Endoscopically assisted decompression of the suprascapular nerve in the supraspinous fossa: a cadaveric feasibility study. Laboratory investigation.
OBJECTIVE
The suprascapular nerve may become entrapped as it travels deep to the suprascapular ligament, necessitating decompression. The present study was performed to verify the feasibility of a minimally invasive, endoscopically assisted technique for decompressing the suprascapular nerve in the supraspinous fossa.


METHODS
The authors performed dissection and decompression of the suprascapular ligament using an endoscopically assisted technique via a 3-cm skin incision in 10 adult cadavers (20 sides). Measurements were also made of the depth from the skin to the suprascapular ligament.


RESULTS
A mean depth of 4 cm was necessary to reach the suprascapular ligament from the skin surface. With the authors' approach, no obvious injury occurred to the suprascapular or other vicinal neurovascular structures (such as the spinal accessory nerve and suprascapular vessels).


CONCLUSIONS
The results of this cadaveric study demonstrate that access to the suprascapular nerve can be obtained endoscopically via a small suprascapular incision. This approach obviates a large incision, entry into the glenohumeral joint, and reduces the risk of spinal accessory nerve injury in the posterior cervical triangle, or atrophy of the trapezius or supraspinatus muscles from a standard larger dissection. To the authors' knowledge an endoscopically assisted approach to decompressing the suprascapular nerve as it courses deep to the suprascapular ligament has not been reported previously.
Tubbs
R Shane
RS
Section of Pediatric Neurosurgery, University of Alabama at Birmingham and Children's Hospital Birmingham, Alabama 35233, USA. rstubbs@uab.edu
Loukas
Marios
M
Shoja
Mohammadali M
MM
Spinner
Robert J
RJ
Middlebrooks
Erik H
EH
Stetler
William R
WR
Acakpo-Satchivi
Leslie
L
Wellons
John C
JC
Blount
Jeffrey P
JP
Oakes
W Jerry
WJ
D000368:Aged; D000369:Aged, 80 and over; D001917:Brachial Plexus / Q000601:surgery*; D002102:Cadaver; D019299:Decompression, Surgical / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy; D012785:Shoulder Joint / Q000294:innervation* / Q000601:surgery*