Arthroscopic Suprascapular Nerve Release for Idiopathic Compression: Clinical and Electromyographic Results of a Continuous Series of 9 Cases

Authors: Philippe Clavert, Franck Dordain, Frédérique Daemgen, Christian Sommaire, Cyril Penz, Jean-François Kempf

References: Presented at ICSES 2010

Purpose: The aim of this study is to evaluate clinical and electrophysiological results of arthroscopic suprascapular nerve decompression at the scapular notch for idiopathic compression.

Materials and methods: This is a retrospective and continuous serie of 9 patients complaining of chronic pain and lack of strength of the shoulder. Pre- operative electromyography (EMG) demonstrated a chronic compression of the suprascapular nerve. No anatomical lesion of the cuff and no spinoglenoïd cyst were observed on ct-scans. There were 5 men and 4 women of a mean age of 37.6 years. Clinical outcomes were assessed by the Constant score, the DASH and the SSV score. The mean follow-up was 17 months (6 to 34). For all patients a control EMG was obtained after the 6th month.

Results: There were no complications due to surgery.average Constant score increased from 54 in pre-operative to 81 after surgery. Patient's strength significantly increased in abduction and External Rotation. The pre-operative pain score of the CS increased from 6.75 to 12. The post-operative EMG showed an improvement in 8 out of 9. This failure may be due to an initial misdiagnosis (fracture of the scapula extending to the scapular notch). Another patient was dissatisfied with the outcome despite the improvement of the EMG but we noted a disabling neck pain (cervical hernia) unrelated to the initial compression. As a risk factor we only found that for 6 out 9 patients has a Body Mass Index over 25.

Conclusions: Arthroscopic release of the supra scapular nerve seems reliable, reproducible and safe. It provides results equivalent to open technique being less invasive with a postoperative period easier for the patient.