Vij Neeraj, Fabian Isabella, Hansen Colby, Kasabali Ahmad J, Urits Ivan, Viswanath Omar
University of Arizona College of Medicine - Phoenix.
Louisiana State University Health Sciences Center Shreveport School of Medicine.
Orthop Rev (Pavia). 2022 Aug 5;14(3):37157. doi: 10.52965/001c.37157. eCollection 2022.
The prevalence of suprascapular neuropathy is higher than previously estimated. Recent literature highlights a myriad of treatment options for patients ranging from conservative treatment and minimally invasive options to surgical management. However, there are no comprehensive review articles comparing these treatment modalities.
The purpose of this review article is to summarize the current state of knowledge on suprascapular nerve entrapment and to compare minimally invasive treatments to surgical treatments.
The literature search was performed in Mendeley. Search fields were varied redundant. All articles were screened by title and abstract and a preliminary decision to include an article was made. A full-text screening was performed on the selected articles. Any question regarding the inclusion of an article was discussed by 3 authors until an agreement was reached.
Recent studies have further elucidated the pathoanatomy and described several risk factors for entrapment ranging. Four studies met our inclusion criteria regarding peripheral nerve stimulation with good pain and clinical outcomes. Two studies met our inclusion criteria regarding pulsed radiofrequency and showed promising pain and clinical outcomes. One study met our inclusion criteria regarding transcutaneous electrical nerve stimulation and showed good results that were equivalent to pulsed radiofrequency. Surgical treatment has shifted to become nearly all arthroscopic and surgical outcomes remain higher than minimally invasive treatments.
Many recently elucidated anatomical factors predispose to entrapment. A history of overhead sports or known rotator cuff disease can heighten a clinician's suspicion. Entrapment at the suprascapular notch is more common overall, yet young athletes may be predisposed to isolated spinoglenoid notch entrapment. Pulsed radiofrequency, peripheral nerve stimulation, and transcutaneous electrical nerve stimulation may be effective in treating patients with suprascapular nerve entrapment. Arthroscopic treatment remains the gold-standard in patients with refractory entrapment symptoms.
肩胛上神经病变的患病率高于先前估计。近期文献强调了针对患者的多种治疗选择，从保守治疗、微创治疗到手术管理。然而，尚无比较这些治疗方式的综合性综述文章。
本文综述的目的是总结肩胛上神经卡压的当前知识状态，并比较微创治疗与手术治疗。
在Mendeley中进行文献检索。检索字段多样且有冗余。所有文章先通过标题和摘要进行筛选，并初步决定是否纳入一篇文章。对选定的文章进行全文筛选。关于一篇文章是否纳入的任何问题由三位作者共同讨论，直至达成共识。
近期研究进一步阐明了病理解剖结构，并描述了多种卡压的危险因素。四项研究符合我们关于周围神经刺激的纳入标准，疼痛和临床结局良好。两项研究符合我们关于脉冲射频的纳入标准，显示出有前景的疼痛和临床结局。一项研究符合我们关于经皮电神经刺激的纳入标准，显示出与脉冲射频相当的良好效果。手术治疗已几乎全部转向关节镜手术，且手术结局仍高于微创治疗。
许多最近阐明的解剖因素易导致卡压。过头运动史或已知的肩袖疾病史会增加临床医生的怀疑。肩胛上切迹处的卡压总体上更常见，但年轻运动员可能易患孤立的冈下肌切迹卡压。脉冲射频、周围神经刺激和经皮电神经刺激可能对治疗肩胛上神经卡压患者有效。关节镜治疗仍然是难治性卡压症状患者的金标准。
