SHOULDER HAND SYNDROME IN CERVICAL SPINAL-CORD INJURY

To characterize the occurrence of shoulder-hand syndrome (SHS) complic ating the rehabilitation of patients with cervical spinal cord injury, we reviewed the medical records of 43 consecutive patients admitted t o the Burke Rehabilitation Center with cervical spinal cord injury, fo cusing on the clinical features of SHS: shoulder pain, hand/wrist pain , edema, vasomotor changes, trophic changes and osteoporosis on x-ray. Twenty-seven patients (63%) had three or more features of SHS. The nu mber of features correlated with age (r = 0.495, p = 0.0007), but not with the presence of upper or lower more neuron findings in the arms, or with autonomic dysfunction. Twenty-three of 25 (92%) SHS patients w ith adequate follow up had satisfactory resolution of symptoms with co nservative therapy (i.e. neither systemic corticosteroids nor stellate ganglion block), but only after a mean of 121 days (range 42-274 days ).