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Wild CJ, Heinze JD, Dorf ER. Intermuscular lipoma in the supraspinatus fossa: a case report. JSES REVIEWS, REPORTS, AND TECHNIQUES 2024; 4:91-95. [PMID: 38323197 PMCID: PMC10840575 DOI: 10.1016/j.xrrt.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Affiliation(s)
- Carrie J. Wild
- Department of Orthopaedic Surgery, Lincoln Memorial University- DeBusk College of Osteopathic Medicine, Harrogate, TN, USA
| | - Jared D. Heinze
- Vail-Summit Orthopaedics and Neurosurgery, Vail, CO, USA
- Vail-Summit Orthopaedics and Neurosurgery, Research and Education Foundation, Vail, CO, USA
| | - Erik R. Dorf
- Vail-Summit Orthopaedics and Neurosurgery, Vail, CO, USA
- Vail-Summit Orthopaedics and Neurosurgery, Research and Education Foundation, Vail, CO, USA
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Joo YB, Lee WY, Chung HJ. Suprascapular nerve entrapment caused by a large hematoma of the scapula: a case report. BMC Musculoskelet Disord 2023; 24:589. [PMID: 37468872 DOI: 10.1186/s12891-023-06723-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 07/12/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Suprascapular nerve entrapment is a rare disorder that is frequently misdiagnosed as another disease. The suprascapular nerve is commonly entrapped at the following two sites: the suprascapular and spinoglenoid notches. Nerve entrapment at the spinoglenoid notch causes infraspinatus muscle weakness and atrophy. Patients present with posterior shoulder pain and weakness. Magnetic resonance imaging is used to confirm the diagnosis of a spinoglenoid cyst and nerve compression. Open or arthroscopic aspiration or decompression is indicated for patients with cysts in whom conservative treatment has failed and those with cysts associated with suprascapular nerve compression. CASE PRESENTATION Herein, we describe the case of a 49-year-old man with suprascapular nerve entrapment caused by a large cyst, namely, a hematoma, in the superior scapular and spinoglenoid notches. Open surgical decompression of the suprascapular nerve was performed owing to an intact rotator cuff and glenoid labrum. CONCLUSION Posterior shoulder pain promptly resolved without complications.
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Affiliation(s)
- Yong Bum Joo
- Department of Orthopedic Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Woo Yong Lee
- Department of Orthopedic Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Hyung Jin Chung
- Department of Orthopedic Surgery, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Daejeon, South Korea.
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Brzoska R, Laprus H, Klaptocz P, Malik SS, Solecki W, Blasiak A. Arm Function After Arthroscopic Decompression of the Suprascapular Nerve at the Spinoglenoid Notch and Suprascapular Notch in Volleyball Players. Orthop J Sports Med 2023; 11:23259671221147892. [PMID: 36874055 PMCID: PMC9974621 DOI: 10.1177/23259671221147892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/21/2022] [Indexed: 03/03/2023] Open
Abstract
Background Suprascapular nerve (SSN) entrapment in volleyball players leads to infraspinatus (ISP) muscle atrophy and weakness of abduction and external rotation (ER) of the shoulder. Purpose To assess functional outcome after arthroscopic extended decompression of SSN in the spinoglenoid notch and suprascapular notch in a group of volleyball athletes. Study Design Case series; Level of evidence, 4. Methods Volleyballers who underwent arthroscopic SSN decompression were analyzed retrospectively. Assessment tools consisted of range of motion and ER strength on Lovett scale and postoperative ER strength measured by dynamometer, Constant-Murley score (CMS), and visual evaluation of ISP muscle recovery by assessing muscle bulk. Results The study included 10 patients (9 male and 1 female). The mean age was 25.9 years (range, 19-33) and mean follow-up was 77.9 months (range, 7-123). The mean range of postoperative ER at 90° of abduction (ER2) was 105.6° (88°-126°) and 108.5° (93°-124°) for the contralateral side, while ER2 strength was 8 ± 2.6 and 12.65 ± 2.8 kg (P < .01) respectively. Mean CMS was 89.9 (84-100). In 5 cases, there was complete recovery of ISP muscle atrophy whereas 2 patients had partial recovery and 3 had none. Conclusion Arthroscopic SSN decompression in volleyball players improves shoulder function, but results of ISP recovery and ER strength are variable.
