Shoulder Numbness in a Patient with Suprascapular Nerve Entrapment Syndrome: Cutaneous Branch of the Suprascapular Nerve: Case Report

Neurosurgery ◽  
2000 ◽  
Vol 47 (6) ◽  
pp. 1452-1452 ◽  
Author(s):  
Kimberly S. Harbaugh ◽  
Rand Swenson ◽  
Richard L. Saunders
Keyword(s):  
Shoulder Pain ◽  
Suprascapular Nerve ◽  
Suprascapular Notch ◽  
Study Results ◽  
Cutaneous Branch ◽  
Shoulder Region ◽  
Motor Abnormalities ◽  
The Right ◽  
And Function ◽  
Nerve Entrapment Syndrome

ABSTRACT OBJECTIVE AND IMPORTANCE The ability to diagnose peripheral nerve disorders is dependent on knowledge of the anatomic course and function of the nerves in question. The classic teaching regarding the suprascapular nerve (SScN) is that it has no cutaneous branches, despite the fact that a cutaneous branch was first reported in the anatomic literature 20 years ago. CLINICAL PRESENTATION We describe a case of a 35-year-old male patient who presented with right shoulder pain and atrophy and weakness of the right supra- and infraspinatus muscles. During the examination, he was also noted to have an area of numbness involving the right upper lateral shoulder region. Electrical study results were consistent with SScN entrapment at the suprascapular notch. INTERVENTION The patient underwent surgical decompression 7 months after the onset of his symptoms. The patient noted resolution of his shoulder pain immediately after the procedure, and his shoulder sensory disturbance had improved by 2 weeks. At 9 months after surgery, he remained pain-free, his shoulder sensation was normal, and his motor abnormalities had improved significantly. CONCLUSION This case provides clinical evidence for the presence of a cutaneous branch of the SScN, as described in cadaveric studies. Although shoulder numbness demands a search for alternative diagnoses, it does not necessarily exclude the diagnosis of SScN entrapment.

scholarly journals Ossification of the superior transverse ligament in a South African scapula: a factor to be considered in the diagnosis of suprascapular nerve entrapment

2016 ◽  
Vol 33 (03) ◽  
pp. 155-156
Author(s):  
O. Azu ◽  
D. Ofusori ◽  
E. Naidu ◽  
J. Naidu
Keyword(s):  
South African ◽  
Critical Factor ◽  
Suprascapular Nerve ◽  
Nerve Entrapment ◽  
Clinical Anatomy ◽  
Shape Variation ◽  
Suprascapular Notch ◽  
Suprascapular Nerve Entrapment ◽  
Shoulder Region ◽  
Superior Transverse Scapular Ligament

Abstract Introduction: Ossification of the superior transverse scapular ligament is one of the factors considered in the classification of the suprascapular notch based on shape. Variation in morphology of the superior transverse scapular ligament is always considered a critical factor in the diagnosis of suprascapular nerve entrapment syndrome. Case Report: This study reports the complete ossification of the superior transverse scapular ligament in a South African scapula and a note on its clinical anatomy. Conclusion: This anatomical knowledge is of extreme clinical relevance to surgeons in relation to various syndromes associated with the shoulder region in the South African population.

scholarly journals Morphological and Radiological Study of Ossified Superior Transverse Scapular Ligament as Potential Risk Factor of Suprascapular Nerve Entrapment

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Michał Polguj ◽  
Marcin Sibiński ◽  
Andrzej Grzegorzewski ◽  
Michał Waszczykowski ◽  
Agata Majos ◽  
...  
Keyword(s):  
Risk Factor ◽  
Potential Risk ◽  
Suprascapular Nerve ◽  
Nerve Entrapment ◽  
Potential Risk Factor ◽  
Suprascapular Notch ◽  
Suprascapular Nerve Entrapment ◽  
Suprascapular Foramen ◽  
The Right ◽  
Superior Transverse Scapular Ligament

The suprascapular notch is covered superiorly by the superior transverse scapular ligament. This region is the most common place of suprascapular nerve entrapment formation. The study was performed on 812 specimens: 86 dry scapulae, 104 formalin-fixed cadaveric shoulders, and 622 computer topography scans of scapulae. In the cases with completely ossified superior transverse scapular ligament, the following measurements were performed: proximal and distal width of the bony bridge, middle transverse and vertical diameter of the suprascapular foramen, and area of the suprascapular foramen. An ossified superior transverse scapular ligament was observed more often in men and in the right scapula. The mean age of the subjects with a completely ossified superior transverse scapular ligament was found to be similar than in those without ossification. The ossified band-shaped type of superior transverse scapular ligament was more common than the fan-shaped type and reduced the space below the ligament to a significantly greater degree. The ossified band-shaped type should be taken into consideration as a potential risk factor in the formation of suprascapular nerve entrapment. It could explain the comparable frequency of neuropathy in various populations throughout the world despite the significant differences between them in occurrence of ossified superior transverse scapular ligament.

