Bhatia Sanjeev, Chalmers Peter N, Yanke Adam B, Romeo Anthony A, Verma Nikhil N
Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois, U.S.A.
Arthrosc Tech. 2012 Sep 28;1(2):e187-92. doi: 10.1016/j.eats.2012.07.004. Print 2012 Dec.
Entrapment of the suprascapular nerve (SSN) is an increasingly recognized entity that can occur due to traction or compression-related etiology. Traction injuries of the SSN are unlikely to respond to surgical management and frequently improve with rest and avoidance of overhead activity. Compression injuries, on the other hand, frequently require surgical decompression for pain relief. SSN entrapment caused by compression at the suprascapular notch by the transverse scapular ligament gives rise to pain and atrophy of both the supraspinatus and infraspinatus muscles. However, compression at the spinoglenoid notch is more insidious because pain fibers may not be involved, causing isolated external rotation weakness. We present our preferred surgical technique for safe decompression of the SSN at the suprascapular and spinoglenoid notch using a subacromial and intra-articular approach, respectively. The key to ensuring efficient and uncomplicated decompression of the SSN relies on an intimate knowledge of the neurovascular anatomy and related landmarks.
肩胛上神经（SSN）卡压是一种越来越被认识到的病症，可因牵引或压迫相关病因引起。SSN的牵引损伤不太可能对手术治疗有反应，通常通过休息和避免进行过头活动而改善。另一方面，压迫性损伤常常需要手术减压以缓解疼痛。肩胛横韧带在肩胛上切迹处压迫导致的SSN卡压会引起冈上肌和冈下肌疼痛及萎缩。然而，肩胛下肌-小圆肌切迹处的压迫更为隐匿，因为疼痛纤维可能未受累，导致单纯的外旋无力。我们分别介绍了通过肩峰下和关节内入路对肩胛上切迹和肩胛下肌-小圆肌切迹处的SSN进行安全减压的首选手术技术。确保SSN高效且无并发症减压的关键在于对神经血管解剖结构和相关标志的深入了解。
