Arthroscopic Management of Suprascapular Nerve Entrapment

Abstract

As orthopaedic surgeons become more aware of suprascapular neuropathy and arthroscopic decom-pressions are performed with increasing frequency, clinical understanding of suprascapular neuropathy has improved. Suprascapular neuropathy is relatively uncommon, however, suprascapular neuropathy is an important pathologic entity for surgeons evaluating shoulder complaints because the diagnosis can be obscure and is often missed.Keeping a high index of suspicion is arguably the most important aspect of treating suprascapular neuropathy. Releasing the nerve does require advanced arthroscopic skill and detailed knowledge of arthroscopic shoulder anatomy, as there are some potential pitfalls. Nevertheless, the authors believe that with practice and meticulous technique, it can be mastered and will become the preferred treatment method for suprascapular neuropathy. Multiple techniques exist for adequate release of the suprascapular nerve (SSN). (3,7,17,58,64) It is likely that the arthroscopic technique requires less dissection and retraction, and produces less postoperative scar formation and fibrosis when compared to open surgical techniques. Subsequently, there is likely less patient morbidity and risk of recurrent nerve compression from significant scarring postoperatively. However, there are no head to head comparative studies exist, in the literature, small series have shown good to excellent results using the open technique for suprascapular nerve decompression. Arthroscopic release of the suprascapular nerve is a less invasive and potentially more effective way to treat suprascapular neuropathy that may occur from a variety of causes.