慢性肩石灰沈着性腱板炎に対する体外衝撃波治療の経験

Extracorporeal Shock Wave Therapy for Chronic Calcific Tendinitis of the Shoulder

　保存療法に抵抗する慢性肩石灰沈着性腱板炎6例7肩に体外衝撃波治療を施行した．10cmVAS(visual analog scale)による疼痛評価では，照射前後で6.1±2.7cmから0.6±1.1cmへと有意に改善した．単純X線像石灰の消失を5肩(71.4％)で確認でき，この石灰消失例では疼痛の軽減・可動域の改善および患者満足度が高かった．照射後の一時的な疼痛の増強を2例に認めた以外は重篤な合併症は認めなかった．体外衝撃波治療は石灰沈着性腱板炎慢性例に対する低侵襲で有効な治療法として期待できる．

　Six patients (7 shoulders) with calcific tendonitis of the rotator cuff that was resistant to typical conservative therapy were treated with extracorporeal shock wave therapy (ESWT).　The results were evaluated on the basis of a 10cm visual analog scale, shoulder radiographs and a patient satisfaction questionnaire.　Electrohydraulic shock waves were administered under local anesthesia.　The intensity of the shocks was 0.29～0.41mj/mm², and 2,000 to 3,000 shocks were administered.　The 10cm visual analog scale after ESWT (0.6±1.1cm) showed statistically significant improvement in comparison with before ESWT (6.1±2.7cm).　Calcium deposit dissolution occurred in 5 shoulders (71.4%), which patients showed satisfactory result.　In the visual analog scale, range of motion of the shoulder and patient satisfactory.　No serious complications occurred.　ESWT shows promise of serving an a new minimally invasive and effective method of treating that is resistant to conservative therapy.