近端肌萎缩型颈椎病患者肩袖撕裂的发生率及其与肩外展肌肌力下降、恢复情况的相关性  

The incidence of rotator cuff tear in patients with proximal muscular atrophy of cervical spondylosis and its correlation with the decline and recovery of shoulder abductor muscles

作　　者：李张 LI Zhang(Department of Joint Surgery,Central Hospital of Zhumadian,Zhumadian,Henan,463000,China)

机构地区：[1]驻马店市中心医院关节外科,河南驻马店463000

出　　处：《颈腰痛杂志》2023年第1期12-15,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨近端型肌萎缩型颈椎病(cervical spondylotic amyotrophy,CSA)患者的肩袖撕裂(rotator cuff tear,RCT)发生率及其与肩外展肌肌力下降、恢复情况的相关性。方法选择2016年1月~2019年12月在本院就诊的78例近端型CSA患者资料进行回顾性分析,患者用软式颈托间歇性固定颈椎3个月,同时配合消肿、消炎及物理治疗。观察RCT发生率,以及RCT及其分级与近端型CSA患者肌力及肌力恢复的关系。结果41例患者检测出RCT,检出率为52.56%。RCT组患者年龄显著高于非RCT组,肩外展肌基线肌力和末次肩外展肌肌力显著低于非RCT组,恢复效果理想率显著低于非RCT组(P<0.05);两组患者的性别、患侧、肱二头肌基线和末次肌力等差异均无统计学意义(P>0.05)。调整年龄因素后,RCT与基线时(β=-0.761,OR=0.457,95%CI:0.332~0.582)和随访3个月(β=-0.902,OR=0.407,95%CI:0.302~0.512)的肩外展肌肌力评分显著相关,与肩外展肌恢复显著相关(β=-0.972,OR=0.396,95%CI:0.311~0.481);基线肩外展肌肌力分级与RCT分级无显著相关性(P>0.05),随访3个月时肩外展肌肌力分级和肌力分级改善与RCT分级均呈负相关(P<0.05)。结论近端型CSA患者RCT的发生率>50%,RCT的存在和严重程度可作为近期CSA患者保守治疗的预后因素。Objective To explore the incidence of rotator cuff tear(RCT)in patients with proximal cervical spondylotic amyotrophy(CSA),and its correlation with the decline and recovery of shoulder abductor muscles.Methods The clinical data of 78 patients with proximal CSA who were treated in our hospital from January 2016 to December 2019 were retrospectively analyzed.The patients used a soft cervical collar to fix the cervical spine intermittently for 3 months,and also cooperated with swelling,anti-inflammatory and physical therapy.The incidence of RCT in patients with proximal CSA was observed,and the relationship between RCT,RCT grading and muscle strength,muscle strength recovery was also observed.Results RCT was detected in 41 of 78 patients,and the detection rate of RCT was 52.56%.The age of patients in RCT group was older than that in non-RCT group,the muscle strength of shoulder abductor at baseline and the last time in RCT group was lower than that in non-RCT group,and the good recovery rate was lower than that in non-RCT group,the differences were statistically significant(P<0.05).There were no significant differences in gender,affected side,biceps brachii baseline and last muscle strength between RCT group and non-RCT group(P>0.05).After adjusting for age,RCT was significantly correlated with strength score of shoulder abductor at baseline(β=-0.761,OR=0.457,95%CI:0.332-0.582)and 3-month follow-up(β=-0.902,OR=0.407,95%CI:0.302-0.512).RCT was significantly correlated with the recovery of shoulder abductor muscles(β=-0.972,OR=0.396,95%CI:0.311-0.481).After adjusting for age,there was no significant correlation between baseline abductor muscle strength grade and RCT grade(P>0.05).At 3-month follow-up,abductor muscle strength grade and improvement of muscle strength grade were negatively correlated with RCT grade(P<0.05).Conclusion The incidence rate of RCT in patients with proximal CSA is more than 50%.The existence and severity of RCT can be used as prognostic factors of conservative treatment in patients with rec

关 键 词：肌萎缩型颈椎病 肩袖撕裂 肩外展肌 肌力 

分 类 号：R274.31[医药卫生—中医骨伤科学]