Clinical and magnetic resonance imaging examinations of both shoulders were performed in 317 paraplegic patients. Mean age was 49 (range, 19-76) years. The level of spinal cord injury was between T2 and T7 In 54 % of patients and between T8 and L3 in 46 % . Constant scores were measured for all shoulders. Pain was analyzed using a visual analog scale.
Rotator cuff tears were not present in 51 % , were unilateral in 20 % , and were bilateral in 29 % . Age was older and duration of spinal cord injury was significantly longer in patients with bilateral tears than in patients without or with unilateral tears (P < .001). In patients with unilateral tears, a full-thickness rupture of the supraspinatus tendon was found in 67 % , whereas a partial-rupture was detected in 33 % . Of the patients with bilateral tears, 75 % presented with a full-thickness rupture and 25 % with a partial rupture. The mean Constant score was 76 (range, 37-98) in patients without cuff tears, 69 (range, 16-94) for patients with unilateral tears, and 64 (16-96) for patients with bilateral tears (P < .001).
Rotator cuff disease is common and correlates highly with age and duration of spinal cord injury, which underlines the theory of ¡°wear and tear?in wheelchair-dependent patients.