Suprascapular Nerve Palsy: Difference between revisions
No edit summary |
No edit summary |
||
| Line 7: | Line 7: | ||
== Anatomy == | == Anatomy == | ||
[[File:Gray810.png|thumb|Posterior view of scapula showing the suprascapular nerve and its muscular innervations]] | [[File:Gray810.png|thumb|Posterior view of scapula showing the suprascapular nerve and its muscular innervations]] | ||
The suprascapular nerve branches out from the upper trunk of the brachial plexus. Its nerve roots are C5 and C6. Sporadically, it may have roots from C4 as well. From the posterior triangle of the neck, the nerve goes over the upper part of the scapula, then downward and laterally, parallel to the omohyoid muscle belly. It then passes below the suprascapular ligament and into the supraspinous fossa where it innervates supraspinatus and continues | The suprascapular nerve branches out from the upper trunk of the brachial plexus. Its nerve roots are C5 and C6. Sporadically, it may have roots from C4 as well. From the posterior triangle of the neck, the nerve goes over the upper part of the scapula, then downward and laterally, parallel to the omohyoid muscle belly. It then passes below the suprascapular ligament, through the suprascapular notch and into the supraspinous fossa where it innervates supraspinatus and continues. Through here it curves around the spinous process of the scapula, through the spinoglenoid notch and then into the infraspinous fossa where it innervates infraspinatus.<ref name=":0" />The suprascapular nerve also provides sensory innervation to the glenohumeral and acromioclavicular joint.<ref>Avery BW, Pilon FM, Barclay JK. Anterior coracoscapular ligament and suprascapular nerve entrapment. Clin Anat. 2002 Nov;15(6):383-6.</ref> | ||
==Etiology== | ==Etiology== | ||
[[File:640px-Suprascapular Canal Scheme Al-Redouan.png|thumb|Common sites for suprascapular nerve compression]] | [[File:640px-Suprascapular Canal Scheme Al-Redouan.png|thumb|Common sites for suprascapular nerve compression]] | ||
Compression neuropathy resulting from nerve entrapment is the most common cause of suprascapular nerve palsy. The common sites of nerve entrapment are the | Compression neuropathy resulting from nerve entrapment is the most common cause of suprascapular nerve palsy. The common sites of nerve entrapment are the suprascapular notch and the spinoglenoid notch.<ref>Gosk J, Urban M, Rutowski R. Entrapment of the suprascapular nerve: anatomy, etiology, diagnosis, treatment. Ortop Traumatol Rehabil. 2007 Jan-Feb;9(1):68-74.</ref> | ||
Trauma to the shoulder resulting from fractures of scapula, clavicle and proximal humerus can significantly damage the suprascapular nerve.<ref>Zoltan JD. Injury to the suprascapular nerve associated with anterior dislocation of the shoulder: case report and review of the literature. J Trauma. 1979 Mar;19(3):203-6.</ref><ref>Solheim LF, Roaas A. Compression of the suprascapular nerve after fracture of the scapular notch. Acta Orthop Scand. 1978 Aug;49(4):338-40.</ref> | Trauma to the shoulder resulting from fractures of scapula, clavicle and proximal humerus can significantly damage the suprascapular nerve.<ref>Zoltan JD. Injury to the suprascapular nerve associated with anterior dislocation of the shoulder: case report and review of the literature. J Trauma. 1979 Mar;19(3):203-6.</ref><ref>Solheim LF, Roaas A. Compression of the suprascapular nerve after fracture of the scapular notch. Acta Orthop Scand. 1978 Aug;49(4):338-40.</ref> | ||
| Line 17: | Line 17: | ||
Post-surgical complications after open or athroscopic shoulder surgery can lead to suprascapular nerve damage.<ref>Mallon WJ, Bronec PR, Spinner RJ, Levin LS. Suprascapular neuropathy after distal clavicle excision. Clin Orthop Relat Res. 1996 Aug;(329):207-11</ref> | Post-surgical complications after open or athroscopic shoulder surgery can lead to suprascapular nerve damage.<ref>Mallon WJ, Bronec PR, Spinner RJ, Levin LS. Suprascapular neuropathy after distal clavicle excision. Clin Orthop Relat Res. 1996 Aug;(329):207-11</ref> | ||
Scapula dyskinesia can lead to suprascapular nerve palsy. | Scapula dyskinesia can lead to suprascapular nerve palsy.<ref>Reece CL, Varacallo M, Susmarski A. Suprascapular Nerve Injury. [Updated 2021 Jul 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. Available from: <nowiki>https://www.ncbi.nlm.nih.gov/books/NBK559151/</nowiki></ref> | ||
