The stenotic concept

Ombregt, Ludwig

doi:10.1016/b978-0-7020-3145-8.00035-1

Cited by 3 publications

(5 citation statements)

References 95 publications

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“…Ludwig Ombregt has proposed the Segmental Error Theory, as an explanation for the complex mechanism of human pain perception in his work, 'A System of Orthopaedic Medicine'. 2 The essence of this theory is that, in most cases, the pain-generating tissue and the skin of the perceived painful area should share a common spinal nerve root. In other words, pain felt at one site may be the result of a distant lesion if it is innervated by the same spinal nerve root.…”

Section: Diagnostic Challengementioning

confidence: 99%

“…4,6 Yet, hip joint and lumbar spine are not the only combination which can induce converging symptoms in human body. 2,7 Due to anatomical similarity, cervical spine and shoulder joint pathologies may result in similar confusion. According to the review in 2016 by Bokshan et al, symptoms originated from C5 and partially C6 root may be located around lateral shoulder, which could be tricky for clinicians to differentiate them from true shoulder lesions.…”

Section: Introductionmentioning

confidence: 99%

“…1 While some clinicians view pain as the direct result of nociceptive input, the manifestation of it, including intensity, location and quality, often varies greatly among subjects who suffer from the same tissue pathology. 2 As de ned by the International Association for the Study of Pain in 1979, pain is 'an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage'. 3 This indicated the multi-factorial nature of pain, and nociceptive input is only one of its parameters.…”

Section: Introductionmentioning

confidence: 99%

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Cervical-Shoulder Syndrome: Shoulder and Cervical Surgeries Are Risk Factors for Each Other

Liang

Hung

Tsui³

et al. 2023

Preprint

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Aim: Converging symptoms of cervical spine and shoulder pathologies can lead to misdiagnosis and unsatisfying outcomes of corresponding surgical interventions, as those seen in published research on hip-spine syndrome. In addition, the intricate biomechanical interdependence between these two sites may be altered after surgery at either site, potentially putting the untreated site at danger of further injury. Thus, this study will examine whether certain surgeries at cervical spine and shoulder joint can be a risk factor for each other. Method: Reimbursement claims of certain shoulder-related and cervical-related surgery from January 1st 2000 to December 31st 2016 were included according to their diagnosis and treatment codes via Taiwan National Health Insurance Research Database (NHIRD) service. Collected subjects in both groups will be matched with control subjects who did not have that surgery based on age, gender, index date and Charlson Comorbidity Index (CCI). Odds ratio and hazard ratio of having surgeries at the other site between patients with and without surgery at one site will be calculated with logistic regression model. Result: The odds ratios of having certain cervical spine surgeries between shoulder surgery subjects and matched controls within 3, 6 and 12 months are 1.78(1.27-2.49), 2.19(1.75-2.75) and 2.55(2.17-3.00), respectively. The odds ratios of having certain shoulder surgeries between cervical subjects and matched controls are 2.08(1.48-2.94), 2.88(2.30-3.61) and 3.32(2.82-3.90), respectively. Hazard ratio of having certain surgeries at the other site between subjects and controls is 3.36(2.86-3.96) for cervical group, and 2.54(2.16-2.98) for shoulder group. Conclusion: Certain cervical surgeries are risk factors of certain shoulder surgeries and vice versa. Detailed physical examinations should be regularly conducted at both sites before arranging surgeries for either one. Preventative measures and early screening for pathologies at the other site should be initiated as soon as allowed to reduce further medical expenses.

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Section: Diagnostic Challengementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cervical-Shoulder Syndrome: Shoulder and Cervical Surgeries Are Risk Factors for Each Other

Liang

Hung

Tsui³

et al. 2023

Preprint

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“…11 Traditionally, corticosteroid injections are administered under the guidance of anatomical landmarks. 12 Henkus et al 13 reported that 30%-80% of shoulder girdle injections reaching the subacromial capsule were regarded as blind injections. Injections performed by image guidance (fluoroscopy or ultrasonography) have been shown to improve the accuracy of shoulder girdle injections.…”

Section: What Is Newmentioning

confidence: 99%

Effectiveness of Ultrasound-Guided Versus Anatomic Landmark–Guided Corticosteroid Injection on Pain, Physical Function, and Safety in Patients With Subacromial Impingement Syndrome

