Self-controlled cohort study of influence on muscular function changes after shoulder arthroscopy on cervical spine morphology and sagittal parameters

doi:10.3877/cma.j.issn.1673-9450.2024.05.001

Abstract

Abstract:

Objective

To evaluate the effect of muscular functions on the cervical sagittal parameters and alignment after shoulder arthroscopy.

Methods

From October 2022 to December 2023, 68 patients with subacromial impingment syndrome admitted in Department of Orthopedics, Beijing Tiantan Hospital, Capital Medical University. The general conditions (gender, age, height, weight, body mass index) of the subjects were evaluated. The quality of life score (VAS of neck and shoulder), imaging parameters (upper cervical curvature, lower cervical curvature, C2-C7 sagittal vertical axis, T1-Slope, cervical alignment) and muscle function index (flexion-relaxation ratio of splenius capitis, upper trapezius and sternocleidomastoid, co-contraction ratio during flexion and extension) were evaluated pre-operation, 3 days and 6 weeks post-operation. The differences of quality of life score, cervical sagittal parameters and muscle function index were evaluated, and the correlation between quality of life score, cervical imaging parameters and muscle function index were evaluated. Multivariate regression analysis was used to analyze the influencing factors of upper cervical curvature, lower cervical curvature and cervical alignment.

Results

There were significant differences in quality of life score, ssagittal parameters and muscular function of cervical spine pre-operation, 3 days and 6 weeks post-operation (P< 0.05). Multivariate regression analysis showed that neck visual analogue scale (β=-0.215, P<0.01) and lower cervical curvature (β=-0.160, P<0.05) were significantly negative predictors of upper cervical curvature. T1-Slope (β=-0.633, P<0.01) and co-contraction ratio during extension (β=-0.124, P<0.05) significantly negatively predicted lower cervical curvature, neck VAS(β=0.108, P<0.05), and C2-C7 sagittal vertical axis (β=0.319, P<0.01) and FRR of upper trapezius (β=0.041, P<0.01) significantly positively predicted lower cervical curvature. The co-contraction ratio during extension (β=-1.325, P<0.01) negatively predicted the alignment of the cervical spine, and the neck VAS(β=0.060, P<0.05) and lower cervical curvature (β=0.032, P<0.01) positively predicted the alignment of the cervical spine.

Conclusions

Neck pain and lower cervical curvature are independent influence factors of upper cervical curvature. Neck pain, C2-C7 sagittal vertical axis, T1-Slope, flexion-relaxation ratio of upper trapeziu and co-contraction ratio during extension were independent influence factors of lower cervical curvature. Neck pain, lower cervical curvature and co-contraction ratio during extension are independent influence factors of cervical alignment.The changes of neck and shoulder muscle function combine with C2-C7 sagittal vertical axis and T1 tilt angle to affect lower cervical curvature, and then affecting upper cervical curvature.

Key words: Arthroscopes, Cervical spine sagittal parameters, Kyphosis, Muscular function, Surface electromyography

Dian Wang, Shuanghe Liu, Zheng Zeng. Self-controlled cohort study of influence on muscular function changes after shoulder arthroscopy on cervical spine morphology and sagittal parameters[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2024, 19(05): 371-378.

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References 25

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项目	VAS_N	VAS_S	C0-C2曲度	C2-C7曲度	C2-C7 SVA	T1S	颈椎顺列形态	FRR_SPL	FRR_UTr	FRR_SCM	CCR_NF	CCR_EN
VAS_N	1	0.024	-0.310^b	0.153^a	-0.018	-0.004	0.224^b	0.074^a	0.192^a	0.161^a	-0.255^b	-0.231^b
VAS_S		1	-0.030	0.003^a	0.113	0.065	-0.110	-0.087	-0.127^a	0.041	0.346^b	0.353^b
C0-C2曲度			1	-0.158^a	-0.102	-0.031	-0.090	0.012	-0.243^b	-0.146^a	0.134	0.029
C2-C7曲度				1	0.167^a	-0.575^b	0.473^b	0.118^a	0.065	-0.157^a	-0.031	-0.141^a
C2-C7 SVA					1	0.162^a	-0.105	0.074	-0.024	-0.089	0.081	0.199^b
T1S						1	-0.301^b	0.041	0.157^a	0.140^a	-0.107	0.074
颈椎顺列形态							1	0.204	-0.124	-0.004	-0.182^b	-0.357^b
FRR_SPL								1	0.317^b	-0.023	-0.256^b	-0.022
FRR_UTr									1	0.304^b	-0.115	-0.221^b
FRR_SCM										1	0.163^a	-0.148^a
CCR_NF											1	0.311^b
CCR_EN												1

项目	VAS_N	VAS_S	C0-C2曲度	C2-C7曲度	C2-C7 SVA	T1S	颈椎顺列形态	FRR_SPL	FRR_UTr	FRR_SCM	CCR_NF	CCR_EN
VAS_N	1	0.024	-0.310^b	0.153^a	-0.018	-0.004	0.224^b	0.074^a	0.192^a	0.161^a	-0.255^b	-0.231^b
VAS_S		1	-0.030	0.003^a	0.113	0.065	-0.110	-0.087	-0.127^a	0.041	0.346^b	0.353^b
C0-C2曲度			1	-0.158^a	-0.102	-0.031	-0.090	0.012	-0.243^b	-0.146^a	0.134	0.029
C2-C7曲度				1	0.167^a	-0.575^b	0.473^b	0.118^a	0.065	-0.157^a	-0.031	-0.141^a
C2-C7 SVA					1	0.162^a	-0.105	0.074	-0.024	-0.089	0.081	0.199^b
T1S						1	-0.301^b	0.041	0.157^a	0.140^a	-0.107	0.074
颈椎顺列形态							1	0.204	-0.124	-0.004	-0.182^b	-0.357^b
FRR_SPL								1	0.317^b	-0.023	-0.256^b	-0.022
FRR_UTr									1	0.304^b	-0.115	-0.221^b
FRR_SCM										1	0.163^a	-0.148^a
CCR_NF											1	0.311^b
CCR_EN												1

参数	B	β	t值	P值	F值	调整R²
VAS_N	-0.752	-0.215	-3.089	0.002	5.285	0.781
C2-C7曲度	-0.080	-0.160	-2.301	0.022
FRR_UTr	-0.280	-0.076	-0.749	0.455
FRR_SCM	-0.136	-0.058	-0.577	0.565

参数	B	β	t值	P值	F值	调整R²
VAS_N	-0.752	-0.215	-3.089	0.002	5.285	0.781
C2-C7曲度	-0.080	-0.160	-2.301	0.022
FRR_UTr	-0.280	-0.076	-0.749	0.455
FRR_SCM	-0.136	-0.058	-0.577	0.565

参数	B	β	t值	P值	F值	调整R²
VAS_N	0.753	0.108	1.955	0.047	5.285	0.745
VAS_S	0.422	0.072	1.284	0.201
C0-C2曲度	-0.193	-0.097	-1.763	0.079
C2-C7 SVA	0.471	0.319	5.488	0.000
T1-Slope	-0.980	-0.633	-11.449	0.000
FRR_UTr	0.305	0.041	0.689	0.002
CCR_E	-7.584	-0.124	-2.075	0.039

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