Arthroscopic Treatment of Suprascapular Neuropathy from a Suprascapular Notch Cyst Using a Lateral Subacromial Approach

JBJS Essent Surg Tech. 2015 Mar 11;5(1):e5. doi: 10.2106/JBJS.ST.N.00103. eCollection 2015 Feb 25.

Abstract

Introduction: We describe a safe surgical technique for arthroscopic decompression of a suprascapular notch cyst in the setting of compressive suprascapular neuropathy.

Step 1 position the patient: Position the patient in the standard beach-chair position.

Step 2 mark anatomic landmarks: Palpate and mark the subcutaneous landmarks of the shoulder in preparation for later arthroscopy.

Step 3 diagnostic arthroscopy: Create standard anterior and posterior portals for glenohumeral visualization.

Step 4 perform suprascapular cyst decompression through a lateral subacromial approach: Establish accessory superior and lateral portals and transition to a lateral viewing portal to perform suprascapular notch decompression.

Step 5 release the transverse scapular ligament: Establish a G Portal and release the transverse scapular ligament using arthroscopic scissors.

Step 6 closure: Perform arthroscopic lavage of the subacromial space and glenohumeral joint and close arthroscopic portals.

Results: As suprascapular nerve entrapment is a relatively rare entity, with only a limited number of studies from which to draw conclusions regarding the outcomes of arthroscopic suprascapular nerve release, Shah et al. recently reported on their results in twenty-four patients using this surgical technique.IndicationsContraindicationsPitfalls & Challenges.