Arthroscopic Suprascapular Nerve Decompression: A Technique Video

Background: Suprascapular neuropathy is an uncommon but treatable cause of shoulder pain and dysfunction. The tortuous course of the suprascapular nerve puts it at risk for entrapment, particularly at the suprascapular and spinoglenoid notches. This video presents a reproducible method for suprascap...

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Main Authors: Eric J. Cotter MD, Joshua H. Chang BS, Daanish Khazi-Syed BS, Catherine M. Hand BS, Camden J. Bohn BS, Chase Gornbein BS, Brian Forsythe MD
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:Video Journal of Sports Medicine
Online Access:https://doi.org/10.1177/26350254241299841
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author Eric J. Cotter MD
Joshua H. Chang BS
Daanish Khazi-Syed BS
Catherine M. Hand BS
Camden J. Bohn BS
Chase Gornbein BS
Brian Forsythe MD
author_facet Eric J. Cotter MD
Joshua H. Chang BS
Daanish Khazi-Syed BS
Catherine M. Hand BS
Camden J. Bohn BS
Chase Gornbein BS
Brian Forsythe MD
author_sort Eric J. Cotter MD
collection DOAJ
description Background: Suprascapular neuropathy is an uncommon but treatable cause of shoulder pain and dysfunction. The tortuous course of the suprascapular nerve puts it at risk for entrapment, particularly at the suprascapular and spinoglenoid notches. This video presents a reproducible method for suprascapular nerve decompression at the suprascapular notch. Indications: Massive rotator cuff tears, compressive masses, or ligament hypertrophy warrants prompt intervention to prevent subsequent denervation in the face of suprascapular neuropathy. In the absence of these pathologies, a trial of conservative management is advised. Patients who have unsuccessful conservative management and evidence of worsening weakness, atrophy, and denervation by electromyography are indicated for surgical intervention. Technique Description: Standard posterior, anterior, lateral, and anterolateral portals are established. The subdeltoid space is dissected following the coracoacromial (CA) ligament to the base of the coracoid to identify the transverse scapular ligament. In the presented case, the CA ligament has been debrided from a previous surgery, so an intra-articular approach was employed, opening the rotator interval to reach the base of the coracoid. A Neviaser portal is made for blunt dissection around the suprascapular notch, with care taken to protect the neurovasculature. A second medial Neviaser portal is used to pass a Kerrison to release the transverse scapular ligament. Nerve adhesions are then gently released with a probe. Results: A systematic review of 276 suprascapular nerve decompressions demonstrated good outcomes in terms of pain relief and function, and all athletes in the review returned to sport. A case series of 112 arthroscopic decompressions at the suprascapular notch found that patients achieved significant improvement in pain and strength, and none resulted in serious complications. These outcome studies support a level 4 video publication level of evidence. Discussion/Conclusion: The presented arthroscopic decompression technique treats suprascapular nerve entrapment at the suprascapular notch. Patients can expect to achieve a satisfactory outcome. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
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series Video Journal of Sports Medicine
spelling doaj-art-7df63c38e7a84645a8820280451252ea2025-08-20T03:52:57ZengSAGE PublishingVideo Journal of Sports Medicine2635-02542025-05-01510.1177/26350254241299841Arthroscopic Suprascapular Nerve Decompression: A Technique VideoEric J. Cotter MD0Joshua H. Chang BS1Daanish Khazi-Syed BS2Catherine M. Hand BS3Camden J. Bohn BS4Chase Gornbein BS5Brian Forsythe MD6University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USAIndiana University School of Medicine, Indianapolis, Indiana, USAUT Southwestern Medical Center, Dallas, Texas, USAUT Health San Antonio Long School of Medicine, San Antonio, Texas, USAIndiana University School of Medicine, Indianapolis, Indiana, USALoyola Stritch School of Medicine, Maywood, Illinois, USAMidwest Orthopaedics at RUSH, Chicago, Illinois, USABackground: Suprascapular neuropathy is an uncommon but treatable cause of shoulder pain and dysfunction. The tortuous course of the suprascapular nerve puts it at risk for entrapment, particularly at the suprascapular and spinoglenoid notches. This video presents a reproducible method for suprascapular nerve decompression at the suprascapular notch. Indications: Massive rotator cuff tears, compressive masses, or ligament hypertrophy warrants prompt intervention to prevent subsequent denervation in the face of suprascapular neuropathy. In the absence of these pathologies, a trial of conservative management is advised. Patients who have unsuccessful conservative management and evidence of worsening weakness, atrophy, and denervation by electromyography are indicated for surgical intervention. Technique Description: Standard posterior, anterior, lateral, and anterolateral portals are established. The subdeltoid space is dissected following the coracoacromial (CA) ligament to the base of the coracoid to identify the transverse scapular ligament. In the presented case, the CA ligament has been debrided from a previous surgery, so an intra-articular approach was employed, opening the rotator interval to reach the base of the coracoid. A Neviaser portal is made for blunt dissection around the suprascapular notch, with care taken to protect the neurovasculature. A second medial Neviaser portal is used to pass a Kerrison to release the transverse scapular ligament. Nerve adhesions are then gently released with a probe. Results: A systematic review of 276 suprascapular nerve decompressions demonstrated good outcomes in terms of pain relief and function, and all athletes in the review returned to sport. A case series of 112 arthroscopic decompressions at the suprascapular notch found that patients achieved significant improvement in pain and strength, and none resulted in serious complications. These outcome studies support a level 4 video publication level of evidence. Discussion/Conclusion: The presented arthroscopic decompression technique treats suprascapular nerve entrapment at the suprascapular notch. Patients can expect to achieve a satisfactory outcome. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.https://doi.org/10.1177/26350254241299841
spellingShingle Eric J. Cotter MD
Joshua H. Chang BS
Daanish Khazi-Syed BS
Catherine M. Hand BS
Camden J. Bohn BS
Chase Gornbein BS
Brian Forsythe MD
Arthroscopic Suprascapular Nerve Decompression: A Technique Video
Video Journal of Sports Medicine
title Arthroscopic Suprascapular Nerve Decompression: A Technique Video
title_full Arthroscopic Suprascapular Nerve Decompression: A Technique Video
title_fullStr Arthroscopic Suprascapular Nerve Decompression: A Technique Video
title_full_unstemmed Arthroscopic Suprascapular Nerve Decompression: A Technique Video
title_short Arthroscopic Suprascapular Nerve Decompression: A Technique Video
title_sort arthroscopic suprascapular nerve decompression a technique video
url https://doi.org/10.1177/26350254241299841
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