Abstract
Background The suprascapular nerve can be compromised as a result of a compression syndrome
in different locations. A (proximal) compression within the scapular notch can lead
to dorsal shoulder pain and simultaneous weakness of the infraspinatus and supraspinatus
muscles. By transection of the lig. transversum this compression syndrome can be treated.
By means of a systematic review, the present work analyzes the motor recovery potential
after arthroscopic decompression.
Material and Methods A systematic review of the U. S. National Library of Medicine/National Institutes
of Health (PubMed) database and the Cochrane Library was performed using the PRISMA
checklist. The search words used were “suprascapular” and “arthroscopic”; “suprascapular”
and “arthroscopy”. Based on the evaluated literature, articles in English with at
least a partial arthroscopic case series from 4 cases on and a compression syndrome
of the suprascapular nerve treated with arthroscopic decompression in the scapular
notch were identified. Motor recovery was described by means of EMG, clinical strength
and MRI.
Results Primarily 408 hits were generated. Six articles met the inclusion criteria and were
further analyzed. The number of arthroscopic cases was between 4 and a maximum of
27. The level of evidence was between III and IV. The majority of the reported clinical
results were good. Motor recovery as measured by EMG was observed, recovery of full
strength was not achieved in the majority of reported cases (60%), neither was regression
of structural (fatty) degeneration of the muscle bellies.
Conclusion Arthroscopic decompression of the suprascapular nerve in the scapular notch provides
good clinical results and considerable pain relief. However, in the majority of cases
it does not lead to a complete recovery of the strength of the supra- and infraspinatus
muscles. Patients should be informed about this. An early decompression after diagnosis
in the event of proximal compression within the suprascapular notch combined with
beginning EMG or MRI changes appears reasonable. These beginning changes should be
further defined. Future studies should develop prognostic criteria for motor recovery.
Awareness regarding the diagnosis needs to be improved due to the probably time-dependent
irreversibility of resulting muscular weakness.
Key words
suprascapular nerve - scapular notch - decompression - recovery - arthroscopic
