Kessler M A, Stoffel K, Oswald A, Stutz G, Gaechter A
Clinic for Orthopedic Surgery, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland.
Arch Orthop Trauma Surg. 2007 May;127(4):287-92. doi: 10.1007/s00402-006-0154-1.
Cysts in the spinoglenoidal or supraglenoidal incisura can be a cause of compression of the suprascapular nerve. There is agglomerated appearance of these cysts in combination with SLAP lesions. Hypothesis is SLAP lesions can lead to cysts in this region and should be repaired.
MRI of five patients (all male, four 30-40 years, one 75 years) showed cysts in the supralabral region. All were in combination with lesions of the superior glenoidal labrum (Type II or more).
In two cases, in addition to cyst resection, the SLAP lesion was also repaired and symptoms disappeared completely and no recurrent cyst was detected in postoperative MRI. Two patients without SLAP repair showed recurrent cystic formation in MRI with similar complaints compared to their preoperative status. One patient (75 years) was treated primarily by puncture and afterwards with open resection of the cyst. His outcome was good in terms of activities of daily living without major pain.
Our results are based on the assumption that cysts in the region of the spinoglenoidal/supraglenoidal incisura can originate from SLAP lesions. If a patient is suspected of having cysts in this region, the question of a SLAP lesion should be clarified. SLAP lesions should be repaired to avoid relapse. Arthroscopic repair of SLAP lesion can lead to the disappearance of symptoms in younger patients. In older patients puncture or resection of the ganglion alone may be an adequate therapeutic strategy.
肩胛下肌盂上或盂上切迹处的囊肿可能是肩胛上神经受压的原因。这些囊肿与SLAP损伤合并出现时呈聚集状。假设是SLAP损伤可导致该区域出现囊肿,应进行修复。
5例患者(均为男性,4例年龄在30 - 40岁,1例75岁)的MRI显示盂上区域有囊肿。所有病例均合并有上盂唇损伤(Ⅱ型或更严重)。
2例患者除囊肿切除外,还修复了SLAP损伤,症状完全消失,术后MRI未检测到复发性囊肿。2例未进行SLAP修复的患者MRI显示有复发性囊肿形成,症状与术前相似。1例75岁患者首先接受穿刺治疗,随后接受囊肿开放切除术。就日常生活活动而言,其预后良好,无明显疼痛。
我们的结果基于这样的假设,即肩胛下肌盂上/盂上切迹区域的囊肿可能起源于SLAP损伤。如果怀疑患者该区域有囊肿,应明确是否存在SLAP损伤。应修复SLAP损伤以避免复发。关节镜下修复SLAP损伤可使年轻患者症状消失。对于老年患者,单独穿刺或切除腱鞘囊肿可能是一种合适的治疗策略。