Cervical Spine Pathology Increases the Risk of Rotator Cuff Tear: A Population-Based Cohort Study

Overview

Journal Orthop J Sports Med

Specialty Orthopedics

Date 2021 Dec 17

PMID 34917691

Authors

Jr-Yi Wang

Yu-Ru Lin

Chen-Kun Liaw

Chih-Hwa Chen

Hui-Wen Lin

Shih-Wei Huang

Affiliations

Soon will be listed here.

Abstract

Background: Patients with cervical radiculopathy typically present with shoulder pain and weakness; these symptoms are similar to those of rotator cuff disease. Studies investigating cervical spine pathology (CSP) as an independent risk factor for rotator cuff tear (RCT) are lacking in the literature.

Purpose: To investigate the risk of RCT among patients with CSP who have undergone cervical diskectomy (CD) and to determine whether CD reduces this risk.

Study Design: Cohort study; Level of evidence, 3.

Methods: The authors queried the Taiwan National Health Insurance Research Database for patients diagnosed with CSP between 2004 and 2008 and followed up until the end of 2010. A control cohort comprised patients without CSP who were age- and sex-matched in a 4-to-1 ratio with patients with CSP through propensity score matching. A Cox multivariate proportional hazards model was applied to analyze the risk factors for RCT. After adjustment for confounders, the authors calculated the hazard ratio (HR) and adjusted HR (aHR) between the study and control cohorts. The effects of CD on the risk of RCT were also analyzed.

Results: The study included 3245 patients and 12,980 matched controls. A higher RCT incidence rate was found in the CSP cohort, with an aHR of 1.52 (95% CI, 1.22-1.89; < .001). Patients with CSP who underwent CD had a risk of RCT similar to that of the controls, with an aHR of 1.65 (95% CI, 0.90-3.03; > .05).

Conclusion: Patients with CSP had a 1.52-fold higher risk of RCT than healthy controls. Patients with CSP with CD did not have a high risk of RCT, possibly indicating a protective effect of diskectomy against RCT.

References

Kim H, Galatz L, Lim C, Havlioglu N, Thomopoulos S . The effect of tear size and nerve injury on rotator cuff muscle fatty degeneration in a rodent animal model. J Shoulder Elbow Surg. 2011; 21(7):847-58. PMC: 3217129. DOI: 10.1016/j.jse.2011.05.004. View

Vad V, Southern D, Warren R, Altchek D, Dines D . Prevalence of peripheral neurologic injuries in rotator cuff tears with atrophy. J Shoulder Elbow Surg. 2003; 12(4):333-6. DOI: 10.1016/s1058-2746(03)00040-5. View

Date E, Gray L . Electrodiagnostic evidence for cervical radiculopathy and suprascapular neuropathy in shoulder pain. Electromyogr Clin Neurophysiol. 1996; 36(6):333-9. View

Weiss J, Thompson G, Doust V, Burgener F . Rotator cuff tears in rheumatoid arthritis. Arch Intern Med. 1975; 135(4):521-5. View

Yang Y, Qu J . The effects of hyperlipidemia on rotator cuff diseases: a systematic review. J Orthop Surg Res. 2018; 13(1):204. PMC: 6098646. DOI: 10.1186/s13018-018-0912-0. View

Zhang A, Theologis A, Tay B, Feeley B . The association between cervical spine pathology and rotator cuff dysfunction. J Spinal Disord Tech. 2014; 28(4):E206-11. DOI: 10.1097/BSD.0000000000000223. View

Huang S, Wang W, Chou L, Liou T, Chen Y, Lin H . Diabetes mellitus increases the risk of rotator cuff tear repair surgery: A population-based cohort study. J Diabetes Complications. 2016; 30(8):1473-1477. DOI: 10.1016/j.jdiacomp.2016.07.015. View

Colvin A, Egorova N, Harrison A, Moskowitz A, Flatow E . National trends in rotator cuff repair. J Bone Joint Surg Am. 2012; 94(3):227-33. PMC: 3262185. DOI: 10.2106/JBJS.J.00739. View

Jimenez-Garcia R, Del Barrio J, Hernandez-Barrera V, de Miguel-Diez J, Jimenez-Trujillo I, Martinez-Huedo M . Is there an association between diabetes and neck pain and lower back pain? Results of a population-based study. J Pain Res. 2018; 11:1005-1015. PMC: 5973317. DOI: 10.2147/JPR.S158877. View

10.

Gowd A, Cvetanovich G, Liu J, Nwachukwu B, Cabarcas B, Cole B . Preoperative Mental Health Scores and Achieving Patient Acceptable Symptom State Are Predictive of Return to Work After Arthroscopic Rotator Cuff Repair. Orthop J Sports Med. 2019; 7(10):2325967119878415. PMC: 6820363. DOI: 10.1177/2325967119878415. View

11.

Fields A, Berg-Johansen B, Metz L, Miller S, La B, Liebenberg E . Alterations in intervertebral disc composition, matrix homeostasis and biomechanical behavior in the UCD-T2DM rat model of type 2 diabetes. J Orthop Res. 2015; 33(5):738-46. PMC: 4408867. DOI: 10.1002/jor.22807. View

12.

Liu X, Manzano G, Kim H, Feeley B . A rat model of massive rotator cuff tears. J Orthop Res. 2010; 29(4):588-95. DOI: 10.1002/jor.21266. View

13.

Sasaki Y, Ochiai N, Hashimoto E, Sasaki Y, Yamaguchi T, Kijima T . Relationship between neuropathy proximal to the suprascapular nerve and rotator cuff tear in a rodent model. J Orthop Sci. 2018; 23(2):414-419. DOI: 10.1016/j.jos.2017.12.005. View

14.

Rawlins B, Girardi F . Rheumatoid arthritis of the cervical spine. Rheum Dis Clin North Am. 1998; 24(1):55-65. DOI: 10.1016/s0889-857x(05)70377-x. View

15.

Longo U, Denaro L, Spiezia F, Forriol F, Maffulli N, Denaro V . Symptomatic disc herniation and serum lipid levels. Eur Spine J. 2011; 20(10):1658-62. PMC: 3175866. DOI: 10.1007/s00586-011-1737-2. View

16.

Costouros J, Porramatikul M, Lie D, Warner J . Reversal of suprascapular neuropathy following arthroscopic repair of massive supraspinatus and infraspinatus rotator cuff tears. Arthroscopy. 2007; 23(11):1152-61. DOI: 10.1016/j.arthro.2007.06.014. View

17.

Rowshan K, Hadley S, Pham K, Caiozzo V, Lee T, Gupta R . Development of fatty atrophy after neurologic and rotator cuff injuries in an animal model of rotator cuff pathology. J Bone Joint Surg Am. 2010; 92(13):2270-8. PMC: 2945930. DOI: 10.2106/JBJS.I.00812. View