Background

Cervical spine (c-spine) and shoulder pathology have been known to cause similar symptoms and often co-exist, making an accurate diagnosis difficult, especially in an elderly population. Reverse total shoulder arthroplasty (rTSA) has been shown to decrease pain and improve quality of life when shoulder pathology is the source of pain and disability. The purpose of this study was to identify the prevalence of c-spine pathology in a cohort of patients who underwent rTSA and to compare postoperative outcome scores to a cohort without c-spine pathology.

Methods

A retrospective review was performed utilizing a single institution's operative records of primary rTSAs. Radiology reports, imaging, and operative reports were reviewed, and presence of any c-spine pathology or previous surgery were recorded. Additionally, postoperative outcome scores (American Shoulder and Elbow Surgeons [ASES], Constant Score, University of California, Los Angeles [UCLA], and Simple Shoulder Test [SST]) were evaluated at >2 years post-rTSA.

Results

A total of 438 primary rTSA cases were evaluated. Of these, 143 (32.6%) had documentation of prior c-spine pathology and/or history of previous c-spine surgery. After applying further exclusion criteria, a total of 50 patients with c-spine pathology and 108 patients without c-spine pathology were found to have complete medical records and postoperative outcome scores to allow comparison between groups. Patients without c-spine pathology were found to have statistically higher postoperative UCLA, ASES, and SST scores when compared to patients with c-spine pathology. Patients without c-spine pathology also demonstrated a significant improvement in the difference between their postoperative and preoperative UCLA and ASES scores.

Conclusion

This study demonstrated a high prevalence of c-spine pathology (32.6%) in a cohort of patients who underwent primary rTSA. Additionally, short-term outcome scores of patients undergoing rTSA with concomitant c-spine pathology are significantly lower than those of patients without a history of c-spine pathology.

中文翻译：

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患有颈椎病变或既往颈椎手术的患者与未接受过颈椎手术的患者相比，初次反向全肩关节置换术后的短期结果

背景

众所周知，颈椎（c-spine）和肩部病变会引起类似的症状，并且经常同时存在，这使得准确的诊断变得困难，尤其是在老年人群中。当肩部病变是疼痛和残疾的根源时，反向全肩关节置换术 (rTSA) 已被证明可以减轻疼痛并提高生活质量。本研究的目的是确定接受 rTSA 的患者队列中颈椎病理的患病率，并将术后结果评分与无颈椎病理的队列进行比较。

方法

利用单个机构的原发性 rTSA 手术记录进行了回顾性审查。审查放射学报告、影像学和手术报告，并记录任何颈椎病理或既往手术的存在。此外，术后结果评分（美国肩肘外科医生 [ASES]、恒定评分、加州大学洛杉矶分校 [UCLA] 和简单肩部测试 [SST]）在 rTSA 后 2 年以上进行评估。

结果

总共评估了 438 例原发性 rTSA 病例。其中，143 例 (32.6%) 有既往颈椎病理学记录和/或既往颈椎手术史。应用进一步的排除标准后，发现共有 50 名有颈椎病理的患者和 108 名无颈椎病理的患者有完整的病历和术后结果评分，以便进行组间比较。与有颈椎病理的患者相比，没有颈椎病理的患者术后 UCLA、ASES 和 SST 评分具有统计学上更高的水平。无颈椎病变的患者术后和术前 UCLA 和 ASES 评分之间的差异也有显着改善。

结论

这项研究表明，在接受初次 rTSA 的患者队列中，c 脊柱病理学的患病率很高（32.6%）。此外，接受 rTSA 并伴有颈椎病理学的患者的短期结果评分显着低于没有颈椎病理史的患者。