The Effect of Endoscopic Bursectomy With Mini-Open Partial Scapulectomy on Snapping Scapula Syndrome

Lien, Shiu-Bii; Shen, Pei; Lee, Chian-Her; Lin, Leou-Chyr

doi:10.1016/j.jss.2008.02.041

Cited by 26 publications

(19 citation statements)

References 20 publications

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“…Many patients with crepitus, treated surgically or nonsurgically, have no pain. Our results were similar to those of Lesprit et al [11] after open resection with respect to crepitus, to those of Lien et al [12] after endoscopic bursectomy with miniopen partial scapulectomy, or to those of Pavlik et al [19] after arthroscopic resection.…”

Section: Discussionsupporting

confidence: 91%

“…Our results were similar to those of Lehtinen et al [10], Lesprit et al [11], and Nicholson and Duckworth [18] with respect to pain (Table 4). After arthroscopic resection [19] and after endoscopic bursectomy and miniopen resection [12], pain scores were a little higher than those of our patients. Several authors have reported similar clinical outcomes after arthroscopic techniques when compared with open or miniopen approaches [10,12], and the trend in surgical management of a snapping scapula seems to be moving toward arthroscopy, including bursectomy and/or resection of the scapula [2,12,13,17,19,20].…”

Section: Discussioncontrasting

confidence: 77%

“…Although many patients can be treated nonsurgically, some remain so severely symptomatic that they wish to undergo surgery; these patients can be treated with resection of the medial upper corner of the scapula, among numerous other possible surgical approaches [1,12,14,18]. Although there have been numerous studies regarding surgical treatment of a painful snapping scapula [2,6,7,10,11,13,15,20], to our knowledge, there are none that have evaluated patients at long term.…”

Section: Discussionmentioning

confidence: 99%

“…The condition usually is managed nonsurgically [8], but when symptoms persist, some are treated with surgery [3,4,8,11,13,21,22,24]. Various open surgical [10,15,16,24] or arthroscopic [2,7,9,12,14,19,20] treatments have been described, from a simple [24,25] to a more-substantial resection of almost the entire supraspinatus fossa [8] with associated bursectomy [12] or bursectomy alone [18,20].…”

Section: Introductionmentioning

confidence: 99%

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Open Surgical Treatment for Snapping Scapula Provides Durable Pain Relief, but so Does Nonsurgical Treatment

Vastamäki

2016

Clinical Orthopaedics &Amp; Related Research

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Background Resection of the medial upper corner of the scapula is one option for treating patients with a painful chronic snapping scapula. However, the degree to which this procedure results in sustained relief of pain during long-term followup, and whether surgical treatment offers any compelling advantages over nonsurgical approaches at long-term followup, are not known. Questions/purposes We asked: (1) At long-term followup after surgical treatment of a painful snapping scapula, did patients' pain decrease? (2) Did scapulocostal crepitation improve? (3) Did patients return to work? Methods Between 1971 and 1992, 15 patients underwent surgery by one surgeon for persistent ([ 1 year) and severely painful crepitus around the superomedial scapula that did not respond to nonsurgical approaches. The procedure consisted of an open resection of the superomedial corner of the scapula and release of the levator scapulae muscle. Patients treated surgically were compared with a group of nine patients treated nonsurgically between 1975 and 1997; their treatments included temporary physiotherapy, massage, and NSAIDs. In general, the patients treated nonsurgically presented with less pain. However, during much of this study period, objective pain and functional scales were not in common use, and so baseline scores were not available. Of the 15 patients treated surgically, nine participated in a clinical and questionnaire survey at a mean of 22 years (range, 16-35 years), and 12 participated in a questionnaire survey a mean 27 years after surgery (range, 23-43 years). Of the nine patients treated nonsurgically, seven participated in a clinical followup and questionnaire survey at a mean followup of 16 years (range, 10-25 years), and all nine completed a questionnaire survey at a mean of 22 years (range, 17-33 years). Patient age at onset of symptoms was a mean of 27 years. The clinical followup and questionnaires focused on pain, crepitation, and work status.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Open Surgical Treatment for Snapping Scapula Provides Durable Pain Relief, but so Does Nonsurgical Treatment

Vastamäki

2016

Clinical Orthopaedics &Amp; Related Research

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“…Chan et al [5] described the upper portal, or Bell portal, which lies in the middle third of the upper edge of the scapula, adding another portal to the medial portals. Scapulothoracic arthroscopy is a surgical technique with specific indications, and the main indications are the following: a snapping scapula [2,4,[8][9][10][11][12], a resection of the foreign body [13] or benign tumors [8,[14][15][16], malunion of a fracture [1], and treatment of chronic pain refractory to conservative treatment [6].…”

Section: Introductionmentioning

confidence: 99%

Scapulothoracic articulation arthroscopy: a new patient positioning

Andreoli¹,

Pochini²,

Monteiro³

et al. 2011

Eur Orthop Traumatol

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Purpose This study evaluated a new patient positioning for scapulothoracic arthroscopy and surgical time, and intraand postoperative edema. Methods Twenty human cadavers, underwent 20 scapulothoracic arthroscopies, were placed in the prone position with the arm medial rotated ("chicken-wing") with a pad underneath the operative shoulder. We then demarcated the arthroscopic portal sites. All cadavers underwent a resection of the scapulothoracic bursa and the superomedial scapular angle. We analyzed the timing and intra-and postoperative degree of surgical edema. Statistical analysis was performed using the Student's t test (t), the receiver-operating characteristic, and the Wald test (Wald X 2 ). Results The average times for the bursal resection and the resection of the superomedial scapular angle were 29.5 min and 21.5 min, respectively. The average total procedure time was 51.5 min. The medial portals and the superior portal (Bell portal) were adequate to perform the resection of the bursa and the superomedial scapular angle. Severe edema occurred in arthroscopies that lasted 50 min or longer. Conclusions The "chicken-wing" position, with the arm medial rotated with a pad underneath the operative shoulder, provided adequate visualization and access to the scapulothoracic articulation. The medial portals and the superior portal (Bell portal) were adequate for resecting the bursa and the superomedial scapular angle.

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Snapping Scapula

Emery¹,

Grégory²

2014

European Surgical Orthopaedics and Traumatology

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The Effect of Endoscopic Bursectomy With Mini-Open Partial Scapulectomy on Snapping Scapula Syndrome

Cited by 26 publications

References 20 publications

Open Surgical Treatment for Snapping Scapula Provides Durable Pain Relief, but so Does Nonsurgical Treatment

Open Surgical Treatment for Snapping Scapula Provides Durable Pain Relief, but so Does Nonsurgical Treatment

Scapulothoracic articulation arthroscopy: a new patient positioning

Snapping Scapula

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