Florid Suprascapular Neuropathy after Primary Rotator Cuff Repair Attributed to Suprascapular Notch Constriction in the Setting of Double Crush Syndrome

John G. Skedros; Casey J. Kiser; Bryce B. Hill

doi:10.1055/s-0035-1567807

Journal of Brachial Plexus and Peripheral Nerve Injury, Inhaltsverzeichnis

J Brachial Plex Peripher Nerve Inj 2015; 10(01): e66-e73
DOI: 10.1055/s-0035-1567807

Case Report

Georg Thieme Verlag KG Stuttgart · New York

Florid Suprascapular Neuropathy after Primary Rotator Cuff Repair Attributed to Suprascapular Notch Constriction in the Setting of Double Crush Syndrome

John G. Skedros

¹Intermountain Medical Center, Salt Lake City, Utah, United States

²University of Utah Department of Orthopaedics, Salt Lake City, Utah, United States

,

Casey J. Kiser

¹Intermountain Medical Center, Salt Lake City, Utah, United States

,

Bryce B. Hill

¹Intermountain Medical Center, Salt Lake City, Utah, United States

› Institutsangaben

Abstract

This report describes a patient who had an open repair of a small supraspinatus tendon tear performed 6 months after an arthroscopic acromioplasty with debridement had failed to provide pain relief. Three months prior to the tendon repair, he had a two-level cervical spine discectomy and fusion (C4–5, C5–6) that improved his neck pain. Florid suprascapular neuropathy was detected 10 weeks after the open rotator cuff repair. Evidence of some nerve recovery resulted in a long period of observation. But unsatisfactory improvement warranted decompression of the suprascapular notch, which was found to be very stenotic. At surgery, there was no evidence of neuroma, cyst, or other compressing lesion or tissue. Therefore, it was ultimately hypothesized that there was an exacerbation of a preexisting, but clinically unrecognized, entrapment of the suprascapular nerve in the suprascapular notch in the setting of cervical radiculopathy (primarily C5). Retrospectively it was also concluded that had this compressive etiology been recognized, it would have favored prompt decompression rather than the long observation period. Three years was required to achieve a good result following suprascapular notch decompression. The underlying C5 radiculopathy may have created a “double crush syndrome” that contributed to the propensity for injury and the prolonged recovery. There should be heightened awareness of this problem in patients who do not have satisfactory improvement in shoulder pain from previous shoulder and neck surgery.

Keywords

suprascapular neuropathy - rotator cuff tear - shoulder pain - suprascapular nerve - supraspinatus - double hit phenomenon - double crush syndrome

