title: Short-term clinical results of frozen shoulder treated with shoulder manipulation under ultrasound-guided cervical nerve root block at outpatient setting: A case series.
abstract: BACKGROUND
  We evaluated the short-term clinical outcomes of frozen shoulder treatment via shoulder manipulation under ultrasound-guided cervical nerve root block (MUC).
  
  
  METHODS
  This study included frozen shoulder patients who were unresponsive to conservative therapy for at least 6 months and were then treated with MUC. Patients with a rotator cuff tear, calcifying tendinitis, osteoarthritis, or any other shoulder disorder were excluded following X-ray, ultrasound, and magnetic resonance imaging evaluation. Although 25 patients were initially included, three patients were not followed-up for at least 1 year. We investigated a final total of 22 patients; the average age was 58 years and 59% were female. We measured shoulder pain, shoulder range of motion, and American Shoulder and Elbow Surgeons shoulder scores immediately prior to MUC, 1 week after MUC, and 1 year after MUC. A Short-Form 36-Item Health Survey was administered before MUC and 1 year after MUC. We used the Friedman and Wilcoxon signed-rank tests to identify statistical differences. Significance was defined as p < 0.05.
  
  
  RESULTS
  MUC significantly improved shoulder pain during motion, range of motion, and American Shoulder and Elbow Surgeons scores 1 week after MUC. This improvement persisted at the 1-year follow-up. Seven of the eight Short-Form 36-Item Health Survey measures were significantly improved 1 year after MUC. One patient (4.5%) developed Horner's syndrome, although symptoms resolved within several hours without treatment.
  
  
  CONCLUSIONS
  MUC for frozen shoulder was safe and resulted in a significant improvement in shoulder pain and range of motion 1 week after the procedure. This improvement persisted at the 1-year follow-up.
authors.affiliation: Department of Orthopaedic Surgery, Fukuoka Mirai Hospital, Fukuoka, Japan. Electronic address: tr-saitou@kkf.biglobe.ne.jp.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Saito
authors.affiliation: Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Sasanuma
authors.affiliation: Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Iijima
authors.affiliation: Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kanaya
authors.affiliation: Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Saito
authors.affiliation: Jichi Children's Medical Center, Tochigi, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Jichi Children's Medical Center, Tochigi, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kikkawa
authors.affiliation: Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Katsushi
authors.initials: K
authors.lastname: Takeshita
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002062:Bursitis / Q000000981:diagnostic imaging* / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D011379:Prognosis; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional