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Arthroscopic Treatment of Suprascapular Neuropathy from a Suprascapular Notch Cyst Using a Lateral Subacromial
Approach
by Justin J. Mitchell, Ryan R. Fader, Melissa Munkwitz, and Lucas S. Rylander
JBJS Essent Surg TechVolume 5(1):e5March 11, 2015
©2015 by The Journal of Bone and Joint Surgery, Inc.
T2-weighted magnetic resonance imaging scans demonstrating coronal (Fig. 1-A), axial (Figs. 1-B and 1-C), and sagittal (Figs. 1-D and 1-E) images of a left shoulder with a contiguous
suprascapular and spinoglenoid notch cyst.
Justin J. Mitchell et al. JBJS Essent Surg Tech 2015;5:e5
©2015 by The Journal of Bone and Joint Surgery, Inc.
Superior view of a left shoulder identifying the surface landmarks of the shoulder, including the Neviaser portal (A), the acromioclavicular joint (B), the coracoid (C), the anterior border of the
acromion (D), and the posterior border of the acromion (E).
Justin J. Mitchell et al. JBJS Essent Surg Tech 2015;5:e5
©2015 by The Journal of Bone and Joint Surgery, Inc.
Arthroscopic view of the coracoacromial (CA) ligament leading to the base of the coracoid.
Justin J. Mitchell et al. JBJS Essent Surg Tech 2015;5:e5
©2015 by The Journal of Bone and Joint Surgery, Inc.
Arthroscopic view of the suprascapular notch cyst exiting underneath the transverse scapular ligament and causing compression of the suprascapular nerve.
Justin J. Mitchell et al. JBJS Essent Surg Tech 2015;5:e5
©2015 by The Journal of Bone and Joint Surgery, Inc.
Penetration of the cyst using a sharp arthroscopic spatula.
Justin J. Mitchell et al. JBJS Essent Surg Tech 2015;5:e5
©2015 by The Journal of Bone and Joint Surgery, Inc.
Arthroscopic imaging demonstrating decompression of the suprascapular notch cyst.
Justin J. Mitchell et al. JBJS Essent Surg Tech 2015;5:e5
©2015 by The Journal of Bone and Joint Surgery, Inc.
Arthroscopic images demonstrating blunt dissection of the decompressed cyst and suprascapular nerve (Fig. 7-A), while the suprascapular neurovascular bundle is protected using
blunt probes placed through a Neviaser portal (Fig. 7-B).
Justin J. Mitchell et al. JBJS Essent Surg Tech 2015;5:e5
©2015 by The Journal of Bone and Joint Surgery, Inc.
Views of the intact transverse scapular ligament (TSL) with the decompressed cyst below (Fig. 8-A) and subsequent release (Fig. 8-B).
Justin J. Mitchell et al. JBJS Essent Surg Tech 2015;5:e5
©2015 by The Journal of Bone and Joint Surgery, Inc.