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Ultrasound-Guided Intralesional Methylene Blue Injection for the Arthroscopic Decompression of Spinoglenoid Notch Cyst Causing Suprascapular Neuropathy.

ABSTRACT: Symptomatic spinoglenoid ganglion cyst is a rare cause of shoulder pain and disability. Surgical treatment, which may be considered after failed nonoperative treatment, includes open or arthroscopic cyst debridement. Arthroscopic treatment is less invasive and has the advantage of addressing intraarticular pathologies; however, exposure of the cyst may be deemed difficult. Furthermore, the suprascapular nerve is susceptible to iatrogenic injury owing to its close proximity to the posterior glenoid rim. The purpose of this article is to present our technique for arthroscopic spinoglenoid cyst decompression after preoperative ultrasound-guided methylene blue injection.

SUBMITTER: Buyukdogan K

PROVIDER: S-EPMC7695623 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Endoscopic/arthroscopic decompression of the suprascapular nerve at the spinoglenoid notch: indications and surgical technique.

Project description:Suprascapular nerve compression at the spinoglenoid notch can lead to posterior shoulder pain, muscle weakness, and longstanding muscle atrophy of the infraspinatus. Although rare, it is most commonly seen in overhead athletes and laborers who perform repetitive overhead activities. Early diagnosis requires a thorough history and physical examination including imaging, diagnostic injections, and electromyography to avoid a missed diagnosis. While a course of nonoperative treatment is most often prescribed, early surgical intervention may be prudent to avoid irreversible damage especially if a space occupying lesion is present. This article will describe the history, physical examination findings, diagnostic workup, and our surgical technique for arthroscopic decompression of the suprascapular nerve at the spinoglenoid notch through a simple posterior approach avoiding the subacromial space.

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Arthroscopic Decompression of Spinoglenoid Notch Cyst and SLAP Repair Through a Single Working Portal.

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Arthroscopic Decompression and Subsequent Bone-Grafting of Spinoglenoid Cyst.

Project description:Spinoglenoid cysts are associated with labral tears; however, little is known about their associated bony pathology. This Technical Note describes an arthroscopic technique to decompress and subsequently graft a spinoglenoid cyst and associated bony defect. Appropriate preoperative imaging is key to understanding the location of the bony defect and therefore crucial to the success of the bone graft. Adequate release of the labrum should be performed to fully visualized the bony lesion. A subchondroplasty cannulated drill is then placed in the bony defect under direct visualization and said defect is then filled with calcium phosphate cement. Care is taken to ensure no cement is allowed to extrude into the shoulder joint. After the cement has cured, labral pathology is repaired and the usual postoperative physiotherapy protocol is initiated.

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A Shortcut to Arthroscopic Suprascapular Nerve Decompression at the Suprascapular Notch: Arthroscopic Landmarks and Surgical Technique.

Project description:Arthroscopic suprascapular nerve decompression at the suprascapular notch is a technically demanding surgical procedure with a steep learning curve. The aim of this Technical Note is to describe important pearls for an arthroscopic decompression of the suprascapular nerve relying on the palpation of the coracoclavicular ligaments before starting the arthroscopic visualization. This reduces the time and minimizes the resection of the surrounding fat.

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Arthroscopic suprascapular nerve decompression: transarticular and subacromial approach.

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Ultrasound-Guided Suprascapular Nerve Block at Spinoglenoid Notch and Glenohumeral Joint Hydrodilation.

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Arthroscopic Intra-articular Spinoglenoid Cyst Resection Following SLAP Repair.

Project description:Spinoglenoid cyst (SGC) is a ganglion arising in the spinoglenoid notch and is thought to be related to SLAP lesion. This cyst often compresses the suprascapular nerve in the spinoglenoid notch. Symptomatic cysts require surgical treatment when conservative treatment fails. In particular, arthroscopic decompression through the torn labral tissue when the cyst is extending into the joint cavity is easy and convenient. However, if the cyst is confined to the spinoglenoid notch, arthroscopic approach through the torn labral tissue is challenging. Thus, we present our preferred technique of addressing the SGC through an additional superior capsular window after completing SLAP repair. We believe that our technique is easy, reproducible, and reasonable.

| S-EPMC5797713 | biostudies-literature

A spinoglenoid cyst compressing on the suprascapular nerve causing supraspinatus and infraspinatus muscle weakness: A case report.

