Suprascapular Neuropathy. Results of Non-Operative Treatment*

Martin, Scott D.; Warren, Russell F.; Martin, Tamara L.; Kennedy, Kevin; O’Brien, Stephen J.; Wickiewicz, Thomas L.

doi:10.2106/00004623-199708000-00007

Cited by 109 publications

(53 citation statements)

References 30 publications

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“…Martin et al 31 stated that, the patients who were operated on within six months of the onset of symptoms, showed better recovery than those who had surgery after a longer interval and that operative excision is indicated in patients whose symptoms result from compression of the nerve by a ganglion. In the present study, regardless of the cause of suprascapular nerve compression the delay in operation within 6 months had better recovery.…”

Section: Discussionmentioning

confidence: 99%

Suprascapular Nerve: Anatomical and Clinical Study

Metwally¹

2016

IJCEMS

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Abstract:The suprascapular nerve arises from the upper trunk (Erb's point) of the brachial plexus in the posterior triangle of the neck.This research was conducted to study the anatomy of the suprascapular nerve in the scapular region and its relation to both suprascapular and spinoglenoid notches. This data is very important in suprascapular nerve block and suprascapular nerve surgical decompression. Dissection of 20 scapular regions of 10 formalin preserved male cadavers was done. Also thirty three adult patients; 26 males and 7 females suffering from vague shoulder pain subjected to suprascapular nerve surgical decompression. In all cadaveric specimens, careful dissection and anatomical study of suprascapular nerve regarding its course, distribution and relations was carried out. Origin of the nerve was demonstrated from upper trunk of the brachial plexus. Passage of the nerve through a narrow medial compartment of supraglenoid canal in all cases has been identified. Measurements of two important diameters relevant to suprascapular notch were also reported. The transverse scapular ligament was identified to be of uniform thickness. In the clinical study of all cases with suprascapular nerve entrapment regardless its etiology whether idiopathic or not, conservative therapy by means of the exercise was of limited value especially for the motor affection. All of the cases were subjected to surgical maneuverer to decompress the nerve. It is concluded that the anatomical findings allow better choice of the surgical procedure, more precise surgical dissection, better results and fewer complications.

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Section: Discussionmentioning

confidence: 99%

Suprascapular Nerve: Anatomical and Clinical Study

Metwally¹

2016

IJCEMS

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“…48 In the absence of an identifiable anatomic source of nerve compression, a trial of nonoperative intervention as outlined in Table 4 is probably most appropriate. 16,38,47,48 Three of the patients presented in this case report were managed nonsurgically and had complete or nearly complete return of strength and resolution of pain in the time that they were followed. The patient who was managed surgically had only minimal improvement in symptoms and function.…”

Section: Possible Trauma Often Insidiousmentioning

confidence: 94%

“…2 Thus, imaging studies to determine the location and source of the lesion, if possible, may be useful in guiding intervention. 2,47 Several authors 16,38 have reported good or excellent results in a majority of patients managed with a conservative (nonsurgical) approach. Other authors 1,3,5,7,48 have reported good or excellent results in a majority of patients managed surgically.…”

Section: Possible Trauma Often Insidiousmentioning

confidence: 99%

Diagnosing Suprascapular Neuropathy in Patients With Shoulder Dysfunction: A Report of 5 Cases