scholarly journals Morphometric study of suprascapular notch and scapular dimensions in Ugandan dry scapulae with specific reference to the incidence of completely ossified superior transverse scapular ligament

2020 ◽  
Author(s):  
Adesanya Olamide Adewale ◽  
Okeniran Olatayo Segun ◽  
Ibe Michael Usman ◽  
Ann Lemuel Monima ◽  
Eric Simidi Kegoye ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Suprascapular Nerve ◽  
Nerve Entrapment ◽  
Population Characteristics ◽  
Specific Reference ◽  
Suprascapular Notch ◽  
Entrapment Syndrome ◽  
Suprascapular Nerve Entrapment ◽  
Superior Transverse Scapular Ligament ◽  
Nerve Entrapment Syndrome

Abstract Background: Understanding of suprascapular notch (SSN) anatomy and relationship with scapular dimensions are vital in diagnosis, prevention, and assessment of suprascapular nerve entrapment syndrome. The study aimed to assess morphometry of suprascapular notch and scapular dimensions in Ugandan dry scapulae with specific reference to scapulae with completely ossified superior transverse scapular ligaments. Methods: This was a cross-sectional analytical study conducted on 50 Ugandan dry scapulae. SSN types and prevalence of completely ossified superior transverse scapular ligament among dry scapulae were quantified and compared with previous data. Scapular dimensions were assessed by measuring scapular length (A), scapular width (B), glenoid length (C), and glenoid width (D). One-way ANOVA was used to compare scapular dimensions of scapulae with different SSN types, and Spearman’s correlation coefficient was used to evaluate the correlation coefficient of scapular dimensions amongst groups. Results: Superior transverse scapular ligament (STSL) was completely ossified in 8% of cases. There was no significant (P > 0.05) difference between scapular dimensions of scapulae with completely ossified STSL compared to scapulae with other SSN types. Scapulae with completely ossified STSL showed strong negative (r = -0.89137, r = -0.877) correlations for its A, B respectively compared against D, this finding was not true to scapulae of other SSN types. Also, there were strong positive or negative (r > 0.7, r > -0.7) correlations: for A, types I and III compared to type VI; for B, types I, III compared to VI; for C, type IV and VI; and for D, type III and VI. Conclusions: The prevalence of completely ossified STSL is moderately high in the Ugandan population. Characteristics of the scapula (scapular dimensions) are not ‘vital’ but rather important or relevant for shoulder pathology with specific reference to suprascapular nerve entrapment syndrome due to completely ossified superior transverse scapular ligaments. Further correlation analyses of scapular dimensions of different SSN types in different populations are important.

scholarly journals Protective and Predisposing Morphological Factors in Suprascapular Nerve Entrapment Syndrome: A Fundamental Review Based on Recent Observations

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Piotr Łabętowicz ◽  
Marek Synder ◽  
Mariusz Wojciechowski ◽  
Krzysztof Orczyk ◽  
Hubert Jezierski ◽  
...  
Keyword(s):  
Suprascapular Nerve ◽  
Nerve Entrapment ◽  
Protective Function ◽  
Suprascapular Notch ◽  
Entrapment Syndrome ◽  
Suprascapular Nerve Entrapment ◽  
Superior Transverse Scapular Ligament ◽  
Nerve Entrapment Syndrome ◽  
Spinoglenoid Notch

Suprascapular nerve entrapment syndrome (SNES) is a neuropathy caused by compression of the nerve along its course. The most common compression sites include the suprascapular notch and the spinoglenoid notch. The aim of this article was to review the anatomical factors influencing the occurrence of SNES in the light of the newest reports. Potential predisposing morphological factors include a V-shaped, narrow, or “deep” suprascapular notch; a band-shaped, bifurcated, or completely ossified superior transverse scapular ligament (STSL); particular arrangements of the suprascapular nerve and vessels at the suprascapular notch. A very recent report indicates structures at the suprascapular notch region that may protect from SNES, such as the suprascapular notch veins (SNV). The role of the anterior coracoscapular ligament (ACSL) is still not clear. While some studies indicate that it may predispose for SNES, the newest study proposes a protective function. Knowledge of these variations is essential for arthroscopic and other surgical procedures of this area in order to avoid iatrogenic injury of the suprascapular nerve or unexpected bleeding from the suprascapular vessels running alongside the STSL.

Management and Outcomes of 42 Surgical Suprascapular Nerve Injuries and Entrapments

Neurosurgery ◽  
2005 ◽  
Vol 57 (1) ◽  
pp. 120-127 ◽  
Author(s):  
Daniel H. Kim ◽  
Judith A. Murovic ◽  
Robert L. Tiel ◽  
David G. Kline
Keyword(s):  
Shoulder Pain ◽  
Suprascapular Nerve ◽  
State University ◽  
Suprascapular Notch ◽  
Presenting Symptoms ◽  
Louisiana State University ◽  
Ganglion Cysts ◽  
Good Improvement ◽  
Grade 3 ◽  
Better Than

Abstract OBJECTIVE: Retrospective chart reviews of 42 patients with surgical suprascapular nerve (SSN) injury/entrapment were performed. Presenting symptoms, findings, operative approach, and results are documented. METHODS: Forty-two patients with SSN injuries/entrapments underwent operations between 1970 and 2002. Charts were retrospectively reviewed for the presence of shoulder pain; spinati muscle function was evaluated with the Louisiana State University Health Sciences Center grading system. Side of lesion and sex were equally represented; mean follow-up was 18 months (range, 12–48 mo). SSN injuries/entrapments were associated with occupational overuse (19), sports-related injury (16), direct trauma (4) and ganglion cysts (3). Thirty-one (79%) of 39 patients with suprascapular notch SSN injuries/entrapments, excluding ganglion cysts, presented with mild to moderate shoulder pain and spinati weakness. RESULTS: Motor function for these 31 patients was graded on a scale of 0 to 5. Preoperatively, patients had supraspinatus function Grades 0 to 2 and infraspinatus function Grades 0 to 2. Supraspinatus function improved postoperatively to Grade 4 or better in 28 patients (90%) and to Grades 2 to 3 in 3 patients (10%). Infraspinatus function improved to better than Grade 3 in 10 patients (32%), to Grades 2 to 3 in 14 patients (45%), and to Grade 1 in 7 patients (23%). Preoperatively, eight (21%) of 39 patients presenting with persistent severe pain had Grade 3 spinati strength. Of these eight patients, seven (88%) had an improvement in pain postoperatively. Strength in this group remained the same or improved to Grade 4. Postoperatively, three patients with ganglion cysts had good improvement in spinati function. CONCLUSION: Although SSN injury/entrapment is rare, 42 patients are presented who responded well to SSN release. Supraspinatus muscle improvement was as good as or better than that achieved in the infraspinatus.

scholarly journals Neuromodulation of the Suprascapular Nerve

2016 ◽  
Vol 1;19 (1;1) ◽  
pp. E235-E239
Author(s):  
Erkan Kurt
Keyword(s):  
Peripheral Nerve ◽  
Shoulder Pain ◽  
Excellent Result ◽  
Treatment Options ◽  
Treatment Protocol ◽  
Suprascapular Nerve ◽  
Orthopedic Procedures ◽  
Invasive Treatment ◽  
Nerve Blocks ◽  
Shoulder Region

Chronic intractable shoulder pain (CISP) is defined as shoulder pain which is present for longer than 6 months and does not respond to standard treatments like medication, physical therapy, rehabilitation, selective nerve blocks and local infiltrations, or orthopedic procedures. The etiology of CISP may be very diverse, varying from many orthopedic conditions to non-orthopedic conditions. The fact that the suprascapular nerve is one of the most important nerves supplying the shoulder region makes this nerve an interesting target in treating patients suffering shoulder pain. Invasive treatment options are peripheral nerve blocks, temporary electrical stimulation, and neurostimulation. To our best knowledge, thus far there are only a few reports describing the technique of permanent neurostimulation of the suprascapular nerve. In this article we present a patient suffering shoulder pain after she underwent surgery for cervical stenosis. After a step by step treatment protocol was done, we finally offered her trial stimulation of the suprascapular nerve. A single quad lead was implanted via a posterior approach under fluoroscopic and ultrasound guidance. Two weeks after successful stimulation, we implanted a permanent neuromodulation system. Permanent neurostimulation of the suprascapular nerve and its end branches may be a new interesting target in treating patients suffering shoulder pain due to various etiologies. In our patient the followup period is 9 months with an excellent result in pain relief, we observed no complications thus far, especially no dislocation or breakage of the lead. In this report, literature on this subject is reviewed, and our technique is well documented with additional anatomical illustrations. Key words: Suprascapular nerve, shoulder pain, peripheral nerve stimulation, neuromodulation, neurostimulation, chronic pain

