NEUROHISTOLOGY OF THE SUBACROMIAL SPACE

Subacromial decompression is one of the most commonly performed should er procedures. Debridement of the subacromial soft tissues is a critic al part of the procedure. However, the extent of soft tissue debrideme nt is not well defined. The purpose of this study was to identify neur al elements within the soft tissues composing the subacromial space. U sing special immunohistochemical stains and electron microscopy, neura l elements were identified within the subacromial bursa, rotator cuff tendon, biceps tendon and tendon sheath, and transverse humeral ligame nt. There was a significantly richer supply of free nerve fibers in th e bursa compared with the other tissues. The nociceptive information r elayed by these fibers may be responsible for the pain associated with impingement syndrome.