Randomized controlled trial of suprascapular nerve blocks for subacute adhesive capsulitis

Ultrasound‐Guided Suprascapular Nerve Block at Suprascapular Notch‐Do We Really Target Suprascapular Notch or Not? Where Is Our Real Target?

“…The deep placement and inconsistent anatomical variations of the SSN can limit the success of ultrasonographic visualization of the SSN at the SS notch, despite extensive documentation of its anatomy. Sonographic distinguishment of the STSL can be difficult, besides the fascia of the supraspinatus muscle might be interpreted as STSL, which was mentioned in previous studies on SSNB 3,13–15 …”

“…Although the literature about US‐guided SSNB is increasing correspondingly, there seems to be confusion about the terminology related with the suprascapular (SS) notch and injection site, and the images in the publications are conflicting 1,2 . The aim of this commentary is to clarify the nomenclature of the US‐guided SSNB including the terminology and the injection site that are unclear and confusing in the literature 3–5 …”

“…1,2 The aim of this commentary is to clarify the nomenclature of the US-guided SSNB including the terminology and the injection site that are unclear and confusing in the literature. [3][4][5] The SSN derives from the upper trunk of the brachial plexus (C5-6) and can receive additional fibers from the C4 nerve. On the upper side of the scapula, it runs beneath the inferior belly of the omohyoid muscle and then passes through the supraspinous fossa via SS notch which is covered by the superior transverse scapular ligament (STSL).…”

“…Sonographic distinguishment of the STSL can be difficult, besides the fascia of the supraspinatus muscle might be interpreted as STSL, which was mentioned in previous studies on SSNB. 3,[13][14][15] Harmon et al first described the US-guided SSNB as injection of anesthetic substance very close to the SSN with inplane technique, by placing the US probe "parallel to the scapular spine" where the SS notch was located at a depth of 4 cm. 15 However, the optimal probe position to visualize the SSN at the SS notch is in coronal alignment with slight anterior tilt because, the scapular spine forms an angle (39.5 AE 5.8 ) to the axis of the scapula, and the probe should be directed anteriorly through the superior edge of the scapula.…”

Frozen Shoulder: Diagnosis and Management

“…Long-term improvements seem to be minimal and of questionable clinical significance, but there does not appear to be any complications specific to suprascapular nerve block reported in the literature. The SSBN should be a combination of anesthetic and corticosteroid in addition to intra-articular steroid injection and typical physical therapy, as this combination appears to provide the best opportunity for added benefit (35)(36)(37)(38)(39).…”