Rotator Cuff Versus Cervical Spine

Wilson, C. A.

doi:10.1097/00006205-200505000-00011

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…The axillary nerve provides sensation to the skin over the lower deltoid as well as motor function to the entire deltoid. Radiculopathy arising from C5 and C6 is very difficult to differentiate from shoulder pathology because the sensory distribution runs from the base of the neck to the outer edge of the shoulder 14) . Radiculopathy of any of the cervical nerves 4 to 6 can produce pain in the scapula, shoulder, upper arm, lower arm and hand.…”

Section: Discussionmentioning

confidence: 99%

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Unrecognized Shoulder Disorders in Treatment of Cervical Spondylosis Presenting Neck and Shoulder Pain

Shin

Hur

et al. 2012

Korean J Spine

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ObjectiveCervical spondylosis and shoulder disorders share with neck and shoulder pain. Differentiating between the two can be challenging and patient with combined pathologies is less likely to have pain improvement even after successful cervical operation. We investigated clinical characteristics of the patients who were diagnosed as cervical spondylosis however, were turned out to have shoulder disorders or the patients whose pain was solely originated from shoulder.MethodsBetween January 2008 and October 2009, the patients presenting neck and shoulder pain with diagnosis of cervical spondylosis were enrolled. Among them, the patients who met following inclusion criteria were grouped into shoulder disorder group and the others were into cervical spondylosis group. Inclusion criteria were as follows. (1) To have residual or unresponsive neck and shoulder pain despite of optimal surgical treatment due to concomitant shoulder disorders. (2) When the operation was cancelled for the reason that shoulder and neck pain was proved to be related with unrecognized shoulder disorders. The authors retrospectively reviewed and compared clinical characteristics, level of pathology, diagnosis of cervical spondylosis and shoulder disorders.ResultsA total of 96 patients were enrolled in this study. Shoulder disorder group was composed of 15 patients (15.8%) and needed additional orthopedic treatment. Cervical spondylosis group was composed of 81 patients (84.2%). There was no significant differences in mean age, sex ratio and major diagnosis in both shoulder disorder and cervical spondylosis group (p=0.33, 0.78, and 0.68 respectively). However, the distribution of pathologic levels was found to be significantly different (p=0.03). In shoulder disorder group, the majority of lesions (15 of 19 levels, 78.9%) were located at the level of C4-5 (36.8%) and C5-6 (42.1%). On the other hand, in cervical spondylosis group, C5-6 (39.0%) and C6-7 (37.1%) were the most frequently observed level of lesions (80 of 105 levels, 16.1%).ConclusionIt is very important for spine surgeons to perform a complete history taking and physical examination using the special tests, and to discover the underlying shoulder disorders causing of symptom in treatment of cervical spondylosis presenting neck and shoulder pain.

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Section: Discussionmentioning

confidence: 99%

“…These tests include the Neer's, Hawkins' and Jobe's tests for rotator cuff pathology. The tests for cervical involvement use the dermatomal chart and the Spurling's and Bakody's tests 4 , 14) .…”

Section: Discussionmentioning

confidence: 99%

Unrecognized Shoulder Disorders in Treatment of Cervical Spondylosis Presenting Neck and Shoulder Pain

Shin

Hur

et al. 2012

Korean J Spine

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“…Studies were included based on the following criteria: (1) described pain referral patterns from various shoulder and spine conditions, (2) explored the use of history and examination to differentiate shoulder from neck pathology, (3) described the coexistence of shoulder and spine problems and optimal treatments strategies for concomitant/masquerading pathology, (4) examined the causative relationship between cervical spine and shoulder pathology.…”

Section: Methodsmentioning

confidence: 99%

“…There have been multiple review articles devoted to the differentiation of shoulder and neck pain based on history and examination. [1][2][3] However, the relationship is more complex than simply understanding overlapping pain patterns and the formation of a differential diagnosis. Recently, Zhang et al showed that degenerative cervical spine pathology may predispose a patient to rotator cuff tears.…”

Section: Introductionmentioning

confidence: 99%

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Overlapping, Masquerading, and Causative Cervical Spine and Shoulder Pathology: A Systematic Review

Katsuura

Bruce

Taylor

et al. 2019

Global Spine Journal

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Study Design: Systematic review. Objective: To assess the current literature regarding the relationship between the shoulder and the spine with regard to (1) overlapping pain pathways; (2) differentiating history, exam findings, and diagnostic findings; (3) concomitant pathology and optimal treatments; and (4) cervical spine-based etiology for shoulder problems. Methods: A systematic literature search was performed according to the guidelines set forth by the Cochrane Collaboration. Studies were included if they examined the clinical, anatomical, or physiological overlap between the shoulder and cervical spine. Two reviewers screened and selected full texts for inclusion according to the objectives of the study. Quality of evidence was graded using OCEBM (Oxford Center for Evidence Based Medicine) and MINORS (Methodological Index for Nonrandomized Studies) scores. Results: Out of 477 references screened, 76 articles were included for review and grouped into 4 main sections (overlapping pain pathways, differentiating exam findings, concomitant/masquerading pathology, and cervical spine-based etiology of shoulder pathology). There is evidence to suggest cervical spine pathology may cause shoulder pain and that shoulder pathology may cause neck pain. Specific examination tests used to differentiate shoulder and spine pathology are critical as imaging studies may be misleading. Diagnostic injections can be useful to confirm sources of pain as well as predicting the success of surgery in both the shoulder and the spine. There is limited evidence to suggest alterations in the relationship between the spine and the scapula may predispose to shoulder impingement or rotator cuff tears. Moreover, cervical neurological lesions may predispose patients to developing rotator cuff tears. The decision to proceed with shoulder or spine surgery first should be delineated with careful examination and the use of shoulder and spine diagnostic injections. Conclusion: Shoulder and spine pathology commonly overlap. Knowledge of anatomy, pain referral patterns, shoulder kinematics, and examination techniques are invaluable to the clinician in making an appropriate diagnosis and guiding treatment. In this review, we present an algorithm for the identification and treatment of shoulder and cervical spine pathology.

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Pitfalls in Cervical Spine Surgery

Denaro¹,

D’Avella²,

Denaro³

2010

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Rotator Cuff Versus Cervical Spine

Cited by 6 publications

References 6 publications

Unrecognized Shoulder Disorders in Treatment of Cervical Spondylosis Presenting Neck and Shoulder Pain

Unrecognized Shoulder Disorders in Treatment of Cervical Spondylosis Presenting Neck and Shoulder Pain

Overlapping, Masquerading, and Causative Cervical Spine and Shoulder Pathology: A Systematic Review

Pitfalls in Cervical Spine Surgery

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