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近端型颈椎病性肌萎缩病例中肩袖状态与肩外展肌力减弱的严重程度及恢复之间的关联

The Association Between the Rotator Cuff Status and the Severity and Recovery of Weakness in the Shoulder Abductor Strength in a Case of Proximal Type Cervical Spondylotic Amyotrophy.

作者信息

Ishiwata Sho, Iizuka Yoichi, Shitara Hitoshi, Mieda Tokue, Takasawa Eiji, Tsunoda Daisuke, Kakuta Yohei, Honda Akira, Ito Shunsuke, Inomata Kazuhiro, Sasaki Tsuyoshi, Hamano Noritaka, Tajika Tsuyoshi, Chikuda Hirotaka

机构信息

Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.

出版信息

Global Spine J. 2022 Sep;12(7):1375-1379. doi: 10.1177/2192568220980441. Epub 2020 Dec 30.

Abstract

STUDY DESIGN

Case series study.

OBJECTIVE

We aimed to clarify the prevalence of rotator cuff tear (RCT), and the association between RCT and the severity and prognosis in patients with proximal type cervical spondylotic amyotrophy (CSA).

METHODS

We retrospectively analyzed 35 proximal type CSA patients who were treated conservatively. The following data was collected: age, rotator cuff status on MRI, manual muscle test (MMT) score of shoulder abductor and biceps brachii muscles both at the first visit and final follow-up. We investigated the prevalence of RCT and the association between the rotator cuff status, and the severity and recovery of upper extremity weakness in patients with proximal type CSA.

RESULTS

Of the 35 patients, 21 had an RCT on MRI, indicating that the prevalence of RCT in patients with proximal type CSA was 60%. An age-adjusted analysis showed that the presence of RCT was significantly associated with the MMT score of the shoulder abductor muscles both at the first visit and at the final follow-up. The presence of RCT was significantly associated with the recovery of the shoulder abductor muscles. The size of the RCT was negatively correlated with the MMT score of the shoulder abductor muscles at the final follow-up. The size of the RCT was independently correlated with the change of the MMT score of the shoulder abductor muscles.

CONCLUSION

RCT was detected in >50% in patients with proximal type CSA, and the presence and severity of RCT can be used as prognostic factors for proximal type CSA patients who are treated conservatively.

摘要

研究设计

病例系列研究。

目的

我们旨在阐明肩袖撕裂(RCT)的患病率,以及RCT与近端型颈椎病性肌萎缩(CSA)患者病情严重程度和预后之间的关联。

方法

我们回顾性分析了35例接受保守治疗的近端型CSA患者。收集了以下数据:年龄、MRI上的肩袖状况、首次就诊和末次随访时肩部外展肌和肱二头肌的徒手肌力测试(MMT)评分。我们调查了近端型CSA患者中RCT的患病率,以及肩袖状况与上肢无力严重程度和恢复情况之间的关联。

结果

35例患者中,21例在MRI上显示有RCT,表明近端型CSA患者中RCT的患病率为60%。年龄校正分析显示,RCT的存在与首次就诊和末次随访时肩部外展肌的MMT评分均显著相关。RCT的存在与肩部外展肌的恢复显著相关。RCT的大小与末次随访时肩部外展肌的MMT评分呈负相关。RCT的大小与肩部外展肌MMT评分的变化独立相关。

结论

近端型CSA患者中RCT的检出率>50%,RCT的存在和严重程度可作为接受保守治疗的近端型CSA患者的预后因素。

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