Prognostic factors of shoulder manipulation under ultrasound-guided cervical nerve root block for frozen shoulder for patient with diabetes mellitus: A retrospective cohort study

Abstract

Introduction Shoulder manipulation under ultrasound-guided cervical nerve root block (MUC) gives good clinical results in patients with frozen shoulder 1 week after the procedure. However, some patients are refractory to MUC. The present study was performed to investigate the prognostic factors of MUC for frozen shoulder. Methods We evaluated 73 frozen shoulders (70 patients) to investigate the prognostic factors of MUC. The patients' mean age was 56.6 years, and 60% were female. The mean duration of symptoms before MUC was 8.6 months. We assessed pain using a numeric rating scale (NRS), range of motion (ROM), and the American Shoulder and Elbow Surgeons (ASES) score before and 1 year after MUC. We compared patients with an ASES score of <80 (defined as a poor clinical result) with those with an ASES score of ≥80 (good clinical result). To identify the risk factors for a poor clinical result, multiple logistic regression analysis was performed using the following variables: age, sex, duration of symptoms before MUC, diabetes mellitus (DM), initial NRS score, and initial ROM. Results The initial NRS score and the prevalence of DM were significantly greater in the poor clinical results group. Multiple logistic regression analysis revealed that DM was the only independent risk factor for a poor clinical result after MUC (odds ratio, 51; 95% confidence interval, 10.9–237; p = .01). Conclusions DM is a negative prognostic factor of MUC for frozen shoulder, and patients with DM should be informed of this before they undergo treatment for frozen shoulder.

Effect of manipulation technique using ultrasound-guided cervical nerve root block on range of motion at the shoulder joint in frozen shoulder: a retrospective study

“…We have used silent manipulation in the hope of removing these burdens. Several previous studies have reported on the safety of conduction anesthesia and the effectiveness of manipulation [ 8 , 9 , 11 ]. A magnetic resonance imaging study in 30 patients who underwent manipulation under an ultrasound-guided cervical nerve root block found a significant improvement in pain with no fractures [ 21 ].…”

“…We have been experimenting with ultrasoundguided treatment for frozen shoulder since about 2010 [5,6]. This treatment, subsequently named "silent manipulation" by Minagawa [7], involves manipulation of the shoulder joint under local anesthetic nerve block and has been widely used [8][9][10]. There have been no serious complications arising from ultrasound-guided cervical nerve root block in previous studies [8][9][10], and its safety has been validated [11].…”

“…This treatment, subsequently named "silent manipulation" by Minagawa [7], involves manipulation of the shoulder joint under local anesthetic nerve block and has been widely used [8][9][10]. There have been no serious complications arising from ultrasound-guided cervical nerve root block in previous studies [8][9][10], and its safety has been validated [11]. However, the previous studies had small sample sizes and smaller than medium effect sizes (Cohen's d = 0.5).…”

Factors influencing prognosis of shoulder manipulation under ultrasound-guided cervical nerve root block for frozen shoulder: A retrospective cohort study

“…It is one of the most commonly observed orthopedic conditions, with a prevalence of 2-5% in the general population, with a risk increase to 10-40% among patients with diabetes mellitus (DM) (2,3). Moreover, some authors have reported poorer outcomes in patients with diabetic frozen shoulder (4)(5)(6)(7). This condition commonly occurs in patients aged 40-60 years, with incidence peaking in the mid-50s (8).…”

“…However, some patients are refractory to MUC, and few studies have focused on the prognostic factors of MUC (5,23). Therefore, this study was conducted to investigate the prognostic factors of MUC for frozen shoulder.…”