| Treatment of suprascapular nerve entrapment syndrome - 9 cases report - |
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Seung-Koo Rhee, Seok-Whan Song, Jin-Young Chung, Jong-Whoon Ji, Man-Kue Bae, Il-Jung Park, Hyun-Sik Lee |
| 상 견갑 신경 포착 증후군의 치료 - 9예 보고 - |
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이승구, 송석환, 정진영, 지종훈, 배만규, 박일중, 이현식 |
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| Abstract |
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Purpose: To review the causes, its combined shoulder pathologies and its operative results and to find out better method for treatment of suprascapular nerve entrapment syndrome. Materials and Methods: From March 1996 to May 2005, nine cases of suprascapular nerve entrapment syndrome caused by ganglion and degenerated thickened spinoglenoid notch ligament were reviewed which were diagnosed using physical examination, EMG and MRI. All of them were treated with open excision of ganglion for 7 cases and of degenerated, thickened spinoglenoid notch ligament for 2 cases, nerve decompression and arthroscopic examination for 7 cases. The clinical results were evaluated using subjective recovery of muscle power and ASES (American Shoulder and Elbow Surgeries) score. Results: Their average age was 39 years, and right shoulder of adult male was frequently involved(7/9, 78%). Pre-operative EMG showed nerve entrapment in 7 cases of suprascapular nerve and 2 cases of inferior branch of suprascapular nerve. MRI revealed 8 cases of ganglion but nil in 1 case which was caused by degenerated, hypertrophied suprascapular and spinoglenoid notch ligament. 2 cases of SLAP and 1 case of Bankart lesion were combined, and 2 cases of ganglion was connected to shoulder joint through SLAP lesion. 2 cases (22%) after surgery showed residual symptom such as intermittent pain, insufficient recovery of muscle power, persistent muscle atrophy. Complete symptomatic recovery was found in 7 cases (78%). Mean value of ASES score was 88.6 (70-99.8) points. Postoperatively, pain was relieved in all of patients, and muscle power was improved in 78% of the patients but the muscle atrophy persisted. Conclusion: Excision of ganglion only is insufficient to relieve the symptoms of nerve entrapment. Not only excision of ganglion but also treatment of intraarticular lesion, decompressive excision of thickened and degenerated superior and inferior transverse scapular ligament which attributable to entrapment should be considered for the better clinical results. |
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