Pulsed radiofrequency applied to the suprascapular nerve in painful cuff tear arthropathy

Kane, T.P.C.; Rogers, Peter; Hazelgrove, J; Wimsey, Simon; Harper, GD

doi:10.1016/j.jse.2007.10.007

Cited by 48 publications

(44 citation statements)

References 30 publications

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“…This salvage procedure can be used for pain relief where this is the major symptom, after initial conservative therapies have been exhausted [42] and the patient is not fit for major surgery, or does not want an operation. The suprascapular nerve is derived from the upper trunk of the brachial plexus (C5, C6) and is a mixed motor and sensory nerve.…”

Section: Conservative Treatmentmentioning

confidence: 99%

“…Blockade of the suprascapular nerve has been shown to improve chronic pain in numerous studies [44]. Among different techniques described are supra scapular nerve blocks (SSNB) [42], percutaneous SSN pulsed radiofrequency and arthroscopic SSN neurectomy [45]. Pulsed radiofrequency (PRF) works by delivering an electrical field to neural tissue rather than thermal coagulation and affects the smaller pain fibres more than the larger motor fibres, thus preserving any residual motor function [45].…”

Section: Conservative Treatmentmentioning

confidence: 99%

“…Pulsed radiofrequency (PRF) works by delivering an electrical field to neural tissue rather than thermal coagulation and affects the smaller pain fibres more than the larger motor fibres, thus preserving any residual motor function [45]. There is morphologic evidence that PRF is less neurodestructive than CRF (continuous radiofrequency) and it is possible that nerve fibres may regenerate after PRF treatment [42]. Kane et al [42] showed that pulsed radiofrequency to the suprascapular nerve in a cohort of 12 patients with painful cuff tear arthropathy resulted in a significant improvement in Constant, Oxford and Visual Analogue scores at 3 months.…”

Section: Conservative Treatmentmentioning

confidence: 99%

“…There is morphologic evidence that PRF is less neurodestructive than CRF (continuous radiofrequency) and it is possible that nerve fibres may regenerate after PRF treatment [42]. Kane et al [42] showed that pulsed radiofrequency to the suprascapular nerve in a cohort of 12 patients with painful cuff tear arthropathy resulted in a significant improvement in Constant, Oxford and Visual Analogue scores at 3 months. In their technique suprascapular notch was identified by use of direct visualization with an image intensifier.…”

Section: Conservative Treatmentmentioning

confidence: 99%

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Options Before Reverse Total Shoulder Replacement

Hackney¹,

Lesniewski²,

Cowling³

2018

Advances in Shoulder Surgery

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Management of massive tears of the rotator cuff tears is one of the most difficult problems an upper limb surgeon encounters. Patients with similar tears can present with minimal discomfort through to a flail shoulder. There are a bewildering number of options available, many with published outcomes not always borne out in clinical practise. These range from rehabilitation, simple arthroscopic surgery, attempts at repair, complex tendon transfers and ultimately a reverse total shoulder replacement. More recently further options of patch augmentation and balloon arthroplasty have been added. This paper attempts to provide a critical assessment of the evidence available.

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Section: Conservative Treatmentmentioning

confidence: 99%

Section: Conservative Treatmentmentioning

confidence: 99%

Section: Conservative Treatmentmentioning

confidence: 99%

Section: Conservative Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Options Before Reverse Total Shoulder Replacement

Hackney¹,

Lesniewski²,

Cowling³

2018

Advances in Shoulder Surgery

View full text Add to dashboard Cite

show abstract

“…6 Patients who are not suited to major surgical intervention are frequently seen by pain specialists who have been able to perform pulsed radiofrequency of the suprascapular nerve under landmark or ultrasound techniques with varying success (Table 1). [7][8][9][10][11][12] The results of these series, however, are limited by mediumterm follow-up. The potential advantages to the arthroscopic technique include the ability to define the extent of the cuff tear, to classify the severity of glenohumeral arthritis and to divide the suprascapular nerve under direct vision without injuring the suprascapular artery.…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic suprascapular neurotomy for the painful irreparable rotator cuff tear

et al. 2014

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Background: Massive irreparable rotator cuff tears are becoming increasingly difficult to manage. Methods: Patients were considered for treatment if they had a painful shoulder in the presence of a compensated cuff tear. All patients had radiological evidence of a massive irreparable cuff tear and underwent suprascapular neurotomy, arthroscopically.Results: There were 15 males and 25 females with a mean age of 74 years (range 59 years to 88 years). The mean preoperative Oxford Shoulder Score (OSS) in all patients was 17.7, with a mean pre-operative visual analogue score (VAS) of 8.0. The mean post-operative OSS was 30.8 [27.42-34.18 ¼ confidence interval (CI) 95%] with a mean VAS of 3.6 (2.64-4.56 CI 95%) at the 3-month (short-term) period (n ¼ 32). The medium-term (1-year) OSS and VAS had improved to 33.6 (32.27-34.93 ¼ CI 95%) and 3.7 (0-8.39 CI 95%) respectively (n ¼ 26). The difference pre-and postoperatively at 12 months was statistically significant (p < 0.001). Patients who underwent biceps tenotomy at the time of surgery had a less significant improvement in their VAS and OSS. Conclusions: Suprascapular neurotomy can afford medium-term benefit in over two-thirds of the patients who would otherwise have undergone reverse polarity shoulder replacements. We consider that this is a reproducible technique.

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