Proximal Approach of Ultrasound-guided Suprascapular Nerve Block: Comparison with Subacromial Steroid Injection

Bae, Kyu Hwan; Kim, Han Hoon; Lim, Tae Kang

doi:10.5397/cise.2019.22.4.210

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…It is evident from the literature that for SSNBs, spine of the scapula and the acromion are routinely used bony landmarks for infiltration of the drug into the suprascapular notch. There are only a few studies that have used coracoid process as the reference point [ 2 ]. Hence, in the current study, a comparison between two posterior approaches that is distance of the suprascapular notch from the spine and the acromion process was determined.…”

Section: Discussionmentioning

confidence: 99%

Variability in the distance between the suprascapular notch with the spine of the scapulae and the acromion

Filkin,

Massy-Westropp,

Wechalekar

2023

Clin Rheumatol

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Introduction The suprascapular notch lies in the superior border of the scapula and is a passageway for the suprascapular nerve that is sensory to the shoulder joint. Suprascapular nerve block involves injection of local anaesthetic into the suprascapular notch, either ultrasound guided or blind, using the spine of scapula and/or the medial border of the acromion as surface landmarks. Aim To investigate the anatomic variations that exist between the distance of the notch from the spine of scapula and acromion. Method Ninety-two dry scapulae were measured with a digital calliper for their length of the spine, distance between the midpoint of the spine and base of the suprascapular notch and distance between the medial border of the acromion and the base of the suprascapular notch. These measurements were compared for variations in the scapular bony landmarks, the spine and the acromion to determine the site for the injection. Results Measurement reliability was assessed by intraclass correlation, Cronbach’s alpha being 0.99, 0.97 and 0.91 for length of spine, distance from spine and distance from acromion respectively. The distance from the acromion had less variation in measurement (3.73 ± 0.42 cm) but a flatter distribution when compared to distance from the spine of the scapula (3.32 ± 0.39 cm). Conclusion Length of the spine of the scapula appeared not to influence either distance from the acromion or distance from the spine of scapula. There is potential for greater variability in placement of nerve blocks that use acromion as the bony reference. Key Points• Dry scapular measurement using electronic Vernier callipers is accurate (0.91–0.97).• There is potential for greater variability in placement of blind nerve blocks that use acromion as the bony reference to locate the suprascapular notch.

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Section: Discussionmentioning

confidence: 99%

Variability in the distance between the suprascapular notch with the spine of the scapulae and the acromion

Filkin,

Massy-Westropp,

Wechalekar

2023

Clin Rheumatol

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“…The nerve can be blocked superiorly, when it passes into the coracoid notch, or posteriorly, when it travels through the spinoglenoid notch. In the former, the patient lies in lateral decubitus, and the lateral-to-medial in-plane approach is used to perform a perineural injection of the suprascapular nerve in the supraclavicular region, where it travels beneath the omohyoid muscle ( 30 ) . In the latter, the patient is seated with the hand on the contralateral shoulder or in prone position.…”

Section: Suprascapular Nerve Blockmentioning

confidence: 99%

Ultrasound-guided musculoskeletal interventional procedures around the shoulder

et al. 2021

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Ultrasound is a fast, accessible, reliable, and radiation-free imaging modality routinely used to assess the soft tissues around the shoulder. It enables to identify a wide range of pathological conditions. Furthermore, most ultrasound-guided musculoskeletal interventional procedures around the shoulder produce better results in terms of accuracy and clinical efficacy than those performed in a blinded fashion. Indeed, intra-articular and peri-articular interventional procedures can be easily performed under continuous ultrasound monitoring to ensure the correct position of the needle and to deliver the medication to a specific target. Several technical approaches and medications can be used to treat different causes of painful shoulder. Intra-articular injections are applied to treat acromioclavicular osteoarthritis as well as glenohumeral joint osteoarthritis and adhesive capsulitis. Subacromialsubdeltoid bursitis, either presenting as a primary inflammatory condition or secondary to rotator cuff disorders, can be easily approached using ultrasound guidance to aspirate synovial effusion and to inject medications. Ultrasound-guided percutaneous irrigation is a well-established technique increasingly applied to treat patients with rotator cuff calcific tendinopathy. Also, degenerative rotator cuff tendinopathy can be conservatively treated by image-guided interventions, specifically with needling under ultrasound guidance that can be associated with injections of platelet-rich plasma. Lastly, periarticular peripheral nerve block can be quickly and safely performed under ultrasound guidance, particularly in conditions involving the suprascapular nerve in the setting of pre-operative analgesia or pain treatment in glenohumeral osteoarthritis and adhesive capsulitis. In this article, the most common ultrasound-guided procedures around the shoulder have been reviewed to discuss indications and techniques.

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Proximal vs Distal Approach of Ultrasound-guided Suprascapular Nerve Block for Patients With Adhesive Capsulitis of the Shoulder: Prospective Randomized Controlled Trial

Bae

Park

Jeong

et al. 2021

Archives of Physical Medicine and Rehabilitation

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Proximal Approach of Ultrasound-guided Suprascapular Nerve Block: Comparison with Subacromial Steroid Injection

Cited by 3 publications

References 17 publications

Variability in the distance between the suprascapular notch with the spine of the scapulae and the acromion

Variability in the distance between the suprascapular notch with the spine of the scapulae and the acromion

Ultrasound-guided musculoskeletal interventional procedures around the shoulder

Proximal vs Distal Approach of Ultrasound-guided Suprascapular Nerve Block for Patients With Adhesive Capsulitis of the Shoulder: Prospective Randomized Controlled Trial

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