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What is Suprascapular Nerve Entrapment, How Is It Treated?

Suprascapular Nerve Entrapment shows signs of pain, loss of sensation, mainly in the back and shoulder area, weakness in overhead and shoulder movements, especially in external rotation.

What is Supraskapular Nerve Entrapment?

The suprascapular nerve is the nerve that runs behind the shoulder blade (scapula) and transmits the sense of touch in the back area as well as working the back muscles. In case of entrapment under pressure, the functions of the supraspinatus-infraspinatus muscle (shoulder rotators) deteriorate and may lead to paralysis.

Patients complain of shoulder and back pain and weakness in overhead arm movements. Volleyball is common in basketball players. The mechanism of injury is traction or falling directly onto the shoulder. Can also occur in heavy sports, crutches users.

What are the Symptoms of Supraskapular Nerve Entrapment?

Back and shoulder pain, loss of sensation, weakness in overhead and shoulder movements, especially in external rotation, are the main symptoms.

How is Suprascapular Nerve Stress Treatment Performed?

The suprascapular nerve is pinched in two places (proximal and distal).

In the proximal type, the suprascapular nerve passes behind the scapula through a groove on the bone. This groove is closed like a hole with the transverse ligament. The trap occurs as a result of the narrowing of the groove after the trauma or the thickening of the ligament and pressing the nerve. The nerve is relaxed by cutting the transverse ligament.

Distal type impingement is more common. After passing through the groove and giving the suprascapular muscle branch, the infrascapular s-branch divides into the glenospinal hemisphere under the teres minor muscle. Cysts created by untreated intra-shoulder injuries such as SLAP tears in this area often cause entrapment neuropathy by compressing the nerve. The nerve is relaxed by removing the cyst and repairing the SLAP tear.

Loosening is done in two ways: open surgery and arthroscopic. In open surgery, the muscles are cut to reach the area, it is very difficult to reach the nerve. The transverse ligament is cut with special retractors, but most of the time the nerve cannot be seen. Arthroscopic treatment is the gold standard. It is mandatory to investigate SLAP with distal type joint arthroscopy. We definitely perform shoulder arthroscopy for proximal impingement.

If there is SLAP rupture, we make sure that the glenospinal stalemate is excised, if any, the bursa-pseudo-cyst and visualized the nerve branch and loosened. Subsequently, we do SLAP repair. Again, this time after bursectomy in the subacromial region, we view and protect the nerve before cutting the transverse ligament that lies next to the coronoid ligament attachment, and remove the trap by opening the ligament.

How Long Does Supraskapular Nerve Entrapment Arthroscopy Take?

The standard duration of shoulder arthroscopy is 60 minutes. Since nerve compression is a delicate procedure that requires effort, it can take up to 2 hours.

What Should the Patient Do Before Arthroscopy?

Arthroscopy preparation should be done in the hospital.

What is the Recovery Process After the Surgery?

In open surgery, the arm is suspended for 6 weeks, it is not possible to return to sports before 6 months. After arthroscopic surgery, you can return to daily life the next day. Exercises are started immediately. The arm sling can be used between exercises for 2-3 weeks. You can return to active sports within 6-12 weeks.

Will It Repeat After Surgery?

There is no question of proximal recurrence. Rarely, post-traumatic cases of the distal type have been reported.

How Much is the Surgery Fee?

It is planned according to the patient's budget.

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