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Affiliation(s)
| | | | | | - Shahbaz S Malik
- Worcestershire Acute Hospitals NHS Trust, Worcester, Worcestershire, UK
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Vij N, Fabian I, Hansen C, Kasabali AJ, Urits I, Viswanath O. Outcomes after minimally invasive and surgical management of suprascapular nerve entrapment: A systematic review. Orthop Rev (Pavia) 2022; 14:37157. [DOI: 10.52965/001c.37157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/29/2022] [Indexed: 11/06/2022] Open
Abstract
Background The prevalence of suprascapular neuropathy is higher than previously estimated. Recent literature highlights a myriad of treatment options for patients ranging from conservative treatment and minimally invasive options to surgical management. However, there are no comprehensive review articles comparing these treatment modalities. Objective The purpose of this review article is to summarize the current state of knowledge on suprascapular nerve entrapment and to compare minimally invasive treatments to surgical treatments. Methods The literature search was performed in Mendeley. Search fields were varied redundant. All articles were screened by title and abstract and a preliminary decision to include an article was made. A full-text screening was performed on the selected articles. Any question regarding the inclusion of an article was discussed by 3 authors until an agreement was reached. Results Recent studies have further elucidated the pathoanatomy and described several risk factors for entrapment ranging. Four studies met our inclusion criteria regarding peripheral nerve stimulation with good pain and clinical outcomes. Two studies met our inclusion criteria regarding pulsed radiofrequency and showed promising pain and clinical outcomes. One study met our inclusion criteria regarding transcutaneous electrical nerve stimulation and showed good results that were equivalent to pulsed radiofrequency. Surgical treatment has shifted to become nearly all arthroscopic and surgical outcomes remain higher than minimally invasive treatments. Conclusions Many recently elucidated anatomical factors predispose to entrapment. A history of overhead sports or known rotator cuff disease can heighten a clinician’s suspicion. Entrapment at the suprascapular notch is more common overall, yet young athletes may be predisposed to isolated spinoglenoid notch entrapment. Pulsed radiofrequency, peripheral nerve stimulation, and transcutaneous electrical nerve stimulation may be effective in treating patients with suprascapular nerve entrapment. Arthroscopic treatment remains the gold-standard in patients with refractory entrapment symptoms.
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Affiliation(s)
- Neeraj Vij
- University of Arizona College of Medicine - Phoenix
| | - Isabella Fabian
- Louisiana State University Health Sciences Center Shreveport School of Medicine
| | - Colby Hansen
- Louisiana State University Health Sciences Center Shreveport School of Medicine
| | - Ahmad J Kasabali
- Louisiana State University Health Sciences Center Shreveport School of Medicine
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Walker CR, Belisario JCY, Vasudevan JM. Suprascapular Neuropathy in Collegiate Tennis Player: A Case Report. Cureus 2021; 13:e20824. [PMID: 35141080 PMCID: PMC8802659 DOI: 10.7759/cureus.20824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2021] [Indexed: 11/16/2022] Open
Abstract
Suprascapular neuropathy can be seen in overhead athletes and should be considered when evaluating an overhead athlete presenting with shoulder pain and/or weakness. The suprascapular nerve innervates the supraspinatus and the infraspinatus, but dynamic entrapment as it passes under the spinoglenoid ligament at the spinoglenoid notch can lead to isolated denervation of the infraspinatus. Specific movements common in tennis cause tensioning and compression of the spinoglenoid ligament and may predispose players to dynamic entrapment at this location. We present a case of an 18-year-old male collegiate tennis player presenting with suprascapular neuropathy causing isolated denervation of the infraspinatus. This case illustrates the consequences of noncompliance with physical therapy and serves as a review of the pathophysiology, evaluation, and treatment of suprascapular neuropathy.
