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Arthroscopic Suprascapular Nerve Release

March 15, 2015

Contributors: Grame Whyte, MD; Maxwell Weinberg, MD; William Ryan, BS; Dylan Lowe, MD; Laith M Jazrawi, MD, FAAOS; Laith M Jazrawi, MD, FAAOS

BACKGROUND: Suprascapular neuropathy is a relatively rare pathology associated with compression of the nerve, dynamic shoulder injury, and repetitive overhead motion. The suprascapular nerve has both sensory and motor components, thus neuropathy can present with posterolateral shoulder pain, weakness, and instability. A precise diagnosis is challenging and there remains controversy over how and when the nerve should be released in symptomatic patients. While treatment depends on the underlying etiology, for many cases there are no formal guidelines on how to best manage these patients. The purpose of this video is to illustrate the technique for arthroscopic suprascapular nerve release for symptomatic patients.

METHODS: A review of the current concepts in suprascapular neuropathy is conducted. This video demonstrates suprascapular nerve release in a patient with suprascapular nerve entrapment at the transverse scapular notch. There is specific focus on relevant patient history, injury presentation, etiology, surgical indications, prognostic factors, surgical technique, concurrent procedures, and rehabilitation. The key steps of the procedure are highlighted, along with the rationale behind the approach.

RESULTS: This video illustrates the important concepts in suprascapular nerve injury and an arthroscopic technique for nerve release. Sensory and motor function can be regained after this procedure and a course of postoperative rehabilitation.

CONCLUSION: While suprascapular neuropathy is a relatively rare pathology, the diagnosis is often missed when it is present. The underlying etiology guides treatment of the patient, and therefore must be identified. Overuse injuries lacking signs of denervation respond reasonably well to conservative therapy. When surgical treatment is indicated, it should be adapted to the underlying etiology. Promising clinical outcomes have been seen for both open and arthroscopic approaches. However, specialized orthopaedic surgeons have been increasingly performing arthroscopic suprascapular nerve release since its inception. This video provides an up to date, standardized, and evidence-based guide for how to optimally manage patients with suprascapular neuropathy.

Results for "Shoulder: Neurovascular"