Technique for Endoscopic Release of Suprascapular Nerve Entrapment at the Suprascapular Notch

Abstract

Purpose: Suprascapular nerve (SSN) entrapment by compression in its course through the suprascapular notch has been well documented. This usually requires an open incision which must split the trapezius muscle. We have developed a new arthroscopic endoscopic technique of SSN decompression using 3 portals, including a new direct superior access to the suprascapular notch that have never been described, which avoid muscle detachment and allow for outpatient surgery. The purpose of this article is to describe our technique and preliminary results of this procedure in our first 9 consecutive cases. We operated on 18 consecutive patients with electromyographic documentation of chronic SSN compression at the transverse scapular notch that underwent endoscopic decompression using a new portal for specific access. Ten had an isolated suprascapularis nerve entrapment, and 8 had an associated cuff tear. In all cases, the landmarks of the coracoclavicular ligaments were identified, and the transverse scapular ligament, artery, and nerve were clearly visualized before sectioning of the transverse scapular ligament. Results: All patients who underwent surgery for isolated nerve compression were discharged from the hospital on the day of surgery, and there were no complications from the procedure. All except one patient described their shoulders as completely relieved of pain and graded their result as excellent. One patient had relief of most of his pain and graded his outcome as good. Postoperative electromyogram that documented the recovery of SSN compression. Conclusion: Preliminary results of endoscopic release of refractory and painful SSN compression show an effective benefit to open release.