Suprascapular Neuropathy

Abstract

Suprascapular neuropathy has often been overlooked as a source of shoulder pain. The condition may be more common than once thought as it is being diagnosed more frequently. Etiologies for suprascapular neuropathy may include repetitive overhead activities, traction from a rotator cuff tear, and compression from a space-occupying lesion at the suprascapular or spinoglenoid notch. Magnetic resonance imaging is useful for visualizing space-occupying lesions, other pathological entities of the shoulder, and fatty infiltration of the rotator cuff. Electromyography and nerve conduction velocity studies remain the standard for diagnosis of suprascapular neuropathy; however, data on interobserver reliability are limited. Initial treatment of isolated suprascapular neuropathy is typically nonoperative, consisting of physical therapy, nonsteroidal anti-inflammatory drugs, and activity modification; however, open or arthroscopic operative intervention is warranted when there is extrinsic nerve compression or progressive pain and/or weakness. More clinical data are needed to determine if treatment of the primary offending etiology in cases of traction from a rotator cuff tear or compression from a cyst secondary to a labral tear is sufficient or whether concomitant decompression of the nerve is warranted for management of the neuropathy.

The successful arthroscopic treatment of suprascapular intraneural ganglion cysts

“…2,5 Along its course to innervate the supraspinatus muscle, infraspinatus muscle, and glenohumeral joint, the suprascapular nerve (SSN) passes through 2 potential points of impingement: the suprascapular notch and the spinoglenoid notch.41 Paralabral (extraneural) cysts are globular masses filled with mucoid material that emanate from the glenohumeral joint and can occasionally extrinsically compress the SSN at these anatomical bottlenecks.2,5,9 A rare variant form, the intraneural ganglion cyst, can extend within the SSN from the glenohumeral joint and assume a characteristic tubular pattern when assessed by MRI. …”

Arthroscopic decompression of paralabral cyst around suprascapular notch causing suprascapular neuropathy

“…Suprascapular neuropathy is infrequent, causing only 1%-2% of diagnoses for shoulder pain. 8 It occurs at 8 6 either the suprascapular notch, resulting in weakness and atrophy of both the infraspinatus and the supraspinatus, or at the spinoglenoid notch, resulting in only infraspinatus weakness. EMG and NCV are the relevant investigations which can help in early diagnosis of suprascapular neuropathy.…”

Posterior Labral Tear With a Paralabral Cyst Causing Suprascapular Nerve Compression

“…Magnetic resonance imaging revealed a posterior labral tear with a large, 3.1-cm multiloculated paralabral cyst, which extended into the spinoglenoid and suprascapular notches, likely resulting in significant compression of the suprascapular nerve (FIGURE 2) and mild supraspinatus and infraspinatus edema. [1][2][3] The patient subsequently underwent arthroscopic labral repair and decompression of the suprascapular nerve, and resumed full military and athletic participation 6 months following surgery without any limitations or complaints of pain. …”

“…1 Right shoulder radiographs demonstrated a relatively high and posterior position to the humeral head (FIGURE 1, available at www.…”