Surgical decompression of impingement in the weightbearing shoulder.

Shoulder pain is a common affliction, posing particular limitations on the spinal cord injured person. Abnormalities of the rotator cuff mechanism are a common cause of shoulder injury in the general population and it has recently been observed that a large percentage of persons with paraplegia suffer from chronic shoulder pain. This report describes six cases of impingement syndrome in four spinal cord injured persons who depend on upper extremity function for the execution of activities of daily living and mobility. All had failed prolonged trials of conservative therapy and subsequently underwent anterior acromioplasty and when indicated, repair of the supraspinatus tendon. In each case, functional capacity that approached or equalled premorbid levels was achieved. Pain complaints also markedly decreased from preoperative levels. It is suggested that surgical decompression of shoulder impingement and rotator cuff repair may be beneficial in spinal cord injured persons who have failed conservative therapy. Further study is required to determine the long-term efficacy of surgical intervention in this population.