肩関節挙上障害症例における頸椎症性筋萎縮症例の検討

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Difficulty of shoulder elevation is mainly caused by shoulder disorder. However patients with deltoid paresis by cervical spondylotic amyotrophy (CSA) are sometimes referred to a shoulder surgeon. We reported on the clinical courses of 19 patients with CSA to analyze their clinical features in order to clarify the point of differentiation from shoulder joint disorder. Of 8118 patients who consulted the shoulder service of our department, 162 patients (2%) were diagnosed as having cervical lesion. Nineteen patients were diagnosed as having CSA based on the clinical features, especially, deltoid palsy associated with weakness of the short rotators and biceps, without definite sensory deficit. MRIs, plain X-rays, and electromyographies were examined supplementarily. Their mean age was 60.3 years old, range 40-75, 15 males and 4 females. Symptoms at the onset, the duration, and the self-evaluation of their present status were investigated. At the onset, disability of shoulder elevation without pain appeared in 10 patients. Eight patients were aware of their shoulder weakness with shoulder or neck pain. Nine patients obtained almost complete relief of symptoms within 3 months from the onset. Muscle weakness or shoulder pain had still remained in 4 patients without ADL disability. Two showed no recovery from pain and weakness. Patients having CSA are sometimes wrongly diagnosed as having shoulder disorder, because it shows slight sensory deficit. Confirmation of biceps weakness is useful in the differentiation of CSA from shoulder disorders.
日本肩関節学会の論文

肩関節挙上障害症例における頸椎症性筋萎縮症例の検討

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