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关节镜下肩胛上神经减压术后感觉障碍的恢复。

Recovery of sensory disturbance after arthroscopic decompression of the suprascapular nerve.

机构信息

The Upper Extremity Center of Joint Replacement and Endoscopic Surgery, Hokushin Orthopaedic Hospital, Sapporo, Japan.

出版信息

J Shoulder Elbow Surg. 2012 Jun;21(6):759-64. doi: 10.1016/j.jse.2011.08.063. Epub 2011 Dec 11.

Abstract

BACKGROUND

The existence of sensory branches of the suprascapular nerve (SSN) has recently been reported, and sensory disturbance at the lateral and posterior aspect of the shoulder has been focused on as a symptom of SSN palsy. We have performed arthroscopic release of SSN at the suprascapular notch in patients with sensory disturbance since 2006. The purposes of this study were to introduce the arthroscopic surgical technique and investigate postoperative recovery of sensory disturbance.

MATERIALS AND METHODS

The study included 11 men and 14 women (25 shoulders), with an average age of 63.9 years (range, 41-77 years). Arthroscopic decompression of the SSN was performed using a suprascapular nerve (SN) portal as a landmark for approaching the suprascapular notch. Sensory disturbance of the shoulder was evaluated preoperatively and postoperatively. The average follow-up was 18.5 months (range, 12-30 months).

RESULTS

The arthroscopic procedures were performed safely. The preoperative sensory disturbance fully recovered postoperatively in all shoulders.

CONCLUSION

Arthroscopic release of the SSN is a useful procedure for SSN entrapment at the suprascapular notch. The sensory disturbance at the lateral and posterior aspect of the shoulder can be used as one of the criteria of diagnosing SSN palsy, especially in shoulders with massive rotator cuff tear, in which diagnosing and assessing the treatment results of associated SSN palsy is usually difficult.

摘要

背景

最近有报道称存在肩胛上神经(SSN)的感觉支,肩部外侧和后侧的感觉障碍已被视为 SSN 麻痹的症状。自 2006 年以来,我们一直在 SSN 肩胛上切迹处进行关节镜下 SSN 松解术,以治疗有感觉障碍的患者。本研究旨在介绍关节镜手术技术,并探讨术后感觉障碍的恢复情况。

材料和方法

本研究纳入 11 名男性和 14 名女性(25 个肩),平均年龄 63.9 岁(范围 41-77 岁)。使用肩胛上神经(SN)入路作为进入肩胛上切迹的标志,进行 SSN 的关节镜减压。术前和术后评估肩部感觉障碍。平均随访 18.5 个月(范围 12-30 个月)。

结果

关节镜手术安全进行。所有肩部的术前感觉障碍均在术后完全恢复。

结论

关节镜下松解 SSN 是治疗 SSN 在肩胛上切迹处受压的有效方法。肩部外侧和后侧的感觉障碍可作为诊断 SSN 麻痹的标准之一,特别是在伴有巨大肩袖撕裂的肩部,在这些肩部中,诊断和评估相关 SSN 麻痹的治疗效果通常较为困难。

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