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References
1 Vad VB, Southern D, Warren RF, Altchek DW, Dines D. Prevalence of peripheral neurologic injuries in rotator cuff tears with atrophy. J Shoulder Elbow Surg 2003; 12 (4) 333-336
2 Mallon WJ, Wilson RJ, Basamania CJ. The association of suprascapular neuropathy with massive rotator cuff tears: a preliminary report. J Shoulder Elbow Surg 2006; 15 (4) 395-398
3 Costouros JG, Porramatikul M, Lie DT, Warner JJ. Reversal of suprascapular neuropathy following arthroscopic repair of massive supraspinatus and infraspinatus rotator cuff tears. Arthroscopy 2007; 23 (11) 1152-1161
4 Boykin RE, Friedman DJ, Zimmer ZR, Oaklander AL, Higgins LD, Warner JJP. Suprascapular neuropathy in a shoulder referral practice. J Shoulder Elbow Surg 2011; 20 (6) 983-988
5 Piasecki DP, Romeo AA, Bach Jr BR, Nicholson GP. Suprascapular neuropathy. J Am Acad Orthop Surg 2009; 17 (11) 665-676
6 Cofield RH, Parvizi J, Hoffmeyer PJ, Lanzer WL, Ilstrup DM, Rowland CM. Surgical repair of chronic rotator cuff tears. A prospective long-term study. J Bone Joint Surg Am 2001; 83-A (1) 71-77
7 Zanotti RM, Carpenter JE, Blasier RB, Greenfield ML, Adler RS, Bromberg MB. The low incidence of suprascapular nerve injury after primary repair of massive rotator cuff tears. J Shoulder Elbow Surg 1997; 6 (3) 258-264
8 Collin P, Treseder T, Lädermann A , et al. Neuropathy of the suprascapular nerve and massive rotator cuff tears: a prospective electromyographic study. J Shoulder Elbow Surg 2014; 23 (1) 28-34
9 Poberaj B, Kovacic L. The presence of suprascapular neuropathy in rotator cuff tears. International Journal of Shoulder Surgery 2007; 1: 58-63
10 Neer II CS. Impingement lesions. Clin Orthop Relat Res 1983; (173) 70-77
11 Brazier JE, Harper R, Jones NM , et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 1992; 305 (6846) 160-164
12 Kocher MS, Horan MP, Briggs KK, Richardson TR, O'Holleran J, Hawkins RJ. Reliability, validity, and responsiveness of the American Shoulder and Elbow Surgeons subjective shoulder scale in patients with shoulder instability, rotator cuff disease, and glenohumeral arthritis. J Bone Joint Surg Am 2005; 87 (9) 2006-2011
13 Kirkley A, Alvarez C, Griffin S. The development and evaluation of a disease-specific quality-of-life questionnaire for disorders of the rotator cuff: The Western Ontario Rotator Cuff Index. Clin J Sport Med 2003; 13 (2) 84-92
14 Godfrey J, Hamman R, Lowenstein S, Briggs K, Kocher M. Reliability, validity, and responsiveness of the simple shoulder test: psychometric properties by age and injury type. J Shoulder Elbow Surg 2007; 16 (3) 260-267
15 Hudak PL, Amadio PC, Bombardier C ; The Upper Extremity Collaborative Group (UECG). Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. Am J Ind Med 1996; 29 (6) 602-608
16 SooHoo NF, McDonald AP, Seiler III JG, McGillivary GR. Evaluation of the construct validity of the DASH questionnaire by correlation to the SF-36. J Hand Surg Am 2002; 27 (3) 537-541
17 Gladstone JN, Bishop JY, Lo IK, Flatow EL. Fatty infiltration and atrophy of the rotator cuff do not improve after rotator cuff repair and correlate with poor functional outcome. Am J Sports Med 2007; 35 (5) 719-728
18 Warner JJ, Higgins L, Parsons IV IM, Dowdy P. Diagnosis and treatment of anterosuperior rotator cuff tears. J Shoulder Elbow Surg 2001; 10 (1) 37-46
19 Burkhead Jr WZ, Skedros JG, O'Rourke PJ, Pierce WA, Pitts TC. A novel double-row rotator cuff repair exceeds strengths of conventional repairs. Clin Orthop Relat Res 2007; 461 (461) 106-113
20 Romeo AA, Rotenberg DD, Bach Jr BR. Suprascapular neuropathy. J Am Acad Orthop Surg 1999; 7 (6) 358-367
21 Walsworth MK, Mills III JT, Michener LA. Diagnosing suprascapular neuropathy in patients with shoulder dysfunction: a report of 5 cases. Phys Ther 2004; 84 (4) 359-372
22 Fritz RC, Helms CA, Steinbach LS, Genant HK. Suprascapular nerve entrapment: evaluation with MR imaging. Radiology 1992; 182 (2) 437-444
23 Zeiss J, Woldenberg LS, Saddemi SR, Ebraheim NA. MRI of suprascapular neuropathy in a weight lifter. J Comput Assist Tomogr 1993; 17 (2) 303-308
24 Inokuchi W, Ogawa K, Horiuchi Y. Magnetic resonance imaging of suprascapular nerve palsy. J Shoulder Elbow Surg 1998; 7 (3) 223-227
25 Antoniou J, Tae S-K, Williams GR, Bird S, Ramsey ML, Iannotti JP. Suprascapular neuropathy. Variability in the diagnosis, treatment, and outcome. Clin Orthop Relat Res 2001; (386) 131-138
26 Duparc F, Coquerel D, Ozeel J, Noyon M, Gerometta A, Michot C. Anatomical basis of the suprascapular nerve entrapment, and clinical relevance of the supraspinatus fascia. Surg Radiol Anat 2010; 32 (3) 277-284
