Ultrasound-guided versus blind subacromial bursa corticosteroid injection for paraplegic spinal cord injury patients with rotator cuff tendinopathy: a randomized, single-blind clinical trial

Abstract

Introduction

Shoulder pain is one of the common musculoskeletal complaints of the patients with spinal cord injury. Corticosteroid injection to the subacromial bursa is one of the confirmed therapies which can be guided by anatomic landmarks or ultrasound. This study is aimed to compare these two methods to find the one with the highest therapeutic impact.

Materials and methods

In this study, 30 patients with paraplegic SCI suffering from shoulder pain were enrolled. They were divided into 2 groups based on 4-block randomization sampling. The first group received subacromial corticosteroid injection through anatomic landmarks; while in the second group, the injection was guided by ultrasound. VAS criterion was employed for investigation of pain severity; while the constant score was used to study the shoulder pain and function. BREF questionnaire was also applied to examine the quality of life.

Findings

The mean scores of VAS and Constant in both groups showed a significant improvement two months after intervention when compared with their condition before the intervention. This improvement was significantly higher in the ultrasound group. The physical, physiological and environmental health scores of BREF questionnaire as well as their total score showed a significant improvement in both groups two months after intervention. But this improvement was not significantly different between the two groups in terms of any of the items.

Discussion

Hence, although ultrasound-guided injection is more costly and requires higher skills in comparison with blind injection, it is significantly more effective in controlling the pain and improving the shoulder function.

Keywords:

• Ultrasound-guided injection
• rotator cuff tendinopathy
• spinal cord injury
• subacromial bursa

Acknowledgments

Authors gratefully acknowledge the assistance of all participants in this study and also all staff members of Imam Khomeini hospitals, Tehran-Iran.

Disclosure statement

None of the contributing authors have any conflict of interest, including specific financial interests or relationships and affiliations relevant to the subject matter or materials discussed in the manuscript.