Deng

Zhu

et al. 2021

Am J Phys Med Rehabil

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The aim of the study was to compare the efficacy and safety of ultrasound-guided versus anatomic landmark-guided corticosteroid injection for the treatment of subacromial impingement syndrome. Design: PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, Scopus, ClinicalTrials.gov, CBM, CNKI, and Wanfang databases were searched from inception to August 15, 2021, for randomized controlled trials comparing ultrasound-guided versus anatomic landmark-guided injections of corticosteroids for the treatment of subacromial impingement syndrome. Results: Twelve randomized controlled trials with 891 patients were included in this study; 454 patients received ultrasound-guided injections and 437 received anatomic landmark-guided injections. Pooled results showed that ultrasound-guided injection was more beneficial for pain relief (10 trials; mean difference = −0.58; 95% confidence interval = −1.05 to −0.10; P = 0.017) and functional improvement (11 trials; standard mean difference = −0.84; 95% confidence interval = −1.41 to −0.27; P = 0.004). There was no significant difference in shoulder range of motion. In the subgroup analysis, there was a significant difference in pain relief and functional improvement at 6-8 wks and with methylprednisolone. Conclusions: Ultrasound-guided injection of corticosteroids is potentially superior to anatomic landmark-guided injection in improving the clinical symptoms of subacromial impingement syndrome; however, these findings should be interpreted with some caution as the quality of evidence was rated as moderate to very low.

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“…7 Impingement test is usually positive, but the diagnosis of chronic subacromial bursitis should be confirmed by a diagnostic block with local anaesthetic since largest concentration of nerve pain fibres is found in the subacromial bursa. 8,9 Treatment of chronic subacromial bursitis includes rest, heat or cold therapy, therapeutic exercise, and anti-inflammatory medications. Among them, a local injection or infiltration (multiple injections) with corticosteroids into the subacromialsubdeltoid bursa is most effective.…”

Section: Introductionmentioning

confidence: 99%

Comparison of corticosteroid injection, physiotherapy and combined treatment for patients with chronic subacromial bursitis – A randomised controlled trial

Hsieh

Kuo

Huang³

et al. 2023

Clin Rehabil

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Objective To investigate whether combination of corticosteroid subdeltoid injections and physiotherapy was more effective than either treatment alone in chronic subacromial bursitis. Design Prospective, three-arm randomised controlled trial. Setting Rehabilitation department of an academic hospital. Subjects Patients with chronic subacromial bursitis. Interventions Patients were divided into corticosteroid injection (N = 36), physiotherapy (N = 40) and combined (N = 35) groups. Two corticosteroid subdeltoid injections in corticosteroid group, 8-week physical therapy emphasising on therapeutic exercise in physiotherapy group, and combined both treatments in combined group. Main outcome measures The primary outcome measures were pain visual analogue scale and Shoulder Pain and Disability Index at 8 weeks after finishing treatment. The secondary outcome measures were active range of motion, Shoulder Disability Questionnaire, Western Ontario Rotator Cuff Index, patient's evaluation of treatment effect, and symptom recurrence. Results Group comparison showed significant statistical difference in shoulder flexion ( P < 0.003) and patient's evaluation of treatment effect ( P < 0.001). The time and group interactions comparison revealed significant statistical differences in pain score ( P < 0.024), external rotation ( P < 0.044) and patient's evaluation of treatment effect ( P < 0.001). The above statistics were in favour of the corticosteroid and combined groups rather than physiotherapy group. The percentage of recurrence was 36.1, 7.5 and 17.1 in the corticosteroid, physiotherapy and combined groups, respectively ( P < 0.001). Conclusion Corticosteroid subdeltoid injection, or combined with physiotherapy, was superior to physiotherapy alone, but the recurrence rate was least in the physiotherapy group.

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The stenotic concept

Cited by 3 publications

References 95 publications

Cervical-Shoulder Syndrome: Shoulder and Cervical Surgeries Are Risk Factors for Each Other

Cervical-Shoulder Syndrome: Shoulder and Cervical Surgeries Are Risk Factors for Each Other

Effectiveness of Ultrasound-Guided Versus Anatomic Landmark–Guided Corticosteroid Injection on Pain, Physical Function, and Safety in Patients With Subacromial Impingement Syndrome

Comparison of corticosteroid injection, physiotherapy and combined treatment for patients with chronic subacromial bursitis – A randomised controlled trial

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