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Yildizgören MT. Ultrasonographic Diagnosis and Treatment of Suprascapular Neuropathy Secondary to Ganglion Cyst. J Med Ultrasound 2021; 29:221-222. [PMID: 34729336 PMCID: PMC8515636 DOI: 10.4103/jmu.jmu_63_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/15/2020] [Accepted: 08/10/2020] [Indexed: 11/14/2022] Open
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Cano-Martínez J, Nicolás-Serrano G, Villodres Corpás J, Bento-Gerard J. Arthroscopic release of proximal supra-scapular nerve entrapment: Medium-term results. Rev Esp Cir Ortop Traumatol (Engl Ed) 2021. [DOI: 10.1016/j.recote.2021.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Nolte PC, Woolson TE, Elrick BP, Tross AK, Horan MP, Godin JA, Millett PJ. Clinical Outcomes of Arthroscopic Suprascapular Nerve Decompression for Suprascapular Neuropathy. Arthroscopy 2021; 37:499-507. [PMID: 33091550 DOI: 10.1016/j.arthro.2020.10.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 10/06/2020] [Accepted: 10/11/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To report clinical outcomes following arthroscopic suprascapular nerve (SSN) decompression for suprascapular neuropathy at the suprascapular and/or spinoglenoid notch in the absence of major concomitant pathology. METHODS We retrospectively reviewed prospectively collected data of 19 patients who underwent SSN release at the suprascapular and/or spinoglenoid notch between April 2006 and August 2017 with ≥2 years of follow-up. Patients who underwent concomitant rotator cuff or labral repairs or had severe osteoarthritis were excluded. Pre- and postoperative strength and patient-reported outcomes were collected, including the American Shoulder and Elbow Surgeons (ASES), Single Assessment Numerical Evaluation (SANE), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), 12-item Short Form (SF-12), and satisfaction. Complications and revisions were recorded. RESULTS At a mean final follow-up of 4.8 years, pre- to postoperative ASES (64.9 ± 18.7 versus 83.5 ± 23.1; P = .018), QuickDASH (28.7 ± 17.2 versus 12.7 ± 17.1; P = .028), SANE (64.3 ± 16.4 versus 80.8 ± 22.3; P = .034), and SF-12 PCS (41.1 ± 10.8 versus 52.3 ± 5.8; P = .007) scores all significantly improved. Median strength for external rotation improved significantly (4 [range 2 to 5] versus 5 [range 3 to 5]; P = .014). There was no statistically significant improvement in median strength for abduction (4 [range 3 to 5] versus 5 [5]; P = .059). Median postoperative satisfaction was 9 (range 1 to 10), with 8 patients (50%) rating satisfaction ≥9. No complications were observed, and no patients went on to revision surgery. CONCLUSION Arthroscopic SSN decompression for suprascapular neuropathy at the suprascapular and/or spinoglenoid notch in the absence of major concomitant glenohumeral pathology results in good functional outcomes with significant improvements from before to after surgery. LEVEL OF EVIDENCE IV, therapeutic case series.
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Affiliation(s)
- Philip C Nolte
- Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; BG Trauma Center Ludwigshafen at the University of Heidelberg, Clinic for Trauma and Orthopaedic Surgery, Ludwigshafen, Germany
| | | | - Bryant P Elrick
- Steadman Philippon Research Institute, Vail, Colorado, U.S.A
| | - Anna-Katharina Tross
- Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; Heidelberg University Hospital, Clinic for Orthopedics and Trauma Surgery, Heidelberg, Germany
| | - Marilee P Horan
- Steadman Philippon Research Institute, Vail, Colorado, U.S.A
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Cano-Martínez JA, Nicolás-Serrano G, Villodres Corpás J, Bento-Gerard J. Arthroscopic release of proximal supra-scapular nerve entrapment: Medium-term results. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020; 65:91-98. [PMID: 33177013 DOI: 10.1016/j.recot.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/22/2020] [Accepted: 10/04/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To evaluate the clinical and electrophysiological results in the medium term of the arthroscopic release of the proximal entrapment of the suprascapular nerve. MATERIAL AND METHOD It is a retrospective study that includes 75 patients with idiopathic entrapment of the suprascapular nerve in the suprascapular notch in whom conservative treatment has failed. All patients underwent electrophysiological tests (EMG) as well as clinical test (Constant and DASH test) preoperatively and during follow-up. RESULTS 75 patients (53 women and 22 men) with a mean age of 44.1 ± 10.7 years met study criteria with a mean follow-up of 63.7 ± 29.1 months. Preoperatively the DASH value was 78,6 ± 10,2, the Constant test value was 37.1 ±8.8 and the EVA value was 8.8 ± 1.1 while the values in the last revision were 19.4 ± 15.8 for DASH, 80.2 ± 9.6 (for the CS and 2 ±1.3 for the EVA scale; the differences were significant in all cases (P<.001). Regarding the results of the electrophysiological test, preoperatively there were 21 very severe grades (28%), 32 severe (42.6%), 17 moderate (22.6%) and 5 mild (6.6%). While in the last review there were 3 severe degrees (4%), 6 moderate (8%), 40 mild (53.3%) and 26 normal (34.6%). There was no very severe grade (0%); 3 patients (4%) had to be reoperated due to persistent symptons. CONCLUSIONS The arthroscopic release of idiopathic entrapment of the suprascapular nerve in the superior scapular notch achieved good clinical and electrophysiological results in the medium term. LEVEL OF EVIDENCE iv; case series; treatment study.
