Cine Hidayet Safak
Neurosurgery, Istanbul Medeniyet University, Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, TUR.
Cureus. 2023 Sep 1;15(9):e44510. doi: 10.7759/cureus.44510. eCollection 2023 Sep.
Background/aim This study investigates the degree of coexistence of cervical disc herniation and shoulder soft tissue pathology, as well as the effect of sleeping positions and orthopedic pillow use. Materials and methods This present study was conducted on 72 patients with shoulder/arm pain operated on for cervical disc herniation. Two groups were examined according to the presence of shoulder soft tissue pathology, four common sleeping positions, and the use of an orthopedic pillow. Preoperative and postoperative shoulder/arm visual analog scale (VAS) scores were compared. Results The preoperative VAS values were 7.35, while the postoperative VAS values were 3.32. Twenty-one patients (29.2%) had a disc at the C3-4 level, a rate equal to that for the C5-6 level. Twenty-four patients (33.3%) had a disc at the C4-5 level. Thirty-two cases (44.4%) slept in a side-lying position on the same side as their disc herniation. Among those with a herniated disc at the C3-4 level, 8 (53.3%) preferred sleeping side-lying on the opposite side of the disc. In contrast, those with a herniated disc at the C4-5 level more frequently (40.6%) slept side-lying on the same side as the disc. Mean VAS scores were significantly higher in cases with shoulder soft tissue pathology and were significantly lower in the group that used orthopedic pillows (p<0.001). Conclusion Shoulder soft tissue pathologies should be considered in postoperative shoulder pain. The use of orthopedic pillows is effective in preoperative and postoperative pain. Sleeping positions do not affect the shoulder/arm pain before and after the operation, but they affect the level of cervical disc herniations.
背景/目的 本研究调查颈椎间盘突出症与肩部软组织病变共存的程度,以及睡眠姿势和使用矫形枕头的影响。材料与方法 本研究对72例因颈椎间盘突出症接受肩部/手臂疼痛手术的患者进行。根据肩部软组织病变的存在、四种常见睡眠姿势以及使用矫形枕头情况对两组进行检查。比较术前和术后肩部/手臂视觉模拟量表(VAS)评分。结果 术前VAS值为7.35,术后VAS值为3.32。21例患者(29.2%)在C3 - 4节段有椎间盘突出,这一比例与C5 - 6节段相同。24例患者(33.3%)在C4 - 5节段有椎间盘突出。32例患者(44.4%)以患侧卧位睡眠。在C3 - 4节段有椎间盘突出的患者中,8例(53.3%)更喜欢患侧卧位睡眠。相比之下,C4 - 5节段有椎间盘突出的患者更频繁地(40.6%)以患侧卧位睡眠。肩部软组织病变患者的平均VAS评分显著更高,而使用矫形枕头的组平均VAS评分显著更低(p<0.001)。结论 术后肩部疼痛应考虑肩部软组织病变。使用矫形枕头对术前和术后疼痛有效。睡眠姿势对手术前后的肩部/手臂疼痛没有影响,但会影响颈椎间盘突出的节段。