Habermeyer P, Rapaport D, Wiedemann E, Wilhelm K
Chirurgischen Klinik und Poliklinik Innenstadt, Ludwig-Maximilians-Universität München.
Handchir Mikrochir Plast Chir. 1990 May;22(3):120-4.
The suprascapular nerve may rarely be entrapped in the suprascapular notch. This causes weakness of the supra- and infraspinatus muscles and pain in the glenohumeral and acromioclavicular joints, which are innervated by this nerve. The entrapment syndrome may result from direct or indirect trauma, fracture of the neck of the scapula, kinking or traction on a sling affecting the nerve, from the shape of the notch, compression by a ganglion, or its cause may be idiopathic. Diagnosis of the syndrome is based upon deep unceasing pain reported at the postero-lateral shoulder, atrophy of the supra- and infraspinatus muscles, and impaired shoulder external rotation and a lidocaine test. The final proof is taken from polyphasic EMG potentials which are decreased in amplitude and increased in distal latency. Initially the entrapment neuropathy may be treated by immobilization, analgesics, and physiotherapy. A tear of the rotator cuff as well as a frozen shoulder have to be excluded by arthrography. In persistent cases of pain and pathologic EMG findings surgical decompression of the nerve should be done. The trapezius muscle is approached by a postero-superior incision. Via the suprascapular fossa the notch may be reached. Then the nerve is decompressed by removing the transverse scapular ligament. Reports of the cases operated so far are promising, though their number is small.
肩胛上神经极少会在肩胛上切迹处受到卡压。这会导致冈上肌和冈下肌无力，并引起由该神经支配的盂肱关节和肩锁关节疼痛。卡压综合征可能由直接或间接创伤、肩胛骨颈部骨折、影响该神经的吊带扭结或牵拉、切迹形状、神经节压迫引起，其病因也可能是特发性的。该综合征的诊断基于肩后外侧持续的深部疼痛、冈上肌和冈下肌萎缩、肩部外旋功能受损以及利多卡因试验。最终诊断依据是多相肌电图电位，其波幅降低、远端潜伏期延长。起初，卡压性神经病可通过固定、止痛药物和物理治疗来治疗。必须通过关节造影排除肩袖撕裂和肩周炎。对于持续疼痛和肌电图检查结果异常的病例，应进行神经手术减压。通过后上方切口显露斜方肌。经肩胛上窝可到达切迹。然后通过切除肩胛横韧带对神经进行减压。尽管目前手术治疗的病例数量不多，但已有的病例报告结果令人满意。