27 Rengachary SS, Burr D, Lucas S, Hassanein KM, Mohn MP, Matzke H. Suprascapular entrapment neuropathy: a clinical, anatomical, and comparative study. Part 2: anatomical study. Neurosurgery 1979; 5 (4) 447-451
28 Warner JP, Krushell RJ, Masquelet A, Gerber C. Anatomy and relationships of the suprascapular nerve: anatomical constraints to mobilization of the supraspinatus and infraspinatus muscles in the management of massive rotator-cuff tears. J Bone Joint Surg Am 1992; 74 (1) 36-45
29 Tubbs RS, Jones VL, Loukas M , et al. Anatomy and landmarks for branches of the brachial plexus: a vade mecum. Surg Radiol Anat 2010; 32 (3) 261-270
30 Bodily KD, Spinner RJ, Shin AY, Bishop AT. Clinical significance of suprascapular nerve mobilization. Clin Anat 2005; 18 (8) 573-579
31 Agrawal V. Arthroscopic decompression of a bony suprascapular foramen. Arthroscopy 2009; 25 (3) 325-328
32 Moen TC, Babatunde OM, Hsu SH, Ahmad CS, Levine WN. Suprascapular neuropathy: what does the literature show?. J Shoulder Elbow Surg 2012; 21 (6) 835-846
33 Kim DH, Murovic JA, Tiel RL, Kline DG. Management and outcomes of 42 surgical suprascapular nerve injuries and entrapments. Neurosurgery 2005; 57 (1) 120-127 , discussion 120–127
34 Jerosch J, Saad M, Greig M, Filler T. Suprascapular nerve block as a method of preemptive pain control in shoulder surgery. Knee Surg Sports Traumatol Arthrosc 2008; 16 (6) 602-607
35 Vorster W, Lange CP, Briët RJ , et al. The sensory branch distribution of the suprascapular nerve: an anatomic study. J Shoulder Elbow Surg 2008; 17 (3) 500-502
36 Lafosse L, Tomasi A. Technique for endoscopic release of suprascapular nerve entrapment at the suprascapular notch. Tech Shoulder Elbow Surg 2006; 7: 1-6
37 Mestdagh H, Drizenko A, Ghestem P. Bases anatomiques du syndrome du nerf sus-scapulaire (n. suprascapularis) [French]. Anat Clin 1981; 3: 67-71
38 Rengachary SS, Neff JP, Singer PA, Brackett CE. Suprascapular entrapment neuropathy: a clinical, anatomical, and comparative study. Part 1: clinical study. Neurosurgery 1979; 5 (4) 441-446
39 Bora Jr FW, Pleasure DE, Didizian NA. A study of nerve regeneration and neuroma formation after nerve suture by various techniques. J Hand Surg Am 1976; 1 (2) 138-143
40 Safran MR. Nerve injury about the shoulder in athletes, part 1: suprascapular nerve and axillary nerve. Am J Sports Med 2004; 32 (3) 803-819
41 Arboleya L, García A. Suprascapular nerve entrapment of occupational etiology: clinical and electrophysiological characteristics. Clin Exp Rheumatol 1993; 11 (6) 665-668
42 Fabre T, Piton C, Leclouerec G, Gervais-Delion F, Durandeau A. Entrapment of the suprascapular nerve. J Bone Joint Surg Br 1999; 81 (3) 414-419
43 Roh MS, Wang VM, April EW, Pollock RG, Bigliani LU, Flatow EL. Anterior and posterior musculotendinous anatomy of the supraspinatus. J Shoulder Elbow Surg 2000; 9 (5) 436-440
44 Meyer DC, Lajtai G, von Rechenberg B, Pfirrmann CW, Gerber C. Tendon retracts more than muscle in experimental chronic tears of the rotator cuff. J Bone Joint Surg Br 2006; 88 (11) 1533-1538
45 Hersche O, Gerber C. Passive tension in the supraspinatus musculotendinous unit after long-standing rupture of its tendon: a preliminary report. J Shoulder Elbow Surg 1998; 7 (4) 393-396
46 Józsa L, Kannus P, Thöring J, Reffy A, Järvinen M, Kvist M. The effect of tenotomy and immobilisation on intramuscular connective tissue. A morphometric and microscopic study in rat calf muscles. J Bone Joint Surg Br 1990; 72 (2) 293-297
47 Osterman AL. The double crush syndrome. Orthop Clin North Am 1988; 19 (1) 147-155
48 Zahir KS, Zahir FS, Thomas JG, Dudrick SJ. The double-crush phenomenon—an unusual presentation and literature review. Conn Med 1999; 63 (9) 535-538
49 Pruksakorn D, Sananpanich K, Khunamornpong S, Phudhichareonrat S, Chalidapong P. Posterior approach technique for accessory-suprascapular nerve transfer: a cadaveric study of the anatomical landmarks and number of myelinated axons. Clin Anat 2007; 20 (2) 140-143
50 Post M. Diagnosis and treatment of suprascapular nerve entrapment. Clin Orthop Relat Res 1999; (368) 92-100
51 Burkhart SS, Barth JR, Richards DP, Zlatkin MB, Larsen M. Arthroscopic repair of massive rotator cuff tears with stage 3 and 4 fatty degeneration. Arthroscopy 2007; 23 (4) 347-354
52 Chalian M, Behzadi AH, Williams EH, Shores JT, Chhabra A. High-resolution magnetic resonance neurography in upper extremity neuropathy. Neuroimaging Clin N Am 2014; 24 (1) 109-125
53 Schulte-Mattler WJ, Grimm T. Common and not so common nerve entrapment syndromes: diagnostics, clinical aspects and therapy [in German]. Nervenarzt 2015; 86 (2) 133-141