Hüseyin Alper KIZILOĞLU, Veysel Atilla AYYILDIZ, Hatice YAKUT, Zülal BEKAR

TEK TARAFLI SERVİKAL AĞRI VE RADİKÜLOPATİSİ OLAN HASTALARDA TRAPEZİUS, MASSETER VE STERNOKLEİDOMASTOİD KAS KALINLIKLARININ, AĞRI EŞİĞİNİN VE ÖZÜRLÜLÜĞÜN DEĞERLENDİRİLMESİ

Amaç Kronik servikal ağrı, dünya çapında gözlenen en yaygın kas iskelet sistemi semptomlarından biridir. Çalışmamızda tek taraflı kronik boyun ağrısı olan olguların ultrasonografide(USG) boyun bölgesinde ve boyun bölgesine komşu kas gruplarında varsa kalınlık değişimlerini göstermeyi amaçladık. Ayrıca aynı hasta grubunun, basınç algometrede kasların ağrı eşiğindeki değişimi göstermeyi de amaçladık. Gereç ve Yöntem Tek taraflı boyun ağrısı olup, servikal manyetik rezonans görüntülemede(MRG) disk herniasyonu olan, elektromyografide(EMG) radikülopati bulguları kanıtlanan ve 12 hafta veya üzeri ağrısı olan (kronik boyun ağrısı tanımına uyan) hastalar çalışmaya dahil edilmiştir. Çalışma prospektif olarak yapılmıştır. Toplamda 32 hasta (25 kadın, 7 erkek) dahil edilmiştir. Hastaların ağrılarını değerlendirmede vizüel analog skala(VAS) testi, basınç algometre ile ölçüm ve boyun özürlülük testi yapılmıştır. Hastaların masseter, sternokleidomastoid (SKM) ve trapezius kas kalınlıkları USG ile ölçülmüştür. Ayrıca her üç kasın ağrı eşikleri basınç algometre ile belirlenmiştir. Bulgular Hastaların yaşları 20-69 arasında değişmekte olup ortalama yaşları 49,71 ± 11,73’dur. Ağrı olan ve olmayan tarafta SKM, trapezius ve masseter kası ağrı eşik seviyeleri için istatistiksel anlamlı fark gözlenmemiştir (sırası ile p = 0,645; p = 0,386; p = 0,545). Ağrı olan ve olmayan tarafta SKM, trapezius ve masseter kas kalınlığı için istatistiksel anlamlı fark gözlenmemiştir (sırası ile p = 0,76; p = 0,563; p = 0,603). Sonuç Tek taraflı kronik boyun ağrısı olan hastada, ağrı olan tarafta ve olmayan tarafta çalışılan her 3 kas için (trapezius, sternokleidomastoid kas ve masseter kası) ağrı eşiklerinde istatistiksel anlamlı fark gözlenme- miştir. Kas kalınlıklarının USG ile ölçümünde de her 3 kas için (trapezius, sternokleidomastoid kas ve masseter kası) ağrı olan ve olmayan taraf için istatistiksel anlamlı fark gösterilememiştir.

Anahtar Kelimeler:

Servikal ağrı, USG, Kas kalınlıkları

EVALUATION OF TRAPEZIUS, MASSETER AND STERNOCLEIDOMASTOID MUSCLE THICKNESS, PAIN THRESHOLD AND DISABILITY IN PATIENTS WITH UNILATERAL CERVICAL PAIN AND RADICULOPATHY

Objective Chronic cervical pain is one of the most common musculoskeletal symptoms observed worldwide. In our study, we aimed to show the thickness changes, if any, in the neck region and muscle groups adjacent to the neck region in ultrasonography (USG) of patients with unilateral chronic neck pain. We also aimed to show the change in the pain threshold of the muscles in pressure algometry in a separate patient group. Material and Method Patients with unilateral neck pain, disc herniation on cervical magnetic resonance imaging (MRI), radiculopathy findings proven on electromyography (EMG), and pain for 12 weeks or longer (fitting the definition of chronic neck pain) were included in the study. The study was conducted prospectively. A total of 32 patients (25 women, 7 men) were included. Visual analog scale (VAS) test, pressure algometer measurement and neck disability test were used to evaluate the pain of the patients. Masseter, sternocleidomastoid (SCM) and trapezius muscle thicknesses of the patients were measured by US. In addition, pain thresholds of all three muscles were determined by pressure algometer. Results The mean age of the patients was 49.71 ± 11.73 years. No statistically significant difference was observed for the pain threshold levels of SCM, trapezius and masseter muscles on the side with and without pain (p = 0.645; p = 0.386; p = 0.545, respectively). No statistically significant difference was observed for SCM, trapezius and masseter muscle thicknesses on the pain and non-pain side (p = 0.76; p = 0.563; p = 0.603, respectively). Conclusion There was no statistically significant difference in pain thresholds for all 3 muscles (trapezius, sternocleidomastoid muscle, and masseter muscle) worked on the pain and non-pain side in the patient with unilateral chronic neck pain. In the measurement of muscle thickness by US, no statistically significant difference was found for the side with and without pain for all 3 muscles (trapezius, sternocleidomastoid muscle and masseter muscle).

Keywords:

Cervical pain, USG, Muscle thicknesses,

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