suprascapular nerve palsy

While shoulder weakness may reflect the presence of a rotator cuff tear, the nerve that normally innervates the supraspinatus and infraspinatus cuff muscles may be the source of the problem.

The Suprascapular nerve can be pinched during its course through the scapular foramen by the transverse scapular ligament, which may ossify-- or a ganglion cyst on the top surface of the glenoid may place pressure on the nerve.

Nerve conduction studies and an MRI are typically checked to confirm the diagnosis. Among shoulder experts, the suprascapular nerve is increasingly indicted as a potential  cause of pain-----and arthroscopic release of the Transverse scapular ligament (TSL) is being likened to release of the Transverse carpal ligament for carpal tunnel syndrome.  There is good evidence that the suprascapular nerve can become kinked in cases of retracted rotator cuff tears-----and that release of the TSL can reverse the electromyographic abnormailities seen on nerve studies--when a repair is performed. Further, for cases where a tear is unfixable because of chronic retraction, there is hope that TSL release my result in improvements in shoulder pain.

As with any new procedure-- the feasibility of arthroscopic release notwithstanding--adviseability  is under investigation as specific indications are refined.The videos on this page are of a patient with good motion, shoulder pain, an unfixable supraspinatus tear, and a fixable infraspinatus tear. Preoperative nerve studues revealed supraspinatus fibrillation, thus TSL release was performed with the hope that pain will decrease, and that nerve dysfunction may decrease.

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