3DCT を用いた腱板断裂患者の肩峰下骨棘の評価

抄録

The aim of this study was to investigate the relation of the morphology of the subacromial spur, and cuff tear size and clinical findings of rotator cuff tears by using three dimensional computed tomography (3DCT). We studied 77 patients (80 shoulders) who had received arthroscopic subacromial decompression with or without arthroscopic rotator cuff repair. The patients were 36 males (39 shoulders) and 41 females (41 shoulders). Mean age at time of surgery was 64.6 years old (range, 36-87 years). We examined the morphology of the subacromial spur, and measured the size with 3DCT, preoperatively. And then, we investigated the relation of the morphology of the spur and patient's age, spur size, cuff tear size, duration of symptoms, clinical outcome (JOA score) and trauma. We classified the morphology of the subacromial spur into the following three types by location, anterior type (type A); 23 shoulders, antero-lateral type (type AL); 17 shoulders and medial type (type M); 40 shoulders. The spur size in type M was significantly biggest of all types. There were significantly more elderly patients in type M. Cuff tear size tended to become larger in type A-L and M than in type A. The spur width is significantly bigger in the complete rotator cuff tear group than the partial thickness tear group. Type M spurs were frequently found in elderly patients and patients with larger cuff tear. Since spur increase in size over time, in many cases, we think that subacromial spur of cuff tear patients progresses from type A to type AL, and then advances to type M last.