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Affiliation(s)
- J A Cano-Martínez
- Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Los Arcos del Mar Menor, Servicio adjunto a la facultad de Medicina de la Universidad de Murcia, San Javier, Murcia, España.
| | - G Nicolás-Serrano
- Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Los Arcos del Mar Menor, Servicio adjunto a la facultad de Medicina de la Universidad de Murcia, San Javier, Murcia, España
| | - J Villodres Corpás
- Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Los Arcos del Mar Menor, Servicio adjunto a la facultad de Medicina de la Universidad de Murcia, San Javier, Murcia, España
| | - J Bento-Gerard
- Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Los Arcos del Mar Menor, Servicio adjunto a la facultad de Medicina de la Universidad de Murcia, San Javier, Murcia, España
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Bozzi F, Alabau-Rodriguez S, Barrera-Ochoa S, Ateschrang A, Schreiner AJ, Monllau JC, Perelli S. Suprascapular Neuropathy around the Shoulder: A Current Concept Review. J Clin Med 2020; 9:jcm9082331. [PMID: 32707860 PMCID: PMC7465639 DOI: 10.3390/jcm9082331] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/16/2020] [Accepted: 07/18/2020] [Indexed: 12/11/2022] Open
Abstract
Suprascapular neuropathy is an uncommon but increasingly recognized cause of shoulder pain and dysfunction due to nerve entrapment. The aim of this review is to summarize some important aspects of this shoulder pathology. An extensive research was performed on PubMed and Clinical Key. The goal was to collect all the anatomical, biomechanical and clinical studies to conduct an extensive overview of the issue. Attention was focused on researching the state of art of the diagnosis and treatment. A total of 59 studies were found suitable and included. This condition is more frequently diagnosed in over-head athletes or patients with massive rotator cuff tears. Diagnosis may be complex, whereas its treatment is safe, and it has a great success rate. Prompt diagnosis is crucial as chronic conditions have worse outcomes compared to acute lesions. Proper instrumental evaluation and imaging are essential. Dynamic compression must initially be treated non-operatively. If there is no improvement, surgical release should be considered. On the other hand, soft tissue lesions may first be treated non-operatively. However, surgical treatment by arthroscopic means is advisable when possible as it represents the gold standard therapy. Other concomitant shoulder lesions must be recognized and treated accordingly.
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Affiliation(s)
- Federico Bozzi
- Department of Orthopaedics and Traumatology, Fondazione Poliambulanza (Brescia)—Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence:
| | - Sergi Alabau-Rodriguez
- Institut Català de Traumatologia i Medicina de l’Esport (ICATME)—Hospital Universitari Quiròn-Dexeus. Universitat Autònoma de Barcelona, 08028 Barcelona, Spain; (S.A.-R.); (S.B.-O.); (J.C.M.); (S.P.)
| | - Sergi Barrera-Ochoa
- Institut Català de Traumatologia i Medicina de l’Esport (ICATME)—Hospital Universitari Quiròn-Dexeus. Universitat Autònoma de Barcelona, 08028 Barcelona, Spain; (S.A.-R.); (S.B.-O.); (J.C.M.); (S.P.)
