Daher Mohammad, Fares Mohamad Y, Boufadel Peter, Zalaquett Ziad, Koa Jonathan, Sakr Itala, Pill Stephan G, Hasan Samer S, Vaccaro Alex R, Abboud Joseph A
Rothman Institute/Thomas Jefferson Medical Center, Philadelphia, PA, USA.
Orthopedic Department, Hôtel Dieu de France, Beirut, Lebanon.
JSES Rev Rep Tech. 2024 Mar 19;4(3):385-392. doi: 10.1016/j.xrrt.2024.02.007. eCollection 2024 Aug.
The anatomic interplay and overlap between the cervical spine and the shoulder constitutes a challenge for shoulder and spine surgeons, as symptoms of spine and shoulder pathologies are often similar and may lead to entity misdiagnosis.
PubMed, Cochrane, and Google Scholar (page 1-20) searches were updated to October 2023 in search of the qualified papers. Boolean Operators were used with a combination of the keywords "spine" OR "neck" And "Shoulder". Furthermore, reference lists from papers were also searched to find literature.
It is of pivotal importance to conduct comprehensive preoperative clinical investigation to appropriately evaluate and assess the source of the pathology and the leading causes behind it. Certain markers can help guide surgeons towards etiologies, and these include areas of pain and physical exam findings with the arm squeeze test having the highest sensitivity and specificity for diagnosing cervical radiculopathy. As for the shoulder, despite its low sensitivity, the Yergason test had the highest specificity for diagnosing subacromial impingement. Local anesthetic injection can help as well in the diagnostic approach. Moreover, the interplay between these anatomic locations is not solely related to preoperative diagnosis. Studies have shown that previous surgery for cervical spine pathology may negatively affect the outcomes of shoulder procedures like arthroplasties.
Shoulder and spine surgeons should be wary and vigilant of accurately diagnosing the etiology of the presenting symptoms to ensure proper management and optimize prognosis.
颈椎与肩部之间的解剖学相互作用和重叠给肩部和脊柱外科医生带来了挑战，因为脊柱和肩部病变的症状往往相似，可能导致实体误诊。
对PubMed、Cochrane和谷歌学术（第1 - 20页）的搜索更新至2023年10月，以寻找合格的论文。使用布尔运算符，结合关键词“脊柱”或“颈部”以及“肩部”进行搜索。此外，还搜索了论文的参考文献列表以查找文献。
进行全面的术前临床检查以适当评估和判断病变的来源及其背后的主要原因至关重要。某些指标有助于指导外科医生明确病因，这些指标包括疼痛部位和体格检查结果，其中手臂挤压试验对诊断神经根型颈椎病具有最高的敏感性和特异性。对于肩部，尽管Yergason试验敏感性较低，但对诊断肩峰下撞击症具有最高的特异性。局部麻醉注射在诊断方法中也有帮助。此外，这些解剖部位之间的相互作用不仅与术前诊断有关。研究表明，先前的颈椎病变手术可能会对肩部手术（如关节成形术）的结果产生负面影响。
肩部和脊柱外科医生应谨慎且警惕地准确诊断当前症状的病因，以确保进行恰当的治疗并优化预后。
