Suprascapular Nerve Palsy

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]

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 while curving 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]

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 supraspinous fossa and the spinoglenoid fossa.

Trauma to the shoulder resulting from fractures of scapula, clavicle and proximal humerus can significantly damage the suprascapular nerve.[3][4]

Post-surgical complications after open or athroscopic shoulder surgery can lead to suprascapular nerve damage.[5]

Scapula dyskinesia can lead to suprascapular nerve palsy.

Tumors, cysts and other space-occupying lesions around the shoulder can compress the suprascapular nerve.[6]

In rare cases, systemic conditions like systemic lupus erthymatosus (SLE) and rheumatoid arthritis (RA) can result in suprascapular nerve pasly.

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. 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.
  2. Avery BW, Pilon FM, Barclay JK. Anterior coracoscapular ligament and suprascapular nerve entrapment. Clin Anat. 2002 Nov;15(6):383-6.
  3. 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.
  4. Solheim LF, Roaas A. Compression of the suprascapular nerve after fracture of the scapular notch. Acta Orthop Scand. 1978 Aug;49(4):338-40.
  5. Mallon WJ, Bronec PR, Spinner RJ, Levin LS. Suprascapular neuropathy after distal clavicle excision. Clin Orthop Relat Res. 1996 Aug;(329):207-11
  6. 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.