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Analysis of fatty degeneration of the trapezius muscle after use of accessory nerve / Análise da degeneração gordurosa do músculo trapézio após uso do nervo acessório
Medical School, Institute of Orthopedics and Traumatology, Hand and Microsurgery GroupYamauti, Lucas Seiki; Medical School, Institute of Orthopedics and Traumatology, Hand and Microsurgery GroupSimão, Danielle Tiemi; Medical School, Institute of Orthopedics and Traumatology, Hand and Microsurgery GroupRodrigues, João Carlos; Medical School, Institute of Orthopedics and Traumatology, Hand and Microsurgery GroupKimura, Luiz Koiti; Medical School, Institute of Orthopedics and Traumatology, Hand and Microsurgery GroupMattar Junior, Rames.
  • Medical School, Institute of Orthopedics and Traumatology, Hand and Microsurgery GroupYamauti, Lucas Seiki; Universidade de São Paulo. Hospital das Clínicas. Medical School, Institute of Orthopedics and Traumatology, Hand and Microsurgery GroupYamauti, Lucas Seiki. São Paulo. BR
  • Medical School, Institute of Orthopedics and Traumatology, Hand and Microsurgery GroupSimão, Danielle Tiemi; Universidade de São Paulo. Hospital das Clínicas. Medical School, Institute of Orthopedics and Traumatology, Hand and Microsurgery GroupSimão, Danielle Tiemi. São Paulo. BR
  • Medical School, Institute of Orthopedics and Traumatology, Hand and Microsurgery GroupRodrigues, João Carlos; Universidade de São Paulo. Hospital das Clínicas. Medical School, Institute of Orthopedics and Traumatology, Hand and Microsurgery GroupRodrigues, João Carlos. São Paulo. BR
  • Medical School, Institute of Orthopedics and Traumatology, Hand and Microsurgery GroupKimura, Luiz Koiti; Universidade de São Paulo. Hospital das Clínicas. Medical School, Institute of Orthopedics and Traumatology, Hand and Microsurgery GroupKimura, Luiz Koiti. São Paulo. BR
  • Medical School, Institute of Orthopedics and Traumatology, Hand and Microsurgery GroupMattar Junior, Rames; Universidade de São Paulo. Hospital das Clínicas. Medical School, Institute of Orthopedics and Traumatology, Hand and Microsurgery GroupMattar Junior, Rames. São Paulo. BR
Acta ortop. bras ; 28(4): 186-189, Jul.-Aug. 2020. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1130760
ABSTRACT
ABSTRACT

Objective:

To investigate, through magnetic resonance imaging, the occurrence of fatty degeneration of the trapezius in adult patients undergoing nerve transfer procedure, using the spinal accessory nerve.

Methods:

A total of 13 patients meeting the criteria of unilateral brachial plexus injury and more than one year of postoperative care after nerve transfer surgery underwent an MRI scan of the trapezius. A T1-weighted 3D sequence was used, with the IDEAL technique using 8.0 mm cut thickness, 8.0 mm cut spacing, TR of 100 ms, TE of 3.45 ms, flip angle of 10 degrees, 20 cuts, on the sagittal plane. The images of the upper, transverse and lower parts of the trapezius muscle were then classified according to the degree of fatty degeneration, compared with the contralateral side, using the Goutallier score.

Results:

For the upper trapezius there was a change of the degeneration state in 23% (p = 0.083), for the transverse section there was a change in 84.6% (p = 0.003), for the lower one there was a change in 92.3% (p = 0.002).

Conclusion:

The upper trapezius did not undergo significant degeneration after transfer. The lower and transverse trapezius suffered fatty degeneration in most patients, indicating severe functional impairment. Level of Evidence IV, Case series.
RESUMO
RESUMO

Objetivo:

Através de imagens de ressonância magnética, investigar a ocorrência de degeneração gordurosa no músculo trapézio em pacientes adultos submetidos a procedimento de transferência de nervo envolvendo o nervo espinal acessório.

Métodos:

13 pacientes com lesão do plexo braquial unilateral e mais de um ano de cirurgia de transferência de nervo utilizando o nervo espinal acessório foram submetidos a exame de ressonância magnética do músculo trapézio. Foi obtida uma sequência 3D ponderada em T1, com a técnica IDEAL, espessura de corte de 8,0 mm, espaçamento entre os cortes de 8,0 mm, TR de 100 ms, TE de 3,45 ms, flip angle de 10 graus e 20 cortes, no plano sagital. As imagens das porções superior, transversa e inferior do músculo trapézio foram classificadas de acordo com o grau de degeneração gordurosa e comparadas com o lado contralateral, utilizando o score de Goutallier.

Resultados:

Para o trapézio superior houve mudança no estado de degeneração em 23% (p = 0,083), para o trapézio transverso houve mudança em 84,6% (p = 0,003), e para o trapézio inferior houve mudança em 92,3% (p = 0,002).

Conclusão:

O trapézio superior não sofreu degeneração significativa após transferência. Os trapézios inferiores e médios sofreram degeneração gordurosa na maioria dos pacientes, indicando comprometimento funcional severo. Nível de Evidência IV, Série de casos .


Full text: Available Index: LILACS (Americas) Language: English Journal: Acta ortop. bras Journal subject: Orthopedics Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR

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Full text: Available Index: LILACS (Americas) Language: English Journal: Acta ortop. bras Journal subject: Orthopedics Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR