Compression of the Suprascapular Nerve After Fracture of the Scapular Notch

1978 ◽  
Vol 49 (4) ◽  
pp. 338-340 ◽  
Author(s):  
Ludvig Fjeld Solheim ◽  
Asbjørn Roaas
Keyword(s):  
Suprascapular Nerve ◽  
Scapular Notch

Suprascapular nerve release for treatment of shoulder and periscapular pain following intracranial spinal accessory nerve injury

2008 ◽  
Vol 109 (5) ◽  
pp. 962-966 ◽  
Author(s):  
Leandro Pretto Flores
Keyword(s):  
Nerve Injury ◽  
Soft Tissues ◽  
Suprascapular Nerve ◽  
Spinal Accessory Nerve ◽  
Accessory Nerve ◽  
Promising Alternative ◽  
Spinal Accessory ◽  
Dorsal Branch ◽  
Scapular Notch ◽  
Surgical Release

Iatrogenic injury to the spinal accessory nerve is one of the most common causes of trapezius muscle palsy. Dysfunction of this muscle can be a painful and disabling condition because scapular winging may impose traction on the soft tissues of the shoulder region, including the suprascapular nerve. There are few reports regarding therapeutic options for an intracranial injury of the accessory nerve. However, the surgical release of the suprascapular nerve at the level of the scapular notch is a promising alternative approach for treatment of shoulder pain in these cases. The author reports on 3 patients presenting with signs and symptoms of unilateral accessory nerve injury following resection of posterior fossa tumors. A posterior approach was used to release the suprascapular nerve at the level of the scapular notch, transecting the superior transverse scapular ligament. All patients experienced relief of their shoulder and scapular pain following the decompressive surgery. In 1 patient the primary dorsal branch of the C-2 nerve root was transferred to the extracranial segment of the accessory nerve, and in the other 2 patients a tendon transfer (the Eden–Lange procedure) was used. Results from this report show that surgical release of the suprascapular nerve is an effective treatment for shoulder and periscapular pain in patients who have sustained an unrepairable injury to the accessory nerve.

Motor Recovery of the Suprascapular Nerve after Arthroscopic Decompression in the Scapular Notch – a Systematic Review

2020 ◽  
Author(s):  
Marius von Knoch ◽  
Stephan Frosch ◽  
Mike H. Baums ◽  
Wolfgang Lehmann
Keyword(s):  
Systematic Review ◽  
Case Series ◽  
Clinical Results ◽  
Suprascapular Nerve ◽  
Motor Recovery ◽  
Cochrane Library ◽  
Suprascapular Notch ◽  
Compression Syndrome ◽  
Pubmed Database ◽  
Scapular Notch

Abstract Background The suprascapular nerve can be compromised as a result of a compression syndrome in different locations. A (proximal) compression within the scapular notch can lead to dorsal shoulder pain and simultaneous weakness of the infraspinatus and supraspinatus muscles. By transection of the lig. transversum this compression syndrome can be treated. By means of a systematic review, the present work analyzes the motor recovery potential after arthroscopic decompression. Material and Methods A systematic review of the U. S. National Library of Medicine/National Institutes of Health (PubMed) database and the Cochrane Library was performed using the PRISMA checklist. The search words used were “suprascapular” and “arthroscopic”; “suprascapular” and “arthroscopy”. Based on the evaluated literature, articles in English with at least a partial arthroscopic case series from 4 cases on and a compression syndrome of the suprascapular nerve treated with arthroscopic decompression in the scapular notch were identified. Motor recovery was described by means of EMG, clinical strength and MRI. Results Primarily 408 hits were generated. Six articles met the inclusion criteria and were further analyzed. The number of arthroscopic cases was between 4 and a maximum of 27. The level of evidence was between III and IV. The majority of the reported clinical results were good. Motor recovery as measured by EMG was observed, recovery of full strength was not achieved in the majority of reported cases (60%), neither was regression of structural (fatty) degeneration of the muscle bellies. Conclusion Arthroscopic decompression of the suprascapular nerve in the scapular notch provides good clinical results and considerable pain relief. However, in the majority of cases it does not lead to a complete recovery of the strength of the supra- and infraspinatus muscles. Patients should be informed about this. An early decompression after diagnosis in the event of proximal compression within the suprascapular notch combined with beginning EMG or MRI changes appears reasonable. These beginning changes should be further defined. Future studies should develop prognostic criteria for motor recovery. Awareness regarding the diagnosis needs to be improved due to the probably time-dependent irreversibility of resulting muscular weakness.

scholarly journals Morphological Aspects in Ultrasound Visualisation of the Suprascapular Notch Region: A Study Based on a New Four-Step Protocol

2018 ◽  
Vol 7 (12) ◽  
pp. 491 ◽  
Author(s):  
Hubert Jezierski ◽  
Michał Podgórski ◽  
Grzegorz Wysiadecki ◽  
Łukasz Olewnik ◽  
Raffaele De Caro ◽  
...  
Keyword(s):  
Suprascapular Nerve ◽  
Transverse Diameter ◽  
Type I ◽  
Suprascapular Notch ◽  
Type Iv ◽  
Morphological Aspects ◽  
Common Location ◽  
Suprascapular Nerve Block ◽  
The Right ◽  
Scapular Notch

Background: Sonographic evaluation of the suprascapular notch (SSN) region is clinically important, because it is the most common location for performing suprascapular nerve block. The aim of the study was to describe the morphology of the SSN region based on ultrasound examination and in accordance with the patients' body mass index (BMI). Material and Methods: The SSN region was sonographically examined in 120 healthy volunteers according to our new four-step protocol. The morphometry of the SSN and the neurovascular bundle was assessed, and patients' BMI were calculated. The shape of the suprascapular notch was classified based on its superior transverse diameter (STD) and maximal depth (MD). Result: The type III scapular notch was the most prevalent (64%). The BMI was higher in type IV/V (27.38 ± 3.76) than in type I (24.77 ± 3.49). However, no significant differences were observed in the distribution of SSN notch types with regard to BMI (p = 0.0536). The suprascapular artery was visualised in all of the recognised SSNs, while the suprascapular vein and nerve were visualised only in 74.9% and 48.1% of the SSNs, respectively. The suprascapular nerve was significantly thicker on the right side (3.5 +/- 1.1 mm) than on the left (1.3 +/- 0.4 mm) (p = 0.001). In contrast, the suprascapular vein (1.5 +/- 0.9 mm) was found to be a significantly wider on the left side than the right (1.2 +/- 0.7 mm) (p = 0.001). Conclusion: Our original four-step sonographic protocol enabled characterising the morphology of the SSN region, despite the SSN notch types. The suprascapular artery is the best sonographic landmark for the suprascapular notch region. No significant differences were found between sides regarding the thickness of the soft tissue above the suprascapular nerve and vessels. Recognition of the SSN morphology is not affected by the BMI.

scholarly journals Ultrasound-guided Suprascapular Nerve Block Technique

2007 ◽  
Vol 6;10 (6;11) ◽  
pp. 746-746
Author(s):  
Dominic Harmon
Keyword(s):  
Case Report ◽  
Real Time ◽  
Nerve Block ◽  
Ultrasound Guidance ◽  
Adhesive Capsulitis ◽  
Suprascapular Nerve ◽  
Ultrasound Transducer ◽  
Suprascapular Notch ◽  
Suprascapular Nerve Block ◽  
Scapular Notch

Background: In this article, we describe a case report of using real-time, high-resolution ultrasound guidance to facilitate blockade of the suprascapular nerve. We describe a case report and technique for using a portable ultrasound scanner (38 mm broadband (13-6 MHz) linear array transducer (SonoSite Micromaxx SonoSite, Inc. 21919 30th Drive SE Bothwell W. A..)) to guide suprascapular nerve block. Methods: A 44-year old male patient presented with severe, painful osteoarthritis with adhesive capsulitis of his right shoulder. The ultrasound transducer in a transverse orientation was placed over the scapular spine. Moving the transducer cephalad the suprascapular fossa was identified. While imaging the supraspinatus muscle and the bony fossa underneath, the ultrasound transducer was moved laterally (maintaining a transverse transducer orientation) to locate the suprascapular notch. The suprascapular nerve was seen as a round hyperechoic structure at 4 cm depth beneath the transverse scapular ligament in the scapular notch. The nerve had an approximate diameter of 200 mm. Real-time imaging was used to direct injection in the scapular notch. Ultrasound scanning confirmed local anesthetic spread. Results: The patient’s pain intensity decreased. Shoulder movement and function improved. These improvements were maintained at 12 weeks. Conclusion: Ultrasound guidance does not expose patients and personnel to radiation. It is also less expensive than other imaging modalities. This technique has applications in both acute and chronic pain management. Key words: Technique, visualization, real-time, Ultrasound,nerve, analgesia.

scholarly journals Decompression of the suprascapular nerve at the superior scapular notch under combined arthroscopic and ultrasound (US) guidance: US-arthroscopy

2021 ◽  
Author(s):  
Clément Prénaud ◽  
Jeanne LOUBEYRE ◽  
Marc SOUBEYRAND
Keyword(s):  
Soft Tissues ◽  
Three Dimensional ◽  
Suprascapular Nerve ◽  
Release Time ◽  
Dimensional Control ◽  
Non Invasive ◽  
Endoscopic Release ◽  
Nerve Localization ◽  
Scapular Notch ◽  
Ultrasound Scanner

Abstract Background: Decompression of the suprascapular nerve (SSNe) at the superior scapular notch (SSNo) is usually performed with an arthroscopic procedure. This technique is well described but locating the nerve is complex because it is deeply buried and surrounded by soft tissue. We propose to combine ultrasound and arthroscopy (US-arthroscopy) to facilitate nerve localization, exposure and release. The main objective of this study was to assess the feasibility of this technique. Methods: This is an experimental, cadaveric study, carried out on 10 shoulders. The first step of our technique is to locate the SSNo using an ultrasound scanner. Then an arthroscope is introduced under ultrasound control to the SSNo. A second portal is then created to dissect the pedicle and perform the ligament release. Results: Ultrasound identification of the SSNo, endoscopic dissection and decompression of the nerve were achieved in 100% of cases. Ultrasound identification of the SSNo took an average of 3 min (+/-4) while dissection and endoscopic release time took an average of 8 min (+/-5). Conclusion: Ultrasound is an extremely powerful tool for non-invasive localization of nerves through soft tissues, but it is limited by the fact that tissue visualization is limited to the ultrasound slice plane, which is two-dimensional. On the other hand, arthroscopy (extra-articular) allows three-dimensional control of the surgical steps performed, but the locating of the nerve involves significant tissue detachment and a risk of damaging the nerve with the dissection. The combination of the two (US-arthroscopy) offers the possibility of combining the advantages of both techniques.

scholarly journals Morphometric Study of Suprascapular Notch and Its Variations in Dried Human Scapulae

2020 ◽  
Vol 2 (6) ◽  
Author(s):  
Kamal D. Pawar ◽  
Sushama. K. Chavan ◽  
Mohini M. Joshi
Keyword(s):  
Statistical Tests ◽  
Anatomical Study ◽  
Suprascapular Nerve ◽  
Coracoid Process ◽  
Morphometric Study ◽  
Transverse Ligament ◽  
Suprascapular Notch ◽  
Endoscopic Techniques ◽  
Notch Edge ◽  
Scapular Notch

The study was undertaken to see the variation of the suprascapular notch. The notch is present on the superior border of the scapula near the root of coracoid process. It is roofed by the superior transverse ligament and is converted into foramen for the passage of suprascapular nerve. The study was carried out on 121 scapulae in the department of Anatomy RMC Loni, Ahmednagar. The parameters included in the study were presence of notch, shape of notch, transvers length of notch, edge of notch, ossification of transverse ligament and other finding were also noted. The parameters were measured by Vernier calliper and appropriate statistical tests were applied. The supra-scapular notch was present in 82.64% of scapulae. U Deep shaped notch was most common shape followed by J shallow shaped notch. Round edge at the depth of the notch was more common. The knowledge of suprascapular notch variations is of great importance for surgeons performing suprascapular nerve decompression especially by means of endoscopic techniques. Our anatomical study helps the clinicians before planning a surgery.

scholarly journals Decompression of the Suprascapular Nerve at the Superior Scapular Notch Under Combined Arthroscopic and Ultrasound (US) Guidance: US-Arthroscopy

2021 ◽  
Author(s):  
Clément Prénaud ◽  
Jeanne LOUBEYRE ◽  
Marc SOUBEYRAND
Keyword(s):  
Soft Tissues ◽  
Three Dimensional ◽  
Suprascapular Nerve ◽  
Release Time ◽  
Dimensional Control ◽  
Non Invasive ◽  
Endoscopic Release ◽  
Nerve Localization ◽  
Scapular Notch ◽  
Ultrasound Scanner

Abstract Background: Decompression of the suprascapular nerve (SSNe) at the superior scapular notch (SSNo) is usually performed with an arthroscopic procedure. This technique is well described but locating the nerve is complex because it is deeply buried and surrounded by soft tissue. We propose to combine ultrasound and arthroscopy (US-arthroscopy) to facilitate nerve localization, exposure and release. The main objective of this study was to assess the feasibility of this technique. Methods: This is an experimental, cadaveric study, carried out on shoulders. The first step of our technique is to locate the SSNo using an ultrasound scanner. Then an arthroscope is introduced under ultrasound control to the SSNo. A second portal is then created to dissect the pedicle and perform the ligament release. Results: Ultrasound identification of the SSNo, endoscopic dissection and decompression of the nerve were achieved in 100% of cases. Ultrasound identification of the SSNo took an average of min (+/-4) while dissection and endoscopic release time took an average of min (+/-5). Conclusion: Ultrasound is an extremely powerful tool for non-invasive localization of nerves through soft tissues, but it is limited by the fact that tissue visualization is limited to the ultrasound slice plane, which is two-82 dimensional. On the other hand, arthroscopy (extra-articular) allows three-dimensional control of the surgical steps performed, but the locating of the nerve involves significant tissue detachment and a risk of damaging the nerve with the dissection. The combination of the two (US-arthroscopy) offers the possibility of combining the advantages of both techniques.

scholarly journals Supra-scapular foramen in Indian dry scapulae

2012 ◽  
Vol 01 (03) ◽  
pp. 133-135 ◽  
Author(s):  
S D Jadhav ◽  
R J Patil ◽  
P P Roy ◽  
M P Ambali ◽  
M A Doshi ◽  
...  
Keyword(s):  
Risk Factor ◽  
Indian Population ◽  
Suprascapular Nerve ◽  
Nerve Decompression ◽  
Anatomical Knowledge ◽  
Suprascapular Foramen ◽  
Scapular Notch ◽  
Superior Transverse Scapular Ligament

Abstract Background and aims : Supra-scapular notch is roofed by superior transverse scapular ligament and converted into a foramen which provides passage for suprascapular nerve. When it is completely ossified that time it manifest as supra-scapular foramen in dry scapulae. Variations of superior transverse scapular ligament include calcification, partial or complete ossification and multiple bands. Presence of this foramen in dry scapulae is considered to be rare. Aim of the study was to verify the prevalence of supra-scapular foramen in Indian dry scapulae. Materials and methods : A total of three fifty dry scapulae were analyzed (Right- 176, Left-174) to see the presence of supra-scapular foramen. Results : In the present study, suprascapular foramen was present in 25 right and in 12 left sided scapulae i.e., 10.57% incidence which is alarming. Conclusion : Present study demonstrates that suprascapular foramen which is the result of complete ossification of superior transverse scapular ligament, is common in Indian population. The anatomical knowledge of this foramen is of extreme importance for clinicians; it can be a risk factor during surgical explorations involving a suprascapular nerve decompression.

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