肩关节镜下通过肩峰下间隙切除冈盂切迹囊肿

Spinoglenoid Notch Cyst Resection through the Subacromial Space under Shoulder Arthroscopy

目的探讨肩关节镜下通过肩峰下间隙切除冈盂切迹囊肿的临床疗效。方法回顾性分析2020年1月至2020年12月北部战区总医院骨科收治的由于军事训练导致的冈盂切迹囊肿共11例。均为男性,年龄为(32.5±5.2)岁(20~46岁);体重为(74.3±17.7)kg。11例病人的术前肌电图均无异常,关节活动范围正常,前屈上举或外展上举动作存在疼痛症状,MRI提示存在冈盂切迹囊肿。全部病例采用关节镜下通过肩峰下间隙切除冈盂切迹囊肿,观察记录术前及术后12个月的Constant⁃Murley评分和疼痛视觉模拟量表(VAS)评分,术后12个月时通过肩关节MRI评估囊肿是否复发。结果随访(12.2±0.8)个月(12~13个月),手术时间为(58.7±15.7)min(52~67 min)。术后切口均一期愈合。末次随访时,全部病例前屈上举或外展上举的疼痛症状减轻,囊肿均无复发。本组病人术前和术后第12个月的Constant⁃Murley评分分别为(42.5±8.7)分、(83.3±6.5)分;VAS评分分别为(6.7±1.6)分、(1.3±0.8)分;术后评分均较术前显著改善,差异均有统计学意义(P均<0.05)。结论肩关节镜下通过肩峰下间隙切除冈盂切迹囊肿,安全、简单,疗效满意。

Objective To explore the clinical efficacy of spinoglenoid notch cyst resection through subacromial space under shoulder arthroscopy.Methods A total of 11 cases of spinoglenoid notch cyst caused by military training in Northern Theater Command General Hospital from January 2020 to December 2020 were retrospectively analyzed.All were male,the average age was(32.5±5.2)years(20⁃46 years),and the average weight was(74.3±17.7)kg.Preoperative electromyography was normal,the range of motion of the joint was normal,there were pain symptoms in flexion and upward lift or abduction,and MRI suggested the presence of spinoglenoid notch cyst.All the patients underwent arthroscopic resection of glenoid notch cyst through subacromial space.Constant⁃Murley score and visual analogue scale(VAS)were observed and recorded before and 12 months after surgery.MRI of shoulder joint was evaluated 12 months after surgery to determine whether there was any recurrence.Results They were followed up for(12.2±0.8)months(12⁃13 months),and the operation time was(58.7±15.7)min(52⁃67 min).All the incisions healed in one stage.At the last follow⁃up,the pain symptoms of all cases were relieved by flexion and abduction lifting,and MRI reexamination showed no recurrence.The Constant⁃Murley score of patients preoperation and 12 months after operation was 42.5±8.7 and 83.3±6.5 respectively;VAS scores were 6.7±1.6 and 1.3±0.8 respectively.The scores after operation were significantly improved as compared with those before operation,and the differences were statistically significant(P<0.05).Conclusion Arthroscopy is a safe,simple and effective method to remove the glenoid notch cyst through the subacromial space.