2017 ISAKOS Biennial Congress ePoster #2124

 

Morphological Ultrasound Examination Of Cervical Nerve Roots In Rotator Cuff Tear, Frozen Shoulder, And Recurrent Anterior Shoulder Dislocation

Yukihiro Kajita, MD, Ichinomiyashi, Aichi-ken JAPAN
Masataka Deie, MD, PhD, Prof., Hiroshima, hiroshima JAPAN
Yusuke Iwahori, MD, PhD, Prof., Kasugai, Aichi-Ken JAPAN

Department of Orthopaedics, Aichi Medical University School of Medicine, Nagakute, JAPAN

FDA Status Not Applicable

Summary

C5 nerve roots on both the affected and unaffected sides in the rotator cuff tear and frozen shoulder patients were larger than those in the healthy volunteers. The C5 nerve root related to chronic shoulder pain.

Abstract

Objective

Pain in shoulder joint conditions such as rotator cuff tear (RCT) and frozen shoulder (FS) is chronic, but its cause is often unclear. RCT, FS, and other shoulder joint conditions are also associated with findings of cervical nerve root injury such as peripheral nerve compression and pain and numbness in the affected arm. The main nerve supply to the shoulder joint branches from the spinal cord between the fourth and fifth cervical nerve root (C4-C5 nerve root). The C5 nerve root can be examined using ultrasound. Here, we report an investigation comparing cross-sectional areas of C5 nerve roots in RCT, FS, and recurrent anterior shoulder dislocation (RASD) patients with those in healthy volunteers.

Subjects and Method: Subjects were patients with unilateral RCT, FS, and RASD, and healthy volunteers with ultrasonically normal shoulders and no shoulder joint complaints. The subjects comprised 36 RCT patients (mean age, 61.6 years; range, 37-73 years; 19 men, 17 women), 16 FS patients (mean age, 52.0 years; range, 33-75 years; 2 men, 14 women), 10 RASD patients (mean age, 32.8 years; range, 17-51 years; 8 men, 2 women), and 100 healthy volunteers (200 shoulder joints; mean age, 44.6 years; range, 21-65 years; 27 men, 73 women). The major axis and the minor axis of the bilateral C5 nerve roots were measured at the level of the cervical vertebral transverse process using ultrasound. The cross-sectional areas of the C5 nerve roots was calculated for both the affected and unaffected sides in each patient, and both sides in each healthy volunteer..

Results

C5 nerve root cross-sectional areas were 7.8 mm2 ± 2.8 mm2 for the affected side and 7.9 mm2 ± 3.0 mm2 for the unaffected side in the RCT patients, 8.7 mm² ± 2.8 mm² for the affected side and 8.3 mm² ±2.4 mm² for the unaffected side in the FS patients, 6.6 mm² ± 2.4 mm² for the affected side and 6.2 mm² ±2.1 mm² for the unaffected side in the RASD patients, and 7.0 mm² ± 2.0 mm² in the healthy volunteers. No significant difference in C5 nerve root cross-sectional areas was noted between the affected and unaffected sides in the RCT, FS, or RASD patients. C5 nerve root cross-sectional areas were significantly larger for both the affected and unaffected sides in the RCT and FS patients than in the healthy volunteers, but did not significantly differ between the RASD patients and the healthy volunteers.

Conclusion

C5 nerve roots on both the affected and unaffected sides in the RCT and FS patients were larger than those in the healthy volunteers. Our results suggested that the C5 nerve root related to chronic shoulder pain.