[1]孟庆阳 刘平*.关节镜下经肩胛冈入路切除冈盂切迹囊肿28例随访1年结果[J].中国微创外科杂志,2022,01(8):609-613.
　Meng Qingyang,Liu Ping..Arthroscopic Excision of Spinoglenoid Notch Cyst Through Mesoscapula Portal: 1 Year Followup Results of 28 Cases[J].Chinese Journal of Minimally Invasive Surgery,2022,01(8):609-613.
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关节镜下经肩胛冈入路切除冈盂切迹囊肿28例随访1年结果()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2022年8期
页码:
609-613
栏目:
临床研究
出版日期:
2022-11-25

文章信息/Info

Title:
Arthroscopic Excision of Spinoglenoid Notch Cyst Through Mesoscapula Portal: 1 Year Followup Results of 28 Cases
作者:
孟庆阳 刘平*
(北京大学第三医院运动医学科北京大学运动医学研究所运动医学关节伤病北京市重点实验室，北京100191)
Author(s):
Meng Qingyang;  Liu Ping.
Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
关键词:
冈盂切迹囊肿;  肩胛冈入路;  肩胛上神经卡压综合征;  盂唇损伤;  肩袖损伤
Keywords:
Spinoglenoid notch cyst; Mesoscapula portal; Suprascapular nerve entrapment syndrome; Labrum injury; Rotator cuff injury
文献标志码:
A
摘要:
目的探讨关节镜下经肩胛冈入路切除冈盂切迹囊肿的临床疗效。方法回顾性分析2014年6月~2020年6月28例冈盂切迹囊肿手术和随访资料，其中4例单纯冈盂切迹囊肿，21例合并肩关节上盂唇前后部(superior labrum anterior and posterior，SLAP)损伤，1例合并后盂唇损伤，2例合并前下盂唇损伤。关节镜下经肩胛冈入路(冈上肌和冈下肌间隙)完全切除囊肿，并处理合并肩关节病变如SLAP损伤、肩袖损伤等。随访期1年，通过ConstantMurley评分、改良美国加州大学（UCLA）肩关节评分和肌力评分评估肩关节功能，行MRI明确囊肿是否复发。结果28例术后无严重并发症，临床症状均较术前明显改善，术后1年ConstantMurley评分、改良UCLA评分均较术前明显提高［(48.5±7.0)分vs.(95.6±3.4)分，t=-35.804，P=0000；(17.0±8.3)分vs.(32.3±3.7)分，t=-9.371，P=0.000］，7例冈下肌萎缩者肩外旋肌力较术前显著提高［(5.4±35)kg vs. (10.7±2.9)kg，t=-2.937，P=0.026］。术后1年复查MRI均未见囊肿复发。结论关节镜下经肩胛冈入路完全切除冈盂切迹囊肿、处理合并肩关节损伤，可改善临床症状，避免囊肿复发。
Abstract:
ObjectiveTo investigate clinical effect of arthroscopic excision of spinoglenoid notch cyst (SNC) through mesoscapula portal.MethodsSurgical and followup data of 28 patients with SNC from June 2014 to June 2020 were retrospectively analyzed. Among them, 4 cases were primary SNC, 21 cases were complicated with superior labrum anterior and posterior (SLAP) injury, 1 case was complicated with posterior labrum injury, and 2 cases were complicated with anteriorinferior labrum injury. The cysts were completely removed through the mesoscapula portal (the space between the supraspinatus and the infraspinatus) under arthroscopy, and the concomitant shoulder lesions such as SLAP injury and rotator cuff injury were treated at the same time. The followup period was 1 year. The shoulder function was evaluated by the ConstantMurley score, modified UCLA shoulder rating scale, and muscle strength test. The MRI was performed to determine whether the cysts recurred.ResultsThere were no serious complications after surgery in the 28 patients. The clinical symptoms of all the patients were significantly improved. The ConstantMurley score and modified UCLA score of 28 patients at 1 year after surgery were significantly higher than those before surgery ［(48.5±7.0) vs. (956±3.4) points, t=-35.804, P=0.000; (17.0±8.3) vs. (32.3±3.7) points, t=-9.371, P=0.000］. The data of external rotatory muscle strength of 7 patients with subaspinatus atrophy after surgery were significantly improved as compared with those preoperation ［(5.4±3.5) kg vs. （10.7±2.9） kg, t=-2.937, P=0.026］. No recurrence of the SNC was observed on MRI 1 year after surgery.ConclusionArthroscopic complete excision of SNC through mesoscapula portal and treatment of concomitant shoulder injuries could improve clinical symptoms and avoid recurrence of cysts.

