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开放性手术减压治疗伴有肩胛上神经病变的大型多房性肩胛盂切迹神经节囊肿

Open Surgical Decompression for Large Multiloculated Spinoglenoid Notch Ganglion Cyst With Suprascapular Nerve Neuropathy.

作者信息

Jerome Terrence Jose, Sabtharishi Vanathi, Sk Thirumagal

机构信息

Orthopaedics, Hand and Reconstructive Microsurgery, Olympia Hospital and Research Centre, Trichy, IND.

Microbiology, KAP Viswanatham Medical College and Hospital, Trichy, IND.

出版信息

Cureus. 2021 Feb 12;13(2):e13300. doi: 10.7759/cureus.13300.

Abstract

Suprascapular nerve entrapment at the spinoglenoid notch causes infraspinatus weakness and wasting. Patients present with shoulder pain and weakness. The spinoglenoid notch cyst is the reason for suprascapular nerve compression. Magnetic resonance imaging (MRI) confirms the diagnosis of spinoglenoid cyst and its nerve compression. Also, MRI rules out other differential diagnosis causing shoulder pain and weakness. One of the treatment modalities for small and asymptomatic cyst is conservative, which has produced acceptable results and functional outcome. Open or arthroscopic aspiration or decompression is indicated for patients with single small cysts where conservative treatment failed, and cyst associated with suprascapular nerve compression. We report a 32-year-old dancer with a large multiloculated multiple spinoglenoid cysts compressing the suprascapular nerve causing infraspinatus wasting and shoulder dysfunction. We performed an open surgical decompression of the suprascapular nerve and excised multiple ganglions. The patient improved significantly and regained his shoulder function and muscle wasting at two-year follow-up.

摘要

肩胛上神经在肩胛下切迹处受压会导致冈下肌无力和萎缩。患者表现为肩部疼痛和无力。肩胛下切迹囊肿是肩胛上神经受压的原因。磁共振成像(MRI)可确诊肩胛下切迹囊肿及其神经受压情况。此外,MRI还可排除其他导致肩部疼痛和无力的鉴别诊断。对于小的无症状囊肿,一种治疗方式是保守治疗,已取得了可接受的结果和功能转归。对于保守治疗失败的单个小囊肿以及与肩胛上神经受压相关的囊肿患者,可采用开放或关节镜下抽吸或减压治疗。我们报告了一名32岁的舞者,其患有多个大的多房性肩胛下切迹囊肿,压迫肩胛上神经,导致冈下肌萎缩和肩部功能障碍。我们对肩胛上神经进行了开放手术减压,并切除了多个腱鞘囊肿。患者在两年随访时明显改善,恢复了肩部功能,肌肉萎缩也有所改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c15/7958802/ed6f582e647a/cureus-0013-00000013300-i01.jpg

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