| | - Atesch Ateschrang
- Orthopedic department, Gemeinschaftsklinikum Mittelrhein, 56073 Koblenz, Germany;
| | - Anna J. Schreiner
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard-Karls University of Tübingen, 72076 Tübingen, Germany;
| | - Juan Carlos Monllau
- Institut Català de Traumatologia i Medicina de l’Esport (ICATME)—Hospital Universitari Quiròn-Dexeus. Universitat Autònoma de Barcelona, 08028 Barcelona, Spain; (S.A.-R.); (S.B.-O.); (J.C.M.); (S.P.)
- Department of Orthopaedic Surgery, Hospital del Mar. Universitat Autònoma de Barcelona (UAB), 08028 Barcelona, Spain
| | - Simone Perelli
- Institut Català de Traumatologia i Medicina de l’Esport (ICATME)—Hospital Universitari Quiròn-Dexeus. Universitat Autònoma de Barcelona, 08028 Barcelona, Spain; (S.A.-R.); (S.B.-O.); (J.C.M.); (S.P.)
- Department of Orthopaedic Surgery, Hospital del Mar. Universitat Autònoma de Barcelona (UAB), 08028 Barcelona, Spain
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Yang J, Feng Q, Wen YL, Fan QH, Luo B, Jia WL, Zhang L. Morphological measurements and classification of the spinoglenoid notch: A three-dimensional reconstruction of computed tomography in the Chinese population. Ann Anat 2019; 226:10-15. [PMID: 31330305 DOI: 10.1016/j.aanat.2019.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/04/2019] [Accepted: 07/09/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND The spinoglenoid notch (SGN) is the second most common location for suprascapular nerve (SN) entrapment; however, there are few relative morphological reports on this condition. Hence, the present morphological study mainly explored the anatomical structure and classification of the SGN and the relationship with entrapment of SN. MATERIALS AND METHODS Four hundred seventy-eight scapulae were analysed thoroughly and systematically in this study. Anatomical structure and classification of the SGN were observed and measured by a three-dimensional (3D) reconstruction of computed tomography (CT). The measurement results were then analysed and recorded. RESULTS Chinese scapulae were classified into three types at the SGN, and it was found that left scapulae had deeper SGN than right ones. Then, significant differences were also noted between sexes. Men had thicker, wider and deeper SGN than women. Type II (small U, 46.04%) was the most common. Type I (large U) was the widest (15.67±1.43mm) and deepest (13.71±2.39mm) compared with other types. Lastly, no significant differences in the above criteria were found in other measurements. CONCLUSIONS These morphological measurements of the SGN may help to improve the diagnosis and successful treatment rate of the surgery for the SN entrapment, but the relative clinical trial is necessary to support it.
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Affiliation(s)
- Jin Yang
- Department of Joint Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China.
| | - Qi Feng
- School of Clinical Medicine, Southwest Medical University, Luzhou 646000, China; Academician Workstation in Luzhou, Luzhou 646000, China.
| | - You-Liang Wen
- School of Rehabilitation Medicine, Gannan Medical University, Ganzhou 341000, China.
| | - Qing-Hong Fan
- Department of Joint Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China.
| | - Bei Luo
- School of Clinical Medicine, Southwest Medical University, Luzhou 646000, China; Academician Workstation in Luzhou, Luzhou 646000, China.
| | - Wen-Li Jia
- School of Clinical Medicine, Southwest Medical University, Luzhou 646000, China; Academician Workstation in Luzhou, Luzhou 646000, China.
| | - Lei Zhang
- Department of Orthopedics, Affiliated Trađitional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China; National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510000, China; Academician Workstation in Luzhou, Luzhou 646000, China.
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Kim JY, Choe JS, Cho JH. A Large Size Lipoma at Spinoglenoid Notch Mimicked Traumatic Rotator Cuff Tear. J Hand Surg Asian Pac Vol 2018; 23:267-269. [PMID: 29734906 DOI: 10.1142/s2424835518720141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Herein, we report a large lipoma at the spinoglenoid notch that mimicked a rotator cuff tear, which occurred in a 61-year-old male farmer. Weakness and pain in the shoulder started abruptly after hard labor, and our first impression was a traumatic rotator cuff tear; however, there was no tear on MRI, and complete marginal excision of a large lipoma at the spinoglenoid notch relieved the symptoms completely at a postoperative three-month follow-up visit. We believe that certain activities such as forceful shoulder abduction may have caused the sudden onset of suprascapular neuropathy in the loosely compressed suprascapular nerve by the lipoma.
