Impact of spine alignment on the rotator cuff in long-term wheelchair users
Section snippets
Subjects
This is a retrospective cross-sectional study of the impact of spine alignment on the rotator cuff in long-term wheelchair users. A total of 319 subjects from the Spinal Cord Injury Center at Heidelberg University Hospital were evaluated. The selection criteria were as follows: (1) subjects had been wheelchair dependent for a minimum of 10 years; (2) they did not have an active shoulder infection and had not previously undergone surgery on the shoulder; (3) they were physically and mentally
Results
The study included a total of 319 wheelchair-bound subjects with paraplegia (227 men and 92 women). The mean age was 52.5 years (range, 32-78 years). The mean DSCI was 20.2 years (range, 10-47 years). An NLI between T2 and T7 was seen in 41.7% of patients (n = 133) and below T7 in 58.3% (n = 186). The interobserver agreement for the Kendall classification20 was good (71%), and for the Roussouly classification,36 it was excellent (98%). All subjects were found to have either the ideal alignment
Discussion
This study discussed a common shoulder disorder among patients with paraplegia who use their upper extremity as the primary source of locomotion, namely RCT. One of the fundamental purposes was to determine its prevalence with respect to the sitting spinal posture. For reasons of clarity and simplicity, we adopted the Kendall classification.20
Although our cohort exhibited either the ideal alignment or the kyphotic-lordotic posture with no observations of flat-back or swayback postures, the
Conclusion
Our findings suggest that individuals with paraplegia with a high NLI and poor trunk posture indicated by hyperkyphosis may be more likely to have cuff tears. We believe that the dominant pathology of the shoulder jointin patients with paraplegia is triggered by overload and mechanical stressors, resulting in higher RCT rates associated with a longer duration of SCI and/or wheelchair dependency. The data from this study may provide support for developing preventive strategies. Further research,
Disclaimer
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
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Cited by (3)
Impact of cervical spine pathology on outcomes after total shoulder arthroplasty
2023, Journal of Shoulder and Elbow SurgeryCitation Excerpt :Unfortunately, there is a scarcity of literature on the effects of cervical spine pathology and how this impacts soft tissue balancing in the shoulder. However, it is known that the integrity of peripheral nerve innervation of the rotator cuff plays an important role in maintaining the normal function of the shoulder girdle.15,25 Costouros et al6 performed an electrodiagnostic test and reported that 54% of patients with massive RCT had peripheral nerve injury and that 3.8% of the RCTs were related to cervical radiculopathy.
Spinal alignment measurement with Kinect sensor is valid for thoracic kyphosis but not for lumbar lordosis
2023, Journal of Orthopaedic Surgery and ResearchOverlapping, Masquerading, and Causative Cervical Spine and Shoulder Pathology: A Systematic Review
2020, Global Spine Journal
The ethics committee of the University of Heidelberg approved this study (application No. S-047/2007).