[Cervico-omo-brachial pain and disability in a person of advanced age].
A person of advanced age usually has degenerative changes of bone, joint and ligament, which can be causes of cervico-omo-brachial pain and disability. He or she may also suffer from metastatic bone tumor of cervical spine or upper extremity. This article described pathology, signs and symptoms and recent treatment of these diseases. Cervical myelopathy and radiculopathy, which are most common causes of cervico-omo-brachial symptoms, are sometimes accompanied by peripheral entrapment neuropathy such as cubital tunnel syndrome or carpal tunnel syndrome (double crush syndrome). In this complicated situation, decompression of neural tissue in both cervical spine and carpal tunnel are necessary. In treatment for carpal tunnel syndrome, release of transverse carpal ligament under an arthroscope has proven to be useful and has been becoming popular. This minimally invasive surgery is also useful in shoulder surgery such as subacromial decompression in aged patients with rotator cuff tear and removal of calcium deposit in the shoulder joint. Osteoarthritis of the elbow also cause pain or disability of the elbow and the hand. Some metastatic bone tumors are treated by tumor resection and reconstruction with instruments, prosthesis or composite grafts, which are attempted not to cure the disease but to maintain or improve the quality of life of the patient.
Usui
M
M
Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Japan.
D000368:Aged; D001859:Bone Neoplasms / Q000150:complications / Q000556:secondary / Q000601:surgery; D020968:Brachial Plexus Neuritis / Q000209:etiology*; D002349:Carpal Tunnel Syndrome / Q000150:complications / Q000601:surgery; D004551:Elbow Joint; D006225:Hand; D006801:Humans; D009069:Movement Disorders / Q000209:etiology*; D010003:Osteoarthritis / Q000150:complications / Q000628:therapy; D011843:Radiculopathy / Q000150:complications; D012785:Shoulder Joint / Q000601:surgery; D052256:Tendinopathy / Q000150:complications