Concomitant Cervical Spine Stenosis Negatively Affects Subpectoral Biceps Tenodesis Outcomes

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Spine Surgery

Background:

• Open subpectoral biceps tenodesis (BT) is a common procedure for shoulder pathologies.
• The influence of concomitant cervical spine pathology on patient-reported outcomes (PROs) after BT is not well understood.
• Cervical spine issues, such as stenosis and disc disease, may affect neurological signaling and pain perception, potentially influencing shoulder surgery outcomes.

Purpose of the Study:

• To investigate the association between cervical spine pathology and postoperative PROs in patients undergoing open subpectoral BT.
• To compare outcomes between patients with and without cervical spine disease undergoing isolated BT.

Main Methods:

• Retrospective review of patients undergoing isolated BT between August 2011 and May 2019.
• Cases: patients with cervical spine disease (disc disease, herniations, stenosis). Controls: patients without cervical spine disease.
• 1:1 matching of cases and controls by age and BMI; PROs collected at minimum 12-month follow-up and compared using statistical tests.

Main Results:

• 23 cases and 23 controls were matched with similar demographics and athlete percentages.
• Cases with cervical spine pathology showed significantly higher Visual Analog Scale (VAS) scores during sport (3.6 vs 1.2, P=.013).
• Cases also reported lower Subjective Shoulder Value (69.5 vs 84.1, P=.070) and Shoulder Instability-Return to Sport after Injury scores (60.4 vs 77.4, P=.046).

Conclusions:

• Cervical spine pathology, specifically stenosis, may be associated with inferior shoulder-specific PROs after biceps tenodesis.
• While some PROs were diminished, key outcomes like return to sport rate and competitiveness were not significantly different between groups.
• Athletes undergoing BT with concurrent cervical spine pathology require thorough pre-operative counseling regarding potential impacts on shoulder function and pain.