A Study on Suprascapular Foramen and Its Clinical Importance: A Cadaveric Study in Western Part of Tamilnadu, India

2021 ◽  
Vol 9 (3.3) ◽  
pp. 8086-8090
Author(s):  
Vijaianand M ◽  
◽  
Sakthivel M ◽  
Keyword(s):  
Imaging Techniques ◽  
Age Groups ◽  
Clinical Importance ◽  
Suprascapular Nerve ◽  
Nerve Entrapment ◽  
Suprascapular Notch ◽  
Suprascapular Nerve Entrapment ◽  
Shoulder Region ◽  
Suprascapular Foramen ◽  
Pass Through

Background: Suprascapular notch is present along the superior border of the scapula close to the lateral angle, which is converted into a Suprascapular foramen by the transverse Suprascapular ligament. Normally the Suprascapular nerve and vein pass through the foramen below the ligament, while the Suprascapular artery runs above the ligament. Suprascapular nerve entrapment is an interesting clinical condition which is widely involved in this area. Aim of the study: To find out the presence of Suprascapular artery passing along with the Suprascapular nerve and vein within the foramen and any pathology associated with it. Materials and Methods: The proposed study is carried out in the Department of Anatomy, Karpagam Faculty of Medical Sciences and Research, Coimbatore, where 51 well embalmed cadavers of both the sexes and various age groups was utilised. Results: Out of 51 cadavers dissected, we found Suprascapular artery was found passing along with the Suprascapular nerve and vein in 2 of the cadavers, of which one each is found in a male and a female cadaver with an incidence of 3.92%. Conclusion: Studies done earlier pointed out the importance of Suprascapular nerve entrapment, the various causes and predisposing factors responsible for it ,and a knowledge of safe zone around the shoulder region should be known well to the operating surgeon and the available imaging techniques should be utilised by the radiologists in order to avoid the complications while dealing with the Suprascapular nerve entrapment. KEY WORDS: Cadaver, Suprascapular foramen, Suprascapular artery, Nerve entrapment, Transverse Suprascapular ligament.

scholarly journals Morphometric study of suprascapular notch and scapular dimensions in Ugandan dry scapulae with specific reference to the incidence of completely ossified superior transverse scapular ligament

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Adesanya Olamide Adewale ◽  
Okeniran Olatayo Segun ◽  
Ibe Michael Usman ◽  
Ann Lemuel Monima ◽  
Eric Simidi Kegoye ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Suprascapular Nerve ◽  
Nerve Entrapment ◽  
Population Characteristics ◽  
Specific Reference ◽  
Suprascapular Notch ◽  
Entrapment Syndrome ◽  
Suprascapular Nerve Entrapment ◽  
Superior Transverse Scapular Ligament ◽  
Nerve Entrapment Syndrome

Abstract Background Understanding of suprascapular notch (SSN) anatomy and relationship with scapular dimensions are vital in diagnosis, prevention, and assessment of suprascapular nerve entrapment syndrome. The study aimed to assess morphometry of suprascapular notch and scapular dimensions in Ugandan dry scapulae with specific reference to scapulae with completely ossified superior transverse scapular ligaments. Methods This was a cross-sectional analytical study conducted on 50 Ugandan dry scapulae. SSN types and prevalence of completely ossified superior transverse scapular ligament among dry scapulae were quantified and compared with previous data. Scapular dimensions were assessed by measuring scapular length (A), scapular width (B), glenoid length (C), and glenoid width (D). One-way ANOVA was used to compare scapular dimensions of scapulae with different SSN types, and Spearman’s correlation coefficient was used to evaluate the correlation coefficient of scapular dimensions amongst groups. Results Superior transverse scapular ligament (STSL) was completely ossified in 8% of cases. There was no significant (P > 0.05) difference between scapular dimensions of scapulae with completely ossified STSL compared to scapulae with other SSN types. Scapulae with completely ossified STSL showed strong negative (r = − 0.89137, r = − 0.877) correlations for its A, B respectively compared against D, this finding was not true to scapulae of other SSN types. Also, there were strong positive or negative (r > 0.7, r > − 0.7) correlations: for A, types I and III compared to type VI; for B, types I, III compared to VI; for C, type IV and VI; and for D, type III and VI. Conclusions The prevalence of completely ossified STSL is moderately high in the Ugandan population. Characteristics of the scapula (scapular dimensions) are not ‘vital’ but rather important or relevant for shoulder pathology with specific reference to suprascapular nerve entrapment syndrome due to completely ossified superior transverse scapular ligaments. Further correlation analyses of scapular dimensions of different SSN types in different populations are important.

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