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Affiliation(s)
- Joon Yub Kim
- * Department of Orthopedic Surgery, Myongji Hospital, Goyang, Korea
| | - Jung Soo Choe
- * Department of Orthopedic Surgery, Myongji Hospital, Goyang, Korea
| | - Jae Ho Cho
- * Department of Orthopedic Surgery, Myongji Hospital, Goyang, Korea
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13
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Wee TC, Wu CH. Ultrasound-Guided Aspiration of a Paralabral Cyst at the Spinoglenoid Notch with Suprascapular Nerve Compressive Neuropathy. J Med Ultrasound 2018; 26:166-167. [PMID: 30283206 PMCID: PMC6159318 DOI: 10.4103/jmu.jmu_39_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 03/14/2018] [Indexed: 11/15/2022] Open
Affiliation(s)
- Tze-Chao Wee
- Department of Rehabilitation Medicine, Changi General Hospital, Singapore
| | - Chueh-Hung Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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14
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Schuh A, Handschu R, Eibl T, Janka M, Hönle W. [Suprascapular nerve entrapment]. MMW Fortschr Med 2018; 159:62-64. [PMID: 29468511 DOI: 10.1007/s15006-017-0068-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Alexander Schuh
- Muskuloskelettales Zentrum Klinikum Neumarkt, Akademisches Lehrkrankenhaus der Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberger Str. 12, D-92318, Neumarkt i. d. OPf., Deutschland.
| | - René Handschu
- Neurologische Klinik, Kliniken des Landkreises Neumarkt i. d. OPf., Neumarkt i. d. OPf., Deutschland
| | - Thomas Eibl
- Neurologische Klinik, Kliniken des Landkreises Neumarkt i. d. OPf., Neumarkt i. d. OPf., Deutschland
| | - Michael Janka
- Muskuloskelettales Zentrum, Klinikum Neumarkt i. d. OPf., Neumarkt i. d. OPf., Deutschland
| | - Wolfgang Hönle
- Muskuloskelettales Zentrum, Klinikum Neumarkt i. d. OPf., Neumarkt i. d. OPf., Deutschland
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Memon M, Kay J, Ginsberg L, Simunovic N, Bak K, Lapner P, Ayeni OR. Arthroscopic management of suprascapular neuropathy of the shoulder improves pain and functional outcomes with minimal complication rates. Knee Surg Sports Traumatol Arthrosc 2018; 26:240-266. [PMID: 28879607 DOI: 10.1007/s00167-017-4694-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/21/2017] [Indexed: 01/02/2023]
Abstract
PURPOSE The purpose of this study was to systematically assess the arthroscopic management of suprascapular neuropathy, including the aetiology, surgical decision-making, clinical outcomes, and complications associated with the procedure. METHODS Three databases [PubMed, Ovid (Medline), and Embase] were searched. Systematic literature screening and data abstraction was performed in duplicate to present a review of studies reporting on arthroscopic management of suprascapular neuropathy. The quality of the included studies was assessed using level of evidence and the MINORS (Methodological Index for Nonrandomized Studies) checklist. RESULTS In total, 40 studies (17 case reports, 20 case series, 2 retrospective comparative studies, and 1 prospective comparative study) were identified, including 259 patients (261 shoulders) treated arthroscopically for suprascapular neuropathy. The most common aetiology of suprascapular neuropathy was suprascapular nerve compression by a cyst at the spinoglenoid notch (42%), and the decision to pursue arthroscopic surgery was most commonly based on the results of clinical findings and investigations (47%). Overall, 97% of patients reported significant improvement in or complete resolution of their pre-operative symptoms (including pain, strength, and subjective function of the shoulder) over a mean follow-up period of 23.7 months. Further, there was a low overall complication rate (4%) associated with the arthroscopic procedures. CONCLUSION While most studies evaluating arthroscopic management of suprascapular neuropathy are uncontrolled studies with lower levels of evidence, results indicate that such management provides patients with significant improvements in pain, strength, and subjective function of the shoulder, and has a low incidence of complications. Patients managed arthroscopically for suprascapular neuropathy may expect significant improvements in pain, strength, and subjective function of the shoulder. LEVEL OF EVIDENCE Level IV, systematic review of level II to IV studies.
