SUPRASCAPULAR NERVE ENTRAPMENT - EXPERIENCE WITH 28 CASES

Suprascapular nerve entrapment (SNE) in the suprascapular notch is a r are entity that must be considered in the differential diagnosis of ra dicular pain, as well as that of shoulder discomfort. Over a period of 10 years (1985-1995), the authors created 28 cases or SNE in 27 patie nts by surgical decompression of the nerve. One patient underwent oper ation bilaterally within 5 years. Five patients presented with a histo ry of trauma to the shoulder region. In three patients, a ganglion cys t was the origin of the nerve lesion. In 16 patients, the nerve proble m was primarily related to athletic activities. Eight of these patient s were professional volleyball players. In the remaining three patient s, there tvas no relationship between the nerve lesion and trauma or a thletic activities. Twenty-one patients (22 cases) complained of pain located over the suprascapular notch. Seventeen patients had paresis a nd atrophy of both the supraspinatus (SS) and infraspinatus (IS) muscl es. In 10 patients only the IS muscle was involved. One patient exhibi ted a sensory deficit over the posterior portion of the shoulder. Elec tromyography was per formed in all cases. The mean follow-up period in the 25 cases (24 patients) that could be evaluated was 20.8 months (r ange 3-70 months). Nineteen of 22 cases with preoperative pain could b e evaluated. Sixteen of these patients were completely free of pain af ter surgery and three patients found their pain had improved. Motor fu nction in the SS muscle improved in 86.7% and motor function in the IS muscle in 70.8% of cases. Atrophy of tile SS muscle resolved in 80.7% and atrophy of the IS muscle in 50% of cases. Surgical treatment of S NE is indicated after failed conservative treatment and in cases of at rophy of tile SS and IS muscles. The authors recommend the posterior a pproach which minimizes risks and complications and produces good post operative results.