Prasad Nikhil K, Spinner Robert J, Smith Jay, Howe Benjamin M, Amrami Kimberly K, Iannotti Joseph P, Dahm Diane L
Neurosurgery, Mayo Clinic, Rochester, Minnesota; and.
Departments of 1 Orthopedics.
Neurosurg Focus. 2015 Sep;39(3):E11. doi: 10.3171/2015.6.FOCUS15201.
OBJECT High-resolution magnetic resonance imaging (MRI) can distinguish between intraneural ganglion cysts and paralabral (extraneural) cysts at the glenohumeral joint. Suprascapular intraneural ganglion cysts share the same pathomechanism as their paralabral counterparts, emanating from a tear in the glenoid labrum. The authors present 2 cases to demonstrate that the identification and arthroscopic repair of labral tears form the cornerstone of treatment for intraneural ganglion cysts of the suprascapular nerve. METHODS Two patients with suprascapular intraneural ganglion cysts were identified: 1 was recognized and treated prospectively, and the other, previously reported as a paralabral cyst, was identified retrospectively through the reinter-pretation of high-resolution MR images. RESULTS Both patients achieved full functional recovery and had complete radiological involution of the intraneural ganglion cysts at the 3-month and 12-month follow-ups, respectively. CONCLUSIONS Previous reports of suprascapular intraneural ganglion cysts described treatment by an open approach to decompress the cysts and resect the articular nerve branch to the glenohumeral joint. The 2 cases in this report demonstrate that intraneural ganglion cysts, similar to paralabral cysts, can be treated with arthroscopic repair of the glenoid labrum without resection of the articular branch. This approach minimizes surgical morbidity and directly addresses the primary etiology of intraneural and extraneural ganglion cysts.
目的 高分辨率磁共振成像（MRI）能够区分盂肱关节处的神经内腱鞘囊肿和盂唇旁（神经外）囊肿。肩胛上神经内腱鞘囊肿与其盂唇旁对应囊肿具有相同的发病机制，均源于肩胛盂唇撕裂。作者报告2例病例，以证明肩胛上神经内腱鞘囊肿的治疗基石是识别并通过关节镜修复盂唇撕裂。方法 确定了2例肩胛上神经内腱鞘囊肿患者：1例为前瞻性确诊并治疗，另1例先前报告为盂唇旁囊肿，通过对高分辨率MR图像的重新解读进行回顾性确诊。结果 2例患者均实现了功能完全恢复，分别在3个月和12个月的随访时神经内腱鞘囊肿在影像学上完全消退。结论 既往关于肩胛上神经内腱鞘囊肿的报告描述了通过开放手术减压囊肿并切除至盂肱关节的关节神经分支的治疗方法。本报告中的2例病例表明，与盂唇旁囊肿相似，神经内腱鞘囊肿可通过关节镜修复肩胛盂唇而无需切除关节分支进行治疗。这种方法可将手术并发症降至最低，并直接解决神经内和神经外腱鞘囊肿的主要病因。
