Suprascapular Nerve Pathology: A Review of the Literature

Abstract

Background:Suprascapular nerve pathology is a rare diagnosis that is increasingly gaining popularity among the conditions that cause shoulder pain and dysfunction. The suprascapular nerve passes through several osseoligamentous structures and can be compressed in several locations.Methods:A thorough literature search was performed using online available databases in order to carefully define the pathophysiology and to guide diagnosis and treatment.Results:Suprascapular neuropathy diagnosis is based on a careful history and a thorough clinical and radiological examination. Although the incidence and prevalence of the condition remain unknown, it is highly diagnosed in specific groups (overhead athletes, patients with a massive rotator cuff tear) probably due to higher interest. The location and the etiology of the compression are those that define the treatment modality.Conclusion:Suprascapular neuropathy diagnosis is based on a careful history and a thorough clinical and radiological examination. The purpose of this article is to describe the anatomy of the suprascapular nerve, to define the pathophysiology of suprascapular neuropathy and to present methodically the current diagnostic and treatment strategies.

Suprascapular Neuropathy around the Shoulder: A Current Concept Review

“…It runs laterally through the posterior cervical triangle and backwards to the clavicle, reaching the superior border of the scapula at the suprascapular notch underneath the superior transverse scapular ligament. The suprascapular artery and vein pass over the transverse ligament [5]. The suprascapular notch represents the most common site of compression of the suprascapular nerve.…”

“…The spinoglenoid ligament is present in 14% to 100% of patients and links the spine of the scapula, the glenoid neck and the posterior shoulder capsule. This capsular attachment causes ligament tightening during cross-body adduction and internal rotation of the limb and may cause dynamic nerve compression [5,22]. From this point, the nerve proceeds downwards and spreads innervation to the infraspinatus muscle.…”

“…Some authors have advanced two hypotheses of vascular etiologies in athletes. One speculates on intimal lesions of the suprascapular or axillar artery resulting in microemboli in the vasa nervorum of suprascapular nerve [3,5,8,33]. The second contemplates a dilatation of the suprascapular veins that could lead to nerve compression at the spinoglenoid notch [28].…”

“…It is considered a rare cause of shoulder pain even though the real incidence rate remains unknown and so may be underestimated [3,4]. The difficulty is to remember this specific and other coexisting shoulder pathologies [5]. However, the diagnosis and recognition rates of this disease are increasing and might represent 1%-2% of all causes of shoulder pain [6].…”

Ultrasound-guided interventions for painful shoulder: from anatomy to evidence

“… 1 The causes of chronic shoulder pain are variable, ranging from rotator cuff pathology to peripheral nerve entrapment. 2 , 3 Advances in ultrasound (US) technology allow static and dynamic evaluation of shoulder problems and offer real-time, radiation-free guidance for therapeutic interventions. 4 The main philosophy behind these interventions starts with “seeing is believing” and continues with “once seen, can be accessed.” Undoubtedly, US guidance provides an additional margin of safety for interventional techniques.…”