Project description:IntroductionSpinoglenoid cysts are a rare cause of suprascapular neuropathy of compressive etiology in which the patient may present with shoulder pain and muscle hypotrophy. MRIs are the imaging modality of choice showing location, size, and extent of the lesion for preoperative assessment. Currently, surgical intervention is the preferred approach for the management of a spinoglenoid cyst with arthroscopy being favored over the open technique.Case presentationA 25-year-old male patient presenting with right posterior shoulder pain and decreased range of motion associated with the development of progressive weakness of the supraspinatus and infraspinatus muscles. Right shoulder MRI showed a posterior tear of the glenoid labrum and a spinoglenoid ganglion cyst. Preoperative electroneuromyography was suggestive of a suprascapular nerve impairment.Follow-upSix months postoperatively, the patient has regained full range of motion of his right shoulder with no residue signs of muscle hypotrophy.ConclusionSpinoglenoid cysts can cause compressive neuropathy with associated pain and muscle hypotrophy. MRI and EMG can help in establishing the diagnosis and in the pre-operative assessment. Surgical intervention with arthroscopy is currently the technique preferred by most surgeons.

| S-EPMC7264009 | biostudies-literature

Arthroscopic intralesional curettage for large benign talar dome cysts.

Project description:IntroductionSurgical management of large talar dome cysts is challenging due to increased morbidity by associated cartilage damage and malleolar osteotomy. The purpose of this study is to evaluate the clinical and radiological outcome of endoscopic curettage and bone graft for large talar dome cysts.MethodsThis is a retrospective analysis of data for eight patients (eight feet) who were treated by arthroscopic curettage and grafting for large talar dome cysts. Seven cases were treated by posterior ankle arthroscopy as the lesion was located posteriorly while one case was treated by anterior ankle arthroscopy as the lesion was breached anteriorly.ResultsThe final diagnosis, was; large osteochondral lesion of talus (two cases), aneurysmal bone cyst (ABC) (two case), intra-osseous ganglion (two cases), Chronic infection in talus (one case) and angiomatous lesion of the talus (one case). The mean follow up period was 18.3 (±3.06 SD) months (range 16-25 months). The median preoperative AOFAS score was 74.5 (±5.34 SD) points. The mean postoperative AOFAS score at one year follow up was 94.6 (±2.97 SD) points. None of the patient had recurrence of the lesion during follow up. Return to normal daily activity was achieved at 11.25 (±2.37 SD) weeks.DiscussionIn this short case series study, large talar dome bony cysts of different pathologies including aneurysmal bone cysts could be treated effectively by endoscopic curettage and bone grafting with no recurrence no complications during the follow-up period.

| S-EPMC4849243 | biostudies-literature

Randomized, controlled trial comparing respiratory and analgesic effects of interscalene, anterior suprascapular, and posterior suprascapular nerve blocks for arthroscopic shoulder surgery.

Project description:Background:Interscalene brachial plexus block (ISB) provides excellent analgesia for arthroscopic shoulder surgeries but is associated with adverse effects including hemidiaphragmatic paresis. We aimed to compare the respiratory effects, forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1) between suprascapular nerve block (SSB) and ISB. METHODS:Sixty patients were recruited and randomized into ISB, anterior SSB, and posterior SSB groups. FVC, FEV1, and diaphragmatic excursion were evaluated at baseline and 30 minutes after intervention. Blocks were performed under ultrasound guidance with 15 ml of 0.5% ropivacaine. Pain scores were assessed at 6, 12, and 24 hours postoperatively. RESULTS:The ISB group showed a reduced FVC of 31.2% ± 17.5% (mean ± SD), while the anterior and posterior SSB groups had less reduction of 3.6% ± 18.6% and 6.8% ± 6.5%, respectively (P < 0.001). The ISB group showed more reduction in diaphragmatic excursion than the anterior and posterior SSB groups (median [IQR]): -85.7% (-95.3% to -63.3%) vs. -1.8% (-13.1% to 2.3%) and -1.2% (-8.8% to 16.8%), respectively (P < 0.001). The median pain scores (IQR) in the ISB and anterior SSB groups were lower than those in the posterior SSB group at 6 hours on movement: 0 (0-2), 1.8 (0-4.5) vs. 5 (2.5-8), respectively (P = 0.002). There was no significant difference in oxycodone consumption postoperatively. CONCLUSIONS:Anterior SSB preserves lung function and has a comparable analgesic effect as ISB. Thus, it is recommended for arthroscopic shoulder surgeries, especially in patients who have reduced lung function.

| S-EPMC7533176 | biostudies-literature

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