The Association Between the Rotator Cuff Status and the Severity and Recovery of Weakness in the Shoulder Abductor Strength in a Case of Proximal Type Cervical Spondylotic Amyotrophy

Ishiwata, Sho; Iizuka, Yoichi; Shitara, Hitoshi; Mieda, Tokue; Takasawa, Eiji; Tsunoda, Daisuke; Kakuta, Yohei; Honda, Akira; Ito, Shunsuke; Inomata, Kazuhiro; Sasaki, Tsuyoshi; Hamano, Noritaka; Tajika, Tsuyoshi; Chikuda, Hirotaka

doi:10.1177/2192568220980441

Cited by 3 publications

(2 citation statements)

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“…The manual muscle test has previously been proven to be a reliable and valid examination tool for clinical applications [24]. Consistent with our approach, Sho Ishiwata also used the manual muscle test in one study to measure the SAS [18]. The nomogram clearly showed that a SAS grade 0-2 had a strong predictive ability: the weight was high, and the corresponding points were between 60 and 70.…”

Section: Discussionsupporting

confidence: 65%

“…Previous studies have shown that a grade of ASIA A and an injury level above C4 are the most common predictors of tracheostomy [16,17]. The shoulder abduction is accomplished by the deltoid in conjunction with the supraspinatus [18]. The deltoid is innervated by the axillary nerve, and the supraspinatus is innervated by the suprascapular nerve.…”

Section: Introductionmentioning

confidence: 99%

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The shoulder abductor strength is a novel predictor of tracheostomy in patients with traumatic cervical spinal cord injury

Jian

Sun

et al. 2022

BMC Musculoskelet Disord

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Background Early prediction of tracheostomy in traumatic cervical spinal cord injury (TCSCI) patients is often difficult. This study aims to clarify the association between shoulder abductor strength (SAS) and tracheostomy in patients with TCSCI. Methods We retrospectively analyzed 513 TCSCI patients who were treated in our hospital. All patients were divided into a tracheostomy group and a non-tracheostomy group. The SAS was assessed using the Medical Research Council (MRC) Scale for Muscle Strength grading. Potential predictors were assessed for their association with tracheostomy in patients. A nomogram was developed based on multivariable logistic regression analysis (MLRA) to visualize the predictive ability of the SAS. Validation of the nomogram was performed to judge whether the nomogram was reliable for visual analysis of the SAS. Receiver operating characteristics curve, specificity, and sensitivity were also performed to assess the predictive ability of the SAS. Results The proportion of patients with the SAS grade 0–2 was significantly higher in the tracheostomy group than in the non-tracheostomy group (88.1% vs. 54.8%, p = 0.001). The SAS grade 0–2 was identified as a significant predictor of the tracheostomy (OR: 4.505; 95% CI: 2.080–9.758; p = 0.001). Points corresponding to both the SAS grade 0–2 and the neurological level of injury at C2-C4 were between 60 and 70 in the nomogram. The area under the curve for the SAS grade 0–2 was 0.692. The sensitivity of SAS grade 0–2 was 0.239. The specificity of SAS grade 0–2 was 0.951. Conclusions SAS is a novel predictor of tracheostomy in patients after TCSCI. The SAS grade 0–2 had a good predictive ability of tracheostomy.

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Section: Discussionsupporting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

The shoulder abductor strength is a novel predictor of tracheostomy in patients with traumatic cervical spinal cord injury

Jian

Sun

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

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Cervicobrachial syndrome: diagnostic and treatment algorithms

Isaykin,

Akhmedzhanova,

Golenkova

et al. 2024

RJTAO

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Neck and shoulder disorders often occur side by side and reinforce each other in their clinical manifestations. Differential diagnosis of neck and shoulder pain can be challenging due to the close anatomical proximity, innervation of neck and shoulder structures, similarity of symptoms and groups of patients suffering from these conditions. Identifying the anatomical source of pain is the most important clinical task when choosing treatment for patients, which is reflected in two clinical observations. In the first clinical case the main complaint was pain in the shoulder; a neuro-orthopedic examination revealed evidence of radicular involvement in the form of a decrease in tendon reflex, pain provocation in Spurling and tension tests, with no evidence of involvement or pain in the joint structures of the shoulder. MRI of the cervical spine revealed signs of CVI discoradicular conflict consistent with the clinical symptoms. In the second observation, the main complaint was pain in the cervical spine and right shoulder, initially considered as radiculopathy; MRI revealed degenerative changes in the spine with possible compression of the CVI root. Neuro-orthopedic examination revealed no signs of radicular lesions; the main anatomical source of pain was coraco-acromial joint involvement, which was confirmed by diagnostic blockade of this joint. Both non-drug methods (kinesiotherapy, manual therapy, ergonomic measures) and medications (non-steroidal anti-inflammatory drugs — Airtal; muscle relaxants — Mydocalm) were used; therapeutic blockades targeting the main source of pain were performed. The cases presented show that it is impossible to determine the main anatomical source of pain based on the pain pattern. It can be determined by a thorough analysis of medical history and a detailed neuro-orthopedic examination. Neuroimaging methods should only be interpreted in the context of the clinical picture. In controversial cases, diagnostic blockades with local anesthetics can be performed to confirm the diagnosis.

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