gms | German Medical Science

Objective: Isolated compression of the suprascapular nerve (SSN) is a rare entity and seldom considered in the differential diagnosis of shoulder pain and disability. Retrospectively, preoperative findings, presenting symptoms, operative approach and results are documented in 55 cases.

Methods: Between 1986 and 8/2006 fifty-four patients (45 males; 9 females) underwent surgical decompression of the nerve in our institution. One patient (a dancer) has been operated bilaterally. 37 of 54 patients were younger than 35 years (67%; mean age 33.7ys). Clinical presentation – including presence of shoulder pain and muscle function (Medical Research Council Grades M0-M5), electrophysiological findings, surgical reports and outcomes were evaluated.

Results: SSN entrapments were associated with sports (involving overhead motion; 21), occupational overuse (12), trauma (5) and ganglion cysts (4). In the remaining 13 cases, there was no relationship between the nerve lesion and any activity so its cause may be idiopathic. Preoperatively 49 patients presented shoulder pain. 36 patients showed a weakness and atrophy of both scapula muscles, 15 showed only infraspinatus muscle involvement (Infraspinatus[IS]: Grades 0-4, Supraspinatus[SS]: Grades 2-4). Electromyography was performed in all cases. 42 patients could be evaluated. The mean follow-up period after surgery was 34 months (3-168 ms). 38 of 42 patients with preoperative pain could be documented. 15 were completely free of pain and 23 found their pain markedly reduced. Patients with SS function of Grades 2-4 improved postoperatively to Grade 4 or better in 93%. IS function improved from Grade 0-4 to better than Grade 3 in 77% of the patients.

Conclusions: When conservative treatment failed or an atrophy of the muscle is presented, surgical decompression is warranted. The postero-superior approach minimizes complications and presents good results.