肩袖撕裂患者神经性疼痛的患病率及诱发因素

Prevalence and predisposing factors of neuropathic pain in patients with rotator cuff tears.

作者信息

Takeuchi Naohide, Kozono Naoya, Nishii Akihiro, Matsuura Koumei, Ishitani Eiichi, Onizuka Toshihiro, Mizuki Yasuhiro, Kimura Takehiro, Yuge Hidehiko, Uchimura Taiki, Iura Kunio, Mori Tatsuya, Ueda Koki, Miake Go, Senju Takahiro, Nabeshima Akira, Tashiro Eiji, Takagishi Kenji, Nakashima Yasuharu

机构信息

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, 812-8582, Japan.

出版信息

J Orthop Sci. 2023 Nov;28(6):1274-1278. doi: 10.1016/j.jos.2022.10.015. Epub 2023 Jan 4.

DOI:10.1016/j.jos.2022.10.015

PMID:36609035

Abstract

BACKGROUND

The management of pain in patients with rotator cuff tears can be challenging. Neuropathic pain is reportedly associated with pain occurrence in musculoskeletal diseases. However, to date, few studies have reported on the prevalence of neuropathic pain in patients with rotator cuff tears or identified the factors associated with neuropathic pain in a multicenter study.

METHODS

A total of 391 patients (205 males and 186 females; median age, 67.7 years; range, 27-92 years) with rotator cuff tears were included in this study. The prevalence of neuropathic pain in rotator cuff tears was investigated using the Japanese version of the painDETECT questionnaire for all patients. In addition, factors significantly associated with the occurrence of neuropathic pain were examined using multivariate logistic regression analysis.

RESULTS

Twenty-eight patients (7.2%) were classified into the neuropathic pain group (score ≥19), 97 (24.8%) into the uncertainty regarding neuropathy group (score 13-18), and 266 (68.0%) into the nociceptive pain group (score ≤12). According to the multivariate logistic regression analysis, the independent predictors of neuropathic pain were the VAS score (most severe pain during the past 4 weeks; odds ratio, 1.55; 95% confidence interval [CI], 1.23-2.09) and UCLA shoulder score (odds ratio, 0.81; 95% CI, 0.65-0.97).

CONCLUSIONS

Based on the study findings, the prevalence of neuropathic pain in patients with rotator cuff tear was 7.2%. It is important to investigate the presence or absence of neuropathic pain when treating patients with painful rotator cuff tears, because neuropathy associated with rotator cuff tears may adversely affect patient outcomes.

摘要

背景

肩袖撕裂患者的疼痛管理具有挑战性。据报道，神经性疼痛与肌肉骨骼疾病中的疼痛发生有关。然而，迄今为止，很少有研究报道肩袖撕裂患者中神经性疼痛的患病率，或在多中心研究中确定与神经性疼痛相关的因素。

方法

本研究纳入了391例肩袖撕裂患者（男性205例，女性186例；中位年龄67.7岁；范围27 - 92岁）。使用疼痛DETECT问卷日文版对所有患者调查肩袖撕裂中神经性疼痛的患病率。此外，使用多因素逻辑回归分析检查与神经性疼痛发生显著相关的因素。

结果

28例患者（7.2%）被归类为神经性疼痛组（评分≥19），97例（24.8%）为神经病变不确定性组（评分13 - 18），266例（68.0%）为伤害性疼痛组（评分≤12）。根据多因素逻辑回归分析，神经性疼痛的独立预测因素是视觉模拟评分（过去4周内最严重疼痛；比值比，1.55；95%置信区间[CI]，1.23 - 2.09）和加州大学洛杉矶分校（UCLA）肩部评分（比值比，0.81；95%CI，0.65 - 0.97）。