Clinic Characters And Diagnose Analysis Of Complex Neck Shoulder Upper Extremity Pain Syndrome

PURPOSE:The patients with compliance of neck shoulder extremity pain(NSEP)are commonly presented in the clinic.Because of complex anatomy and multiple pathogenesis,the NESP is complicated to identify for the physician.To analyze the clinic characters of the NESP,making the further categories and summarize aimed to improve the recognition of clinicians,and make the valuable reference for the clinical work.METHODS:A retrospective study was performed.The information of symptoms,signs,physical examinations,radiographs,laboratory examinations and diagnosis were sumarized and categoried.The patients with NSEP who presented in the multi-disciplinary consultation platform on the NSEP of China-Japan Union Hospital during Jul 2015 to Mar 2017 were collected.RESULTS:A total of 91 patients were included in the study,including 41 males 50 famales,the patients' NSEP duration was from 5 days to 30 years and average duration was 25.4 months.Ages from 47-67 is the most common presented with 53 persons(58.2%).Except for pain,numbness(35%),weakness(13%),myophagism(11%)and activity limitation are the most common symptom.In the 24 cases with positive Spurling's sign,17 cases were cervical spondylotic radiculopathy(70.8%);11cases get through the anterior and middle scalene muscle diagnosis block,and 8 patients with positive results,7of these 8 patients are confirmed as thoracic outlet syndrome(TOS),in 48 cases diagnosis of single disease,cervical spondylosis present as 10(21%),thoracic outlet syndrome present as 9cases(19%),peripheral nerve disease of 9 cases(19%),nervous centralis disorder present as 7 cases(15%),toumor of 4cases(8%),infection of 3cases(6%),others of 6cases(12%).in other 29 cases of mixture complex diagnosis,TOS combine with other diseases acts as 16 cases(55.2%),and in these 16 cases,8 present with cervical spondylosis.The number of cervical spondylosis with other disease is 7(24.1%).CONCLUSION:Complex neck shoulder extremity pain(CNSEP),most present in the middle aged,especially female.cervical spondylosis is one of the most common factor in CNSEP,as well as TOS present a large amount.Both these two disease can appear in the single patient.Spurling's sign and anterior middle scalene muscle diagnosis block have an important effect in the diagnosis of CNSEP.