Kanta M, Ehler E, Lastovicka D, Habalová J, Adamkov J, Rehák S
Neurochirurgická klinika lékarské fakulty UK Hradec Králové, FN Hradec Králové.
Rozhl Chir. 2009 Sep;88(9):497-501.
Compression of suprascapular nerve at the suprascapular notch or spinoglenoid notch can be a cause of a rare mononeuropathy. Patients complain of pain in scapula and shoulder, and selective wasting and weakness of the supraspinatus and infraspinatus muscles. Tenderness at the suprascapular notch and pain by forced abduction of arm are typical and useful signs. Electromyographic signs of various grade denervation are regularly found in both muscles. Development of entrapment syndromes is associated with chronic overload, shoulder injuries, with surgical procedures, or with shoulder-arm fixation. The authors present their own group of 10 patients, who were operated on for entrapment syndrome of suprascapular nerve during 7 year period. Direct or indirect traumatic mechanisms of development of nerve compression were disclosed in most patients. During postoperative period there was not only substantial decrease of pain, but also regression of weakness and wasting of both muscles. In discussion, necessity of differential diagnostic procedures in case of pain and muscle wasting, use of appropriate imaging techniques, demand of purposeful EMG examination, and postoperative follow-ups are emphasized.
肩胛上神经在肩胛上切迹或肩胛冈盂切迹处受压可导致一种罕见的单神经病。患者会出现肩胛骨和肩部疼痛,以及冈上肌和冈下肌选择性萎缩和无力。肩胛上切迹处压痛以及上臂强迫外展时疼痛是典型且有用的体征。在这两块肌肉中经常能发现不同程度去神经支配的肌电图表现。卡压综合征的发生与慢性超负荷、肩部损伤、外科手术或肩臂固定有关。作者介绍了他们自己的一组10例患者,这些患者在7年期间接受了肩胛上神经卡压综合征手术。大多数患者发现了神经受压发展的直接或间接创伤机制。术后不仅疼痛明显减轻,而且两块肌肉的无力和萎缩也有所恢复。在讨论中,强调了在出现疼痛和肌肉萎缩时进行鉴别诊断程序的必要性、使用适当的成像技术、进行有针对性的肌电图检查的要求以及术后随访。