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Abstract：
OBJECTIVE: Prevalence of axillary (AN) and/or suprascapular (SSN) neuropathy in rotator cuff tear arthropathy (RCTA) is unknown. We aimed to prospectively evaluate for preoperative neurodiagnostic abnormalities in order to determine their prevalence, location, and influence on reverse shoulder arthroplasty (RSA) outcomes.
METHODS: Patients who underwent RSA for RCTA were prospectively included. An electromyography and nerve conduction study were performed pre and post-surgery. Clinical situation: VAS, Relative Constant-Murley Score (rCMS) and ROM over a minimum of two years follow-up.
RESULTS: Forty patients met the inclusion criteria; mean follow-up was 28.4 months (SD 4.4). Injuries in RCTA were present in 83.9% (77.4% in AN and 45.2% in SSN). There were no differences on preoperative VAS, ROM, and rCMS between patients with and without preoperative nerve injuries. Four acute postoperative neurological injuries were registered under chronic preoperative injuries. Six months after RSA, 69% of preoperative neuropathies had improved (82.14% chronic injuries and 77.7% disuse injuries). No differences in improvement between disuse and chronic injuries were found, but patients with preoperative neuropathy that had not improved at the postoperative electromyographic study at six months, scored worse on the VAS (1.44 vs 2.66; p .14) and rCMS (91.6 vs 89.04; p .27).
CONCLUSIONS: The frequency of axillary and suprascapular neuropathies in RCTA is much higher than expected. Most of these injuries improve after surgery, with almost complete neurophysiological recovery and little functional impact on RSA. However, those patients with preoperative neuropathies and absence of neurophysiological improvement six months after surgery have lower functional results.
METHODS: Patients who underwent RSA for RCTA were prospectively included. An electromyography and nerve conduction study were performed pre and post-surgery. Clinical situation: VAS, Relative Constant-Murley Score (rCMS) and ROM over a minimum of two years follow-up.
RESULTS: Forty patients met the inclusion criteria; mean follow-up was 28.4 months (SD 4.4). Injuries in RCTA were present in 83.9% (77.4% in AN and 45.2% in SSN). There were no differences on preoperative VAS, ROM, and rCMS between patients with and without preoperative nerve injuries. Four acute postoperative neurological injuries were registered under chronic preoperative injuries. Six months after RSA, 69% of preoperative neuropathies had improved (82.14% chronic injuries and 77.7% disuse injuries). No differences in improvement between disuse and chronic injuries were found, but patients with preoperative neuropathy that had not improved at the postoperative electromyographic study at six months, scored worse on the VAS (1.44 vs 2.66; p .14) and rCMS (91.6 vs 89.04; p .27).
CONCLUSIONS: The frequency of axillary and suprascapular neuropathies in RCTA is much higher than expected. Most of these injuries improve after surgery, with almost complete neurophysiological recovery and little functional impact on RSA. However, those patients with preoperative neuropathies and absence of neurophysiological improvement six months after surgery have lower functional results.
摘要：
目的：肩袖撕裂性关节病（RCTA）的腋窝（AN）和/或肩胛骨上（SSN）神经病的患病率尚不清楚。我们旨在前瞻性评估术前神经诊断异常，以确定其患病率。location,以及对反向肩关节置换术（RSA）结局的影响。
方法：前瞻性纳入接受RCTA的RSA患者。手术前后进行了肌电图和神经传导研究。临床情况：VAS，相对恒定Murley评分（rCMS）和ROM在至少两年的随访。
结果：40例患者符合纳入标准；平均随访28.4个月（SD4.4）。RCTA的损伤发生率为83.9%（AN为77.4%，SSN为45.2%）。术前VAS无差异，ROM,有术前神经损伤和无术前神经损伤的患者之间的rCMS。在慢性术前损伤下记录了四种急性术后神经损伤。RSA六个月后，69％的术前神经病变得到改善（82.14％的慢性损伤和77.7％的废用损伤）。未发现废用和慢性损伤之间的改善差异，但术前神经病变患者在术后6个月的肌电图研究中没有改善，在VAS（1.44vs2.66；第14页）和rCMS（91.6vs89.04；第27页）上得分更差。
结论：RCTA中腋窝和肩胛骨上神经病变的频率远高于预期。这些损伤大多在手术后改善，几乎完全的神经生理恢复，对RSA的功能影响很小。然而,那些术前有神经病变且术后6个月无神经生理学改善的患者,其功能结果较低.
方法：前瞻性纳入接受RCTA的RSA患者。手术前后进行了肌电图和神经传导研究。临床情况：VAS，相对恒定Murley评分（rCMS）和ROM在至少两年的随访。
结果：40例患者符合纳入标准；平均随访28.4个月（SD4.4）。RCTA的损伤发生率为83.9%（AN为77.4%，SSN为45.2%）。术前VAS无差异，ROM,有术前神经损伤和无术前神经损伤的患者之间的rCMS。在慢性术前损伤下记录了四种急性术后神经损伤。RSA六个月后，69％的术前神经病变得到改善（82.14％的慢性损伤和77.7％的废用损伤）。未发现废用和慢性损伤之间的改善差异，但术前神经病变患者在术后6个月的肌电图研究中没有改善，在VAS（1.44vs2.66；第14页）和rCMS（91.6vs89.04；第27页）上得分更差。
结论：RCTA中腋窝和肩胛骨上神经病变的频率远高于预期。这些损伤大多在手术后改善，几乎完全的神经生理恢复，对RSA的功能影响很小。然而,那些术前有神经病变且术后6个月无神经生理学改善的患者,其功能结果较低.