Tumors, cysts and other space-occupying lesions around the shoulder can compress the suprascapular nerve.<ref>Sjödén GO, Movin T, Güntner P, Ingelman-Sundberg H. Spinoglenoid bone cyst causing suprascapular nerve compression. J Shoulder Elbow Surg. 1996 Mar-Apr;5(2 Pt 1):147-9.</ref> | Tumors, cysts and other space-occupying lesions around the shoulder can compress the suprascapular nerve.<ref>Sjödén GO, Movin T, Güntner P, Ingelman-Sundberg H. Spinoglenoid bone cyst causing suprascapular nerve compression. J Shoulder Elbow Surg. 1996 Mar-Apr;5(2 Pt 1):147-9.</ref> | ||
Revision as of 06:14, 18 November 2021
Original Editor - Arnold Fredrick D'Souza
Top Contributors - Arnold Fredrick D'Souza, Kim Jackson, Joseph Zahn and Naomi O'Reilly
Introduction[edit | edit source]
The suprascapular nerve is a mixed nerve of the upper limb. Suprascapular nerve injury is experiencing an increase in clinical significance due to its role in shoulder pain and upper limb weakness.[1]
Anatomy[edit | edit source]
The suprascapular nerve branches out from the upper trunk of the brachial plexus. Its nerve roots are C5 and C6. Sporadically, it may have roots from C4 as well. From the posterior triangle of the neck, the nerve goes over the upper part of the scapula, then downward and laterally, parallel to the omohyoid muscle belly. It then passes below the suprascapular ligament, through the suprascapular notch and into the supraspinous fossa where it innervates supraspinatus and continues. Through here it curves around the spinous process of the scapula, through the spinoglenoid notch and then into the infraspinous fossa where it innervates infraspinatus.[1]The suprascapular nerve also provides sensory innervation to the glenohumeral and acromioclavicular joint.[2]
Etiology[edit | edit source]
Compression neuropathy resulting from nerve entrapment is the most common cause of suprascapular nerve palsy. The common sites of nerve entrapment are the suprascapular notch and the spinoglenoid notch.[3]
Trauma to the shoulder resulting from fractures of scapula, clavicle and proximal humerus can significantly damage the suprascapular nerve.[4][5]
Post-surgical complications after open or athroscopic shoulder surgery can lead to suprascapular nerve damage.[6]
Scapula dyskinesia can lead to suprascapular nerve palsy.[7]
Tumors, cysts and other space-occupying lesions around the shoulder can compress the suprascapular nerve.[8]
In rare cases, systemic conditions like systemic lupus erthymatosus (SLE) and rheumatoid arthritis (RA) can result in suprascapular nerve palsy.[9]
Examination[edit | edit source]
Clinical presentation[edit | edit source]
Management[edit | edit source]
Surgical[edit | edit source]
Physiotherapy[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 Kostretzis L, Theodoroudis I, Boutsiadis A, Papadakis N, Papadopoulos P. Suprascapular Nerve Pathology: A Review of the Literature. Open Orthop J. 2017 Feb 28;11:140-53.
- ↑ Avery BW, Pilon FM, Barclay JK. Anterior coracoscapular ligament and suprascapular nerve entrapment. Clin Anat. 2002 Nov;15(6):383-6.
- ↑ Gosk J, Urban M, Rutowski R. Entrapment of the suprascapular nerve: anatomy, etiology, diagnosis, treatment. Ortop Traumatol Rehabil. 2007 Jan-Feb;9(1):68-74.
- ↑ Zoltan JD. Injury to the suprascapular nerve associated with anterior dislocation of the shoulder: case report and review of the literature. J Trauma. 1979 Mar;19(3):203-6.
- ↑ Solheim LF, Roaas A. Compression of the suprascapular nerve after fracture of the scapular notch. Acta Orthop Scand. 1978 Aug;49(4):338-40.
- ↑ Mallon WJ, Bronec PR, Spinner RJ, Levin LS. Suprascapular neuropathy after distal clavicle excision. Clin Orthop Relat Res. 1996 Aug;(329):207-11
- ↑ Reece CL, Varacallo M, Susmarski A. Suprascapular Nerve Injury. [Updated 2021 Jul 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559151/
- ↑ Sjödén GO, Movin T, Güntner P, Ingelman-Sundberg H. Spinoglenoid bone cyst causing suprascapular nerve compression. J Shoulder Elbow Surg. 1996 Mar-Apr;5(2 Pt 1):147-9.
- ↑ Zehetgruber H, Noske H, Lang T, Wurnig C. Suprascapular nerve entrapment. A meta-analysis. Int Orthop. 2002;26(6):339-43.
