Neuropathy of the suprascapular nerve and massive rotator cuff tears: a prospective electromyographic study

Collin, Philippe; Treseder, Tom; Lädermann, Alexandre; Benkalfate, T.; Mourtada, Reda; Courage, Olivier; Favard, Luc

doi:10.1016/j.jse.2013.07.039

Cited by 69 publications

(51 citation statements)

References 25 publications

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“…These data thus call into question the concept of SSN injury as a direct consequence of muscle retraction. Prospective and carefully conducted studies indicate a rare occurrence of isolated motor SSN injury in patients with RC tendon tears, even in massive and/or traumatic RC tendon tear 16; 153 . Within the largest patient series in this topic area 16 , peripheral neuropathy was found in 12% of patients and only one patient exhibited positive signs of SSN injury.…”

Section: Motor Nerves and Neuromuscular Junctionmentioning

confidence: 99%

“…Some categorize EMG findings based upon the isolated or combined occurrence of positive EMG signs 134 while others use graded scoring based on semi-quantitative assessments of EMG abnormalities 16; 18; 134 . Regarding NCS, some compare latencies to previously published values 13; 16 and/or to the contralateral side 16; 18; 153 while others compared latencies of patients with positive and negative EMG findings 13 . Severe retraction, ultrastructural muscle changes and/or non-uniform denervation may also complicate EMG/NCS in RC muscles 8 .…”

Section: Motor Nerves and Neuromuscular Junctionmentioning

confidence: 99%

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The role of the peripheral and central nervous systems in rotator cuff disease

Bachasson

Singh

Shah

et al. 2015

Journal of Shoulder and Elbow Surgery

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Rotator cuff (RC) disease is an extremely common condition associated with shoulder pain, reduced functional capacities and impaired quality of life. It primarily involves alterations in tendon health and mechanical properties that can ultimately lead to tendon failure. RC tendon tears induce progressive muscular changes that negatively impact surgical reparability of the RC tendons and clinical outcomes. At the same time, a significant base of clinical data suggests a relatively weak relationship between RC integrity and clinical presentation, emphasizing the multifactorial aspects of RC disease. This review aims to summarize the potential contribution of peripheral, spinal and supraspinal neural factors that may: (i) exacerbate structural and functional muscle changes induced by tendon tear, (ii) compromise the reversal of these changes during surgery and rehabilitation, (iii) contribute to pain generation and persistence of pain, iv) impair shoulder function through reduced proprioception, kinematics and muscle recruitment, and iv) help to explain interindividual differences and response to treatment. Given the current clinical and scientific interest in peripheral nerve injury in the context of RC disease and surgery, we carefully reviewed this body of literature with a particular emphasis for suprascapular neuropathy that has generated a large number of studies in the past decade. Within this process, we highlight the gaps in current knowledge and suggest research avenues for scientists and clinicians.

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Section: Motor Nerves and Neuromuscular Junctionmentioning

confidence: 99%

Section: Motor Nerves and Neuromuscular Junctionmentioning

confidence: 99%

The role of the peripheral and central nervous systems in rotator cuff disease

Bachasson

Singh

Shah

et al. 2015

Journal of Shoulder and Elbow Surgery

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“…An abnormal NC assessment finding is defined according to the following values: infraspinatus latency >4.5 ms and an amplitude <8 mV from peak to peak and supraspinatus muscle latency >3.5 ms and an amplitude <8 mV from peak to peak [12]. The contralateral nerve will also be examined.…”

Section: Methodsmentioning

confidence: 99%

Suprascapular neuropathy in the setting of rotator cuff tears: study protocol for a double-blinded randomized controlled trial

Sachinis

Boutsiadis

Papagiannopoulos

et al. 2016

Trials

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BackgroundIt has been indicated that rotator cuff tears, especially large or massive ones, can cause suprascapular neuropathy. When such a diagnosis has been established, it is still unknown whether an arthroscopic release of the superior transverse scapular ligament during cuff repair can change the course of this neuropathy.Methods/designThis is a single-center, double-blinded randomized controlled trial for which 42 patients with large or massive repairable rotator cuff tears and suprascapular neuropathy will be recruited and followed up at 6 and 12 months. Nerve function will be measured by nerve conduction and electromyography studies preoperatively and at the selected follow-up periods. Patients will be randomly divided into equally numbered groups, the first one being the control group. Patients of this group will undergo arthroscopic repair of the rotator cuff without combined arthroscopic release of the superior transverse scapular ligament; in the second group the ligament will be released. The primary objective is to test the null hypothesis that arthroscopic repair of large/massive rotator cuff tears in patients with combined suprascapular neuropathy provides equivalent outcomes to one-stage arthroscopic cuff repair where the superior suprascapular ligament is additionally released. The secondary objective is to search for a relation between rotator cuff tear size and degree of suprascapular nerve recovery. The tertiary objective is to demonstrate any relation between rotator cuff muscle fatty infiltration grade and degree of suprascapular nerve function. Patients, clinicians during follow-up clinics and the neurologist will be blinded to the type of surgery performed.DiscussionTo the best of our knowledge, we are unaware of any prospective, randomized double-blinded studies with similar objectives. So far, the evidence suggests a positive correlation between massive rotator cuff tears and suprascapular neuropathy. However, there is mixed evidence suggesting that neuropathy can be effectively treated with rotator cuff repair with or without release of the superior transverse scapular ligament.Trial registrationClinicalTrials.gov registration number NCT02318381; date of initial release: 5 December 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1672-y) contains supplementary material, which is available to authorized users.

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“…Consequently, the available data provide no guidance regarding the appropriateness of nerve release at the scapular notch. Lafosse et al [18] and Romeo et al [31] stated that this procedure was clearly beneficial, whereas results reported by Collin et al [12] can be interpreted as challenging the concept of traction neuropathy or as suggesting that electromyography may lack sensitivity for detecting neuropathy in patients with muscle wasting.…”

Section: Suprascapular Nerve Entrapment Related To Rotator-cuff Tearsmentioning

confidence: 98%

“…The potential relevance of concomitant rotator-cuff tears remains debated [10][11][12]. Less common causes include tumours, scapular fractures, and direct trauma involving traction.…”

Section: Introductionmentioning

confidence: 99%

Peri-articular suprascapular neuropathy

Clavert¹,

Thomazeau

2014

Orthopaedics & Traumatology: Surgery & Research

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Suprascapular nerve entrapment was first described in 1959 by Kopell and Thompson. Although rare, this condition is among the causes of poorly explained shoulder pain in patients with manifestations suggesting a rotator-cuff tear but normal tendons by imaging studies. Suprascapular nerve entrapment may cause 2% of all cases of chronic shoulder pain. Among the many reported causes of suprascapular nerve entrapment, the most common are para-labral cysts, usually in the spinoglenoid notch, and microtrauma in elite athletes. The potential relevance of concomitant rotator-cuff tears remains debated. Less common causes include tumours, scapular fractures, and direct trauma involving traction. Early diagnosis and treatment are crucial to avoid the development of irreversible muscle wasting. Endoscopic surgery to treat the various causes of suprascapular nerve compression has superseded open nerve release.

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Neuropathy of the suprascapular nerve and massive rotator cuff tears: a prospective electromyographic study

Cited by 69 publications

References 25 publications

The role of the peripheral and central nervous systems in rotator cuff disease

The role of the peripheral and central nervous systems in rotator cuff disease

Suprascapular neuropathy in the setting of rotator cuff tears: study protocol for a double-blinded randomized controlled trial

Peri-articular suprascapular neuropathy

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