参考文献/References:

[1]Memon M,Kay J,Ginsberg L,et al.Arthroscopic management of suprascapular neuropathy of the shoulder improves pain and functional outcomes with minimal complication rates.Knee Surg Sports Traumatol Arthrosc,2018,26(1):240-266.
[2]朱金国,孙建雨,刘俊,等.冈盂切迹囊肿引起肩胛上神经卡压综合征一例.中国修复重建外科杂志,2022,36(1):133-134.
[3]Sreehari CK,Varshney A,Yoo YS,et al.Arthroscopic intraarticular spinoglenoid cyst resection following SLAP repair.Arthrosc Tech,2017,6(5):e1795-e1799.
[4]冯思嘉,陈俊,张健,等.肩关节不稳与SLAP损伤联系的研究进展.中国修复重建外科杂志,2022,36(2):135-142.
[5]张寅权,王一,楼毅,等. 肩关节镜手术治疗SLAP损伤的中期疗效随访.中国骨与关节损伤杂志,2021,36(3):279-281.
[6]丁少华,毕明光,丁伟,等.关节镜下“三明治”补片上关节囊重建术治疗巨大不可修复性肩袖撕裂.中华骨科杂志,2021,41(24):1753-1761.
[7]孙凯,姜文学,李轶津.SLAP损伤合并冈盂切迹囊肿的关节镜治疗.中华肩肘外科电子杂志,2019,7(4):368-371.
[8]Pasco JA,Stuart AL,HollowayKew KL,et al.Lowerlimb muscle strength: normative data from an observational populationbased study.BMC Musculoskelet Disord,2020,21(1):89.
[9]Bilsel K,Erdil M,Elmadag M,et al.The effect of infraspinatus hypotrophy and weakness on the arthroscopic treatment of spinoglenoid notch cyst associated with superior labrum anteriortoposterior lesions.Knee Surg Sports Traumatol Arthrosc,2014,22(9):2209-2215.
[10]刘炜洁,蔡琰,戚超,等.关节镜下经后关节囊切开减压治疗冈盂切迹囊肿引起的肩胛上神经卡压综合征.中华骨科杂志,2018,38(7):390-395.
[11]刘世同,王绍华,李绍科,等.MRI诊断冈盂切迹囊肿所致肩胛上神经卡压初探.临床放射学杂志,2019,38(9):1730-1733.
[12]Schroeder AJ,Bedeir YH,Schumaier AP,et al.Arthroscopic management of SLAP lesions with concomitant spinoglenoid notch ganglion cysts:a systematic review comparing repair alone to repair with decompression.Arthroscopy,2018,34(7):2247-2253.
[13]Wee TC,Wu CH.Ultrasoundguided aspiration of a paralabral cyst at the spinoglenoid notch with suprascapular nerve compressive neuropathy.J Med Ultrasound,2018,26(3):166-167.
[14]Feinberg JH,Mehta P,Gulotta LV,et al.Electrodiagnostic evidence of suprascapular nerve recovery after decompression.Muscle Nerve,2019,59(2):247-249.
[15]Buyukdogan K,Altintas B,Koyuncu O,et al.Ultrasoundguided intralesional methylene blue injection for the arthroscopic decompression of spinoglenoid notch cyst causing suprascapular neuropathy.Arthrosc Tech,2020,9(11):e1785-e1789.
[16]Kim DS,Park HK,Park JH,et al.Ganglion cyst of the spinoglenoid notch:comparison between SLAP repair alone and SLAP repair with cyst decompression.J Shoulder Elbow Surg,2012,21(11):1456-1463.
[17]Hashiguchi H,Iwashita S,Ohkubo A,et al.SLAP repair with arthroscopic decompression of spinoglenoid cyst.SICOT J,2016,2：1.
[18]Jerome TJ,Sabtharishi V,Thirumagal Sk.Open surgical decompression for large multiloculated spinoglenoid notch ganglion cyst with suprascapular nerve neuropathy.Cureus,2021,13(2):e13300.
[19]Kim SJ,Choi YR,Jung M,et al.Outcomes of arthroscopic decompression of spinoglenoid cysts through a subacromial approach.Arthroscopy,2017,33(1):62-67.
[20]Promsang T,Kongrukgreatiyos K,Kuptniratsaikul S.Arthroscopic decompression of spinoglenoid notch cyst and SLAP repair through a single working portal.Arthrosc Tech,2018,7(9):e963-e967.

备注/Memo

备注/Memo:
*通讯作者，Email：bjusmlp@126.com
更新日期/Last Update: 2022-11-25