Open Surgical Decompression for Large Multiloculated Spinoglenoid Notch Ganglion Cyst With Suprascapular Nerve Neuropathy

Abstract

Suprascapular nerve entrapment at the spinoglenoid notch causes infraspinatus weakness and wasting. Patients present with shoulder pain and weakness. The spinoglenoid notch cyst is the reason for suprascapular nerve compression. Magnetic resonance imaging (MRI) confirms the diagnosis of spinoglenoid cyst and its nerve compression. Also, MRI rules out other differential diagnosis causing shoulder pain and weakness. One of the treatment modalities for small and asymptomatic cyst is conservative, which has produced acceptable results and functional outcome. Open or arthroscopic aspiration or decompression is indicated for patients with single small cysts where conservative treatment failed, and cyst associated with suprascapular nerve compression. We report a 32-year-old dancer with a large multiloculated multiple spinoglenoid cysts compressing the suprascapular nerve causing infraspinatus wasting and shoulder dysfunction. We performed an open surgical decompression of the suprascapular nerve and excised multiple ganglions. The patient improved significantly and regained his shoulder function and muscle wasting at two-year follow-up.

Clinical Analysis of Shoulder Arthroscopy in the Treatment of Cysts in the Spinal Pelvic Incision

“…Both approaches can achieve the goal, and the surgeon can choose their own familiar approach. The main surgical methods are fenestration and decompression of the cyst [11] or complete resection. Meng Qingyang et al [12] believe that SNC is pathologically consistent with tenosynovial cysts, and internal septated or non fenestrated polycystic cysts are the basis for recurrence, and should be completely removed to avoid cyst recurrence.…”

Suprascapular nerve entrapment caused by a large hematoma of the scapula: a case report

“…The suprascapular nerve is commonly entrapped in the following two sites: the suprascapular and spinoglenoid notches [ 2 ]. If the nerve is entrapped in the suprascapular notch, it induces supraspinatus and infraspinatus muscle weakness [ 3 , 4 ]. In the case of entrapment in the spinoglenoid notch, infraspinatus muscle weakness alone is induced [ 4 , 5 ].…”

“…If the nerve is entrapped in the suprascapular notch, it induces supraspinatus and infraspinatus muscle weakness [ 3 , 4 ]. In the case of entrapment in the spinoglenoid notch, infraspinatus muscle weakness alone is induced [ 4 , 5 ]. Furthermore, suprascapular nerve compression is believed to be responsible for chronic shoulder pain [ 6 ].…”

“…Multiple etiologies of suprascapular nerve compression exist, with various mechanisms depending on the location of the compression. Ganglion cysts, direct nerve trauma, scapular fractures, vascular malformation, and iatrogenic injury potentially cause suprascapular nerve neuropathy at compression sites and the suprascapular and spinoglenoid notches [ 4 , 7 , 8 ].…”

“…Certain authors have reported that solitary paralabral cysts are a common cause of suprascapular nerve entrapment in relation to SLAP lesions [ 4 , 8 ]. Conservative treatments, such as analgesics, manual therapy, and ultrasound-guided minimally invasive cyst aspiration combined with exercise, have demonstrated functional improvements [ 4 , 7 , 8 ]. However, surgical treatment can be considered if repeated conservative treatments prove ineffective.…”