信息

Orthop J Sports Med. 2017 Nov 1;5(11):2325967117735319. doi: 10.1177/2325967117735319. eCollection 2017 Nov.

Abstract

BACKGROUND

Many patients with rotator cuff tears suffer from nocturnal shoulder pain, resulting in sleep disturbance.

PURPOSE

To determine whether rotator cuff tear size correlated with sleep disturbance in patients with full-thickness rotator cuff tears.

STUDY DESIGN

Cross-sectional study; Level of evidence, 3.

METHODS

Patients with a diagnosis of unilateral full-thickness rotator cuff tears (diagnosed via magnetic resonance imaging [MRI]) completed the Pittsburgh Sleep Quality Index (PSQI), a visual analog scale (VAS) quantifying their shoulder pain, and the American Shoulder and Elbow Surgeons (ASES) questionnaire. Shoulder MRI scans were analyzed for anterior-posterior tear size (mm), tendon retraction (mm), Goutallier grade (0-4), number of tendons involved (1-4), muscle atrophy (none, mild, moderate, or severe), and humeral head rise (present or absent). Bivariate correlations were calculated between the MRI characteristics and baseline survey results.

RESULTS

A total of 209 patients with unilateral full-thickness rotator cuff tears were included in this study: 112 (54%) female and 97 (46%) male (mean age, 64.1 years). On average, shoulder pain had been present for 24 months. The mean PSQI score was 9.8, and the mean VAS score was 5.0. No significant correlations were found between any of the rotator cuff tear characteristics and sleep quality. Only tendon retraction had a significant correlation with pain.

CONCLUSION

Although rotator cuff tears are frequently associated with nocturnal pain and sleep disruption, this study demonstrated that morphological characteristics of full-thickness rotator cuff tears, such as size and tendon retraction, do not correlate with sleep disturbance and have little to no correlation with pain levels.

摘要

背景

许多肩袖撕裂患者患有夜间肩部疼痛,导致睡眠障碍。

目的

确定全层肩袖撕裂患者的肩袖撕裂大小是否与睡眠障碍相关。

研究设计

横断面研究;证据等级,3级。

方法

诊断为单侧全层肩袖撕裂(通过磁共振成像[MRI]诊断)的患者完成匹兹堡睡眠质量指数(PSQI)、量化其肩部疼痛的视觉模拟量表(VAS)以及美国肩肘外科医师(ASES)问卷。对肩部MRI扫描分析前后撕裂大小(毫米)、肌腱回缩(毫米)、Goutallier分级(0 - 4级)、受累肌腱数量(1 - 4条)、肌肉萎缩(无、轻度、中度或重度)以及肱骨头抬高(存在或不存在)。计算MRI特征与基线调查结果之间的双变量相关性。

结果

本研究共纳入209例单侧全层肩袖撕裂患者:112例(54%)女性和97例(46%)男性(平均年龄64.1岁)。平均而言,肩部疼痛已持续24个月。PSQI平均得分为9.8,VAS平均得分为5.0。未发现任何肩袖撕裂特征与睡眠质量之间存在显著相关性。仅肌腱回缩与疼痛存在显著相关性。

结论

尽管肩袖撕裂常与夜间疼痛和睡眠中断相关,但本研究表明,全层肩袖撕裂的形态学特征,如大小和肌腱回缩,与睡眠障碍无关,且与疼痛程度几乎没有相关性。

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