关节镜下经肩胛冈入路切除冈盂切迹囊肿28例随访1年结果  

Arthroscopic Excision of Spinoglenoid Notch Cyst Through Mesoscapula Portal:1 Year Follow-up Results of 28 Cases

作　　者：孟庆阳[1] 刘平[1] Meng Qingyang;Liu Ping(Department of Sports Medicine,Peking University Third Hospital,Institute of Sports Medicine of Peking University,Beijing Key Laboratory of Sports Injuries,Beijing 100191,China)

机构地区：[1]北京大学第三医院运动医学科,北京大学运动医学研究所,运动医学关节伤病北京市重点实验室,北京100191

出　　处：《中国微创外科杂志》2022年第8期609-613,共5页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的 探讨关节镜下经肩胛冈入路切除冈盂切迹囊肿的临床疗效。方法 回顾性分析2014年6月~2020年6月28例冈盂切迹囊肿手术和随访资料,其中4例单纯冈盂切迹囊肿,21例合并肩关节上盂唇前后部(superior labrum anterior and posterior, SLAP)损伤,1例合并后盂唇损伤,2例合并前下盂唇损伤。关节镜下经肩胛冈入路(冈上肌和冈下肌间隙)完全切除囊肿,并处理合并肩关节病变如SLAP损伤、肩袖损伤等。随访期1年,通过Constant-Murley评分、改良美国加州大学(UCLA)肩关节评分和肌力评分评估肩关节功能,行MRI明确囊肿是否复发。结果 28例术后无严重并发症,临床症状均较术前明显改善,术后1年Constant-Murley评分、改良UCLA评分均较术前明显提高[(48.5±7.0)分vs.(95.6±3.4)分,t=-35.804,P=0.000;(17.0±8.3)分vs.(32.3±3.7)分,t=-9.371,P=0.000],7例冈下肌萎缩者肩外旋肌力较术前显著提高[(5.4±3.5)kg vs.(10.7±2.9)kg,t=-2.937,P=0.026]。术后1年复查MRI均未见囊肿复发。结论 关节镜下经肩胛冈入路完全切除冈盂切迹囊肿、处理合并肩关节损伤,可改善临床症状,避免囊肿复发。Objective To investigate clinical effect of arthroscopic excision of spinoglenoid notch cyst(SNC)through mesoscapula portal.Methods Surgical and follow-up data of 28 patients with SNC from June 2014 to June 2020 were retrospectively analyzed.Among them,4 cases were primary SNC,21 cases were complicated with superior labrum anterior and posterior(SLAP)injury,1 case was complicated with posterior labrum injury,and 2 cases were complicated with anterior-inferior labrum injury.The cysts were completely removed through the mesoscapula portal(the space between the supraspinatus and the infraspinatus)under arthroscopy,and the concomitant shoulder lesions such as SLAP injury and rotator cuff injury were treated at the same time.The followup period was 1 year.The shoulder function was evaluated by the Constant-Murley score,modified UCLA shoulder rating scale,and muscle strength test.The MRI was performed to determine whether the cysts recurred.Results There were no serious complications after surgery in the 28 patients.The clinical symptoms of all the patients were significantly improved.The Constant-Murley score and modified UCLA score of 28 patients at 1 year after surgery were significantly higher than those before surgery[(48.5±7.0)vs.(95.6±3.4)points,t=-35.804,P=0.000;(17.0±8.3)vs.(32.3±3.7)points,t=-9.371,P=0.000].The data of external rotatory muscle strength of 7 patients with subaspinatus atrophy after surgery were significantly improved as compared with those preoperation[(5.4±3.5)kg vs.(10.7±2.9)kg,t=-2.937,P=0.026].No recurrence of the SNC was observed on MRI 1 year after surgery.Conclusion Arthroscopic complete excision of SNC through mesoscapula portal and treatment of concomitant shoulder injuries could improve clinical symptoms and avoid recurrence of cysts.

关 键 词：冈盂切迹囊肿 肩胛冈入路 肩胛上神经卡压综合征 盂唇损伤 肩袖损伤 

分 类 号：R687.4[医药卫生—骨科学]