2004

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Background and Purpose. Suprascapular neuropathy, resulting in shoulder pain and weakness, is frequently misdiagnosed. The consequences of misdiagnosis can include inappropriate physical rehabilitation or surgical procedures. The purpose of this case report is to describe the differential diagnosis of suprascapular neuropathy. Case Descriptions. Five patients were initially diagnosed with subacromial impingement syndrome and referred for physical therapy. Physical therapist examination findings were consistent with subacromial impingement syndrome and suprascapular neuropathy. Subsequent electrophysiologic testing confirmed the diagnosis of suprascapular neuropathy in all 5 patients. Discussion. The differential diagnosis of patients with suprascapular neuropathy includes subacromial impingement syndrome, rotator cuff pathology, C5-6 radiculopathy, and upper trunk brachial plexopathy. The diagnostic process and a S uprascapular neuropathy (SSN) may be overlooked or mistaken for other conditions such as subacromial impingement syndrome (SAIS), rotator cuff injury, cervical radiculopathy, or brachial plexopathy. [1][2][3][4][5][6] The signs and symptoms of SSN include shoulder weakness, atrophy, and diffuse aching or burning pain at the shoulder, which often includes the posterolateral aspect of the shoulder in the region of the scapula. [1][2][3][4][5]7 However, painless cases, which involved denervation of the infraspinatus muscle only, also have been reported. 8 Although SSN is uncommon, it should be considered in the differential diagnosis of patients with shoulder pain and weakness. [1][2][3][4][5]7 Suprascapular neuropathy has been reported in 10 patients (0.4%) in a series of 2,520 patients with shoulder pain, 6 but some authors 7 have speculated that this condition is so frequently misdiagnosed that it is probably the cause in 1% to 2% of patients with shoulder pain. Of 10 patients with SSN reported by Post and Mayer, 6 8 patients were initially misdiagnosed, leading to inappropriate intervention. Two patients were managed surgically for SAIS with acromioplasty, 1 patient was managed surgically with C4 -5 diskectomy, 3 patients were managed with cervical traction, 1 patient was managed with a cervical soft collar, and 1 patient was managed for acromioclavicular joint sprain. Six of the 10 patients were managed with unspecified physical therapy interventions. In a later case series of 39 patients with SSN, 18 patients were managed with 30 inappropriate surgical procedures for SAIS, the cervical spine, and thoracic outlet syndrome. 5 In another series of 27 patients, 6 patients underwent surgical procedures for thoracic outlet syndrome and 3 patients underwent cervical diskectomies without relief prior to their diagnosis of SSN. 3 The suprascapular nerve is a mixed motor and sensory nerve arising from the upper trunk of the brachial plexus with contributions primarily from the anterior primary rami of the C5 and C6 nerve roots. It then courses posteroinferiorly beneath the superior transverse scapular lig...

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“…Describing the pain is not a difficult procedure, as there is no particular diversity amongst documented cases; Patients report deep, posterior pain, which oftentimes remains during night and gradually becomes constant and can turn to a feeling of heatburn [9,25].…”

Section: Clinical Presentation-symptomsmentioning

confidence: 99%

“…Special attention should be addressed to the infraspinatus and suspraspinatus, in all of their functional roles; both as antagonists and protagonists, as well as assistors and stabilizers, both in closed and in open kinetic chains. The weight should be used from the beginning, and remain stable in the long run, unlike with the repetitions that should increase as the rehabilitation program progresses [25,[38][39][40].…”

Section: Physical Therapymentioning

confidence: 99%

Suprascapular Neuropathy: An Overview

Angoules¹,

Boutsikari²

2015

J Nov Physiother

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Objective: To present an overview on suprascapular neuropathy (SSN), a compressive neuropathy which leads to a significant upper extremity impairment. Methods: A narrative review of international medical literature was conducted in order to depict current concepts of diagnosis and treatment.Conlusion: Supracapular neuropathy is a rare albeit painful condition affecting mainly overhead athletes. Although not always observable as initial diagnosis it should be included in the differential diagnosis when assessing a shoulder dysfunction.

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Suprascapular Neuropathy. Results of Non-Operative Treatment*

Cited by 109 publications

References 30 publications

Suprascapular Nerve: Anatomical and Clinical Study

Suprascapular Nerve: Anatomical and Clinical Study

Diagnosing Suprascapular Neuropathy in Patients With Shoulder Dysfunction: A Report of 5 Cases

Suprascapular Neuropathy: An Overview

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