The School of Medicine, Nankai University, Tianjin, 300071, P. R. China.
Department of Pharmacy, The Second Hospital of Hebei Medical University, Shijiazhuang, 050051, P. R. China.
PLoS One. 2024 Mar 28;19(3):e0301066. doi: 10.1371/journal.pone.0301066. eCollection 2024.
Subacromial spurs are considered the one of the pathology underlying shoulder impingement syndrome. Furthermore, few studies have focused on the morphology of the subacromial spurs in normal Chinese people. This study aimed to study the spur distribution and to illustrate the morphology of spurs, which may help guide the extent of acromioplasty.
A total of 93 normal individuals were enrolled, and both shoulders of all enrolled individuals were analyzed. The subjects were divided and classified into three different groups by ages: group I = 18-40 years, group II = 41-60 years, and group III ≥ 61 years. The osteophyte distribution, osteophyte area, subacromial surface area and osteophyte area/subacromial surface area ratio were measured and illustrated using Mimics and 3-matic software. The shape of the acromion was classified according to the Bigliani and Morrison classification system. The acromial angle was also classified. Then, the relationship between osteophytes, acromial classification and acromial angle was analyzed.
Type II (curved shape) was the most common type of acromion, and the hooked shape was a rare form. A significant increase in the left subacromial surface area in males was observed in group III compared with group I (P < 0.001) and group II (P = 0.004). The total spur/subacromial area ratio was significantly higher in group II than I. An obvious increase in the right subacromial area was observed in group III compared with group I (P = 0.004). Furthermore, there was a significant increase in the right spur area (P = 0.021) and total spur/subacromial area ratio (P = 0.006) in females in group II compared with group I. Fewer spurs were observed on the left than on the right side (p = 0.0482). One spur was most common among type II acromions (29/36) (80.56%) on the left side and the right side (34/52, 65.38%).
Spurs osteophytes are mainly distributed with an irregular shape and mostly run through the medial and lateral sides of the subacromial surface in normal subjects. The characteristics of subacromial spurs are so diverse that a surgeon must conduct subacromial decompression completely based on the morphology of individual spurs.
肩峰下骨刺被认为是肩峰下撞击综合征的病理学基础之一。此外，很少有研究关注正常中国人的肩峰下骨刺的形态。本研究旨在研究骨刺的分布，并说明骨刺的形态，这可能有助于指导肩峰成形术的范围。
共纳入 93 名正常个体，对所有纳入个体的双侧肩部进行分析。根据年龄将受试者分为三组：I 组=18-40 岁，II 组=41-60 岁，III 组≥61 岁。使用 Mimics 和 3-matic 软件测量和图示骨赘分布、骨赘面积、肩峰下表面面积和骨赘面积/肩峰下表面面积比。根据 Bigliani 和 Morrison 分类系统对肩峰形态进行分类，对肩峰角度进行分类。然后分析骨赘、肩峰分类和肩峰角度之间的关系。
II 型（弯曲形状）是最常见的肩峰类型，钩状是一种罕见的形式。与 I 组（P < 0.001）和 II 组（P = 0.004）相比，III 组男性左侧肩峰下表面面积明显增加。与 I 组相比，II 组的总骨刺/肩峰面积比显著升高。与 I 组相比，III 组右侧肩峰下面积明显增加（P = 0.004）。此外，与 I 组相比，II 组女性右侧肩峰下区（P = 0.021）和总骨刺/肩峰下区面积比（P = 0.006）明显增加。左侧骨刺少于右侧（p = 0.0482）。左侧和右侧 II 型肩峰中最常见的是一个骨刺（29/36）（80.56%）和（34/52，65.38%）。
在正常受试者中，骨刺主要呈不规则形状分布，主要分布于肩峰下表面的内侧和外侧。肩峰下骨刺的特征如此多样，外科医生必须根据个体骨刺的形态进行完全的肩峰下减压。
