Experience of endoscopic transcapsular axillary nerve decompression: а series of clinical cases

Abstract

Introduction. Posttraumatic axillary nerve neuropathy is a widely spread pathology, more often is seen after shoulder joint trauma. It can be also occurred as a complication after orthopaedic surgeries, for example, after Latarjet procedure for shoulder stabilization. Endoscopic surgical technique of decompression is an effective less traumatic alternative to open procedures. Goal. Improve the results of treatment of patients with axillary nerve neuropathy. Material and methods. The results of endoscopic transcapsular axillary nerve decompression in 5 patients, which were operated from 2018 to 2021 year, with the clinics of axillary nerve neuropathy. The mean age of the patients was 44.414.9. Patients were performed endoscopic axillary nerve decompression. Statistical analysis was made according to Mann-Whitney U test. Results. According to VAS-scale the severity of pain syndrome before the surgery was 64.6 points, 6 months after decreased to 1.4 0.5 points (p0.05). According to DASH scale the function of the of shoulder joint before the surgery was 77,6 6,9 points, 6 months after decreased to 12 5,2 points (p0.05). According to BMRC scale (M0-M5) strength of the deltoid muscle was 2 0,4 points, after increased to 4,4 0,5 points (p0.05). Range of motion in a shoulder was: flexion 107 45,6, extension 102 49, external rotation 22 13,6; 6 months after: flexion 154 25,6, extension 156 22,4, external rotation 50 8 (p0,05). The thickness of deltoid muscle according to US before the surgery was 7.21.04 mm., after 6 months - 11.81.44 mm (p0.05). Conclusion. The results characterize the method of endoscopic transcapsular axillary nerve decompression as a reproducible, minimally invasive and effective technique for pain relief, can treat neurological and intraarticular pathology, promotes early restoration of the function of upper limb.