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Affiliation(s)
- M Memon
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - J Kay
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - L Ginsberg
- Department of Life Sciences, McMaster University, Hamilton, ON, Canada
| | - N Simunovic
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - K Bak
- Sports Clinic, Aleris-Hamlet Parken, Oester Alle 42, 2nd Floor, Copenhagen, Denmark
| | - P Lapner
- Division of Orthopaedic Surgery, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - O R Ayeni
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University Medical Centre, McMaster University, 1200 Main St West, 4E15, Hamilton, ON, L8N 3Z5, Canada.
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Loirat MA, Tierny M, Hervé A, Lignel A, Berton E, Ropars M, Thomazeau H. A new approach for endoscopic neurolysis of the suprascapular nerve at the spinoglenoid notch: A preliminary cadaver study. Orthop Traumatol Surg Res 2017; 103:861-864. [PMID: 28705649 DOI: 10.1016/j.otsr.2017.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/09/2017] [Accepted: 04/18/2017] [Indexed: 02/02/2023]
Abstract
The suprascapular nerve (SSN) can become compressed at its 2 scapular attachments: the suprascapular and the spinoglenoid notch. The objective of this study was to describe a new arthroscopic approach for SSN neurolysis at the spinoglenoid notch. Ten cadaver shoulders were used. Two were dissected to simulate the "classical" arthroscopic approach and to help in the creation of a new "direct medial retrospinal" approach. Eight other shoulders were used to validate this new approach, with control of the whole juxta-glenoid course of the SSN as criterion of success. The retrospinal posterior approach allowed the entire juxta-glenoid segment of the SSN to be explored in 6 cases out of 8. One exploration was incomplete, another not feasible. SSN neurolysis at the spinoglenoid notch was feasible in cadavers on a retrospinal approach.
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Affiliation(s)
- M-A Loirat
- Service de chirurgie orthopédique et traumatologique, université de Rennes-1, CHU de Ponchaillou, 2, rue Henri-le-Guilloux, 35033 Rennes, France; Laboratoire M2S (mouvement sport santé), université Rennes 2, école Normale-Supérieure-Bretagne-université européenne de Bretagne, campus de Ker-Lann, Bruz, France.
| | - M Tierny
- Service de chirurgie orthopédique et traumatologique, université de Rennes-1, CHU de Ponchaillou, 2, rue Henri-le-Guilloux, 35033 Rennes, France
| | - A Hervé
- Service de chirurgie orthopédique et traumatologique, université de Rennes-1, CHU de Ponchaillou, 2, rue Henri-le-Guilloux, 35033 Rennes, France
| | - A Lignel
- Service de chirurgie orthopédique et traumatologique, université de Rennes-1, CHU de Ponchaillou, 2, rue Henri-le-Guilloux, 35033 Rennes, France
| | - E Berton
- Laboratoire d'anatomie, université de Rennes-1, 2, avenue du Professeur-Léon-Bernard, 35000 Rennes, France
| | - M Ropars
- Service de chirurgie orthopédique et traumatologique, université de Rennes-1, CHU de Ponchaillou, 2, rue Henri-le-Guilloux, 35033 Rennes, France; Laboratoire M2S (mouvement sport santé), université Rennes 2, école Normale-Supérieure-Bretagne-université européenne de Bretagne, campus de Ker-Lann, Bruz, France; Laboratoire d'anatomie, université de Rennes-1, 2, avenue du Professeur-Léon-Bernard, 35000 Rennes, France
| | - H Thomazeau
- Service de chirurgie orthopédique et traumatologique, université de Rennes-1, CHU de Ponchaillou, 2, rue Henri-le-Guilloux, 35033 Rennes, France
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