摘要
目的:研究颈肩背疼痛伴肩外展肌力下降病例的病因。方法:对28例此类患者进行了详细的临床观察和分析。保守治疗21例,行前、中斜角肌切断及C_5神经根松解术7例。结果:保守治疗后近期虽有一定疗效,但不理想。7例术后随访1年半,症状消失,均未见复发。其主要症状为颈肩背部疼痛,患侧上肢乏力,无明显外伤史。在颈外静脉和胸锁乳突肌后缘交界处和肩胛内上角内侧,是颈背部明显压痛点的位置。感觉障碍以前臂内侧及手部尺侧刺痛觉减退为主。X线片示:C_(4～7)椎体有明显增生24例,椎间隙狭窄15例。结论:颈肩痛伴同侧上肢外展肌力下降的病因是在前中斜角肌引起胸廓出口综合征的基础上,同时压迫C_5神经根,或者是前中斜角肌对C_5神经根的直接压迫所致。
Objective: To study the etiology of neck-shoulder-pain accompanied with weakness of shoulder abduction. Methods: Detailed observation and analysis was conducted in 28 eases. 21 cases received conservative treatment.Resection of scalenus anticus and medius and C_5 root neurolysis were undertaken in 7 cases. Results: Conservative treatment led to short-term alleviation of the symptoms. The result was far from satisfaction. One and a half years' follow up of the 7 surgieally treated eases revealed complete elimination of the symptoms without relapse. The characteristics of this clinical entity were pain of the neck,shoulder and back area; weakness of the involved limb; no apparent history of trauma. The most obvious tenderness point was located at the juncture of external jugular vein and posterior margin of sternoclaidomastoid muscle. Impairment of sensation was menifested as deereased sting at medial antebrachial area and the ulnar side of the hand. Roentgenograph showed hypertrophy of C_(4～7) vertebrae in 24 patients,and a narrowing of intervertebral space in 15. Conclusions: The etiology of neck-shoulder-pain accompanied with weakness of shoulder abduction lies in compression of C_5 nerve root in TOS, or direct compression of C_5 by scalenus anticus and medius.
出处
《中华手外科杂志》
CSCD
1997年第3期136-139,共4页
Chinese Journal of Hand Surgery
基金
卫生部科研基金
关键词
脊神经根
骨骼肌
肩痛
臂丛
胸廓出口综合征
Spinal nerve roots Muscle,skeletal Neck Shoulder Pain Brachial plexus Thoracic outlet syndrome
