BACKGROUND: This study analyzed the demographic and morphologic features of rotator cuff disease in paraplegic patients who presented with or without shoulder pain. METHODS: Clinical and magnetic resonance imaging examinations of both shoulders were performed in 317 paraplegic patients. Mean age was 49 (range, 19-76) years. The level of spinal cord injury was between T2 and T7 In 54% of patients and between T8 and L3 in 46%. Constant scores were measured for all shoulders. Pain was analyzed using a visual analog scale. RESULTS: Rotator cuff tears were not present in 51%, were unilateral in 20%, and were bilateral in 29%. Age was older and duration of spinal cord injury was significantly longer in patients with bilateral tears than in patients without or with unilateral tears (P < .001). In patients with unilateral tears, a full-thickness rupture of the supraspinatus tendon was found in 67%, whereas a partial-rupture was detected in 33%. Of the patients with bilateral tears, 75% presented with a full-thickness rupture and 25% with a partial rupture. The mean Constant score was 76 (range, 37-98) in patients without cuff tears, 69 (range, 16-94) for patients with unilateral tears, and 64 (16-96) for patients with bilateral tears (P < .001). CONCLUSIONS: Rotator cuff disease is common and correlates highly with age and duration of spinal cord injury, which underlines the theory of "wear and tear" in wheelchair-dependent patients.
BACKGROUND: This study analyzed the demographic and morphologic features of rotator cuff disease in paraplegic patients who presented with or without shoulder pain. METHODS: Clinical and magnetic resonance imaging examinations of both shoulders were performed in 317 paraplegic patients. Mean age was 49 (range, 19-76) years. The level of spinal cord injury was between T2 and T7 In 54% of patients and between T8 and L3 in 46%. Constant scores were measured for all shoulders. Pain was analyzed using a visual analog scale. RESULTS: Rotator cuff tears were not present in 51%, were unilateral in 20%, and were bilateral in 29%. Age was older and duration of spinal cord injury was significantly longer in patients with bilateral tears than in patients without or with unilateral tears (P < .001). In patients with unilateral tears, a full-thickness rupture of the supraspinatus tendon was found in 67%, whereas a partial-rupture was detected in 33%. Of the patients with bilateral tears, 75% presented with a full-thickness rupture and 25% with a partial rupture. The mean Constant score was 76 (range, 37-98) in patients without cuff tears, 69 (range, 16-94) for patients with unilateral tears, and 64 (16-96) for patients with bilateral tears (P < .001). CONCLUSIONS:Rotator cuff disease is common and correlates highly with age and duration of spinal cord injury, which underlines the theory of "wear and tear" in wheelchair-dependent patients.
Authors: Y Kentar; R Zastrow; H Bradley; M Brunner; W Pepke; T Bruckner; P Raiss; A Hug; H Almansour; M Akbar Journal: Spinal Cord Date: 2018-01-24 Impact factor: 2.772
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