Compression of the suprascapular nerve by a ganglion cyst of the spinoglenoid notch: the arthroscopic solution

  • Sven Lichtenberg
  • Petra Magosch
  • Peter Habermeyer


We evaluated an all arthroscopic technique for treating suprascapular nerve entrapment by cyst formation in the spinoglenoid notch. Eight patients showed positive MRI and EMG findings with clinical sign of weakness and pain and with atrophy of the muscle. All patients underwent an all-arthroscopic procedure. The patients were evaluated preoperatively and 6 weeks and 3 months postoperatively and for the latest follow-up by clinical examination, MRI, and EMG. All patients improved in terms of pain, strength, and function. We found six superior labrum anterior and posterior (SLAP) lesions. In these patients the cyst was drained, and the SLAP lesion was repaired. In two patients there was no communication between the joint and the cyst, and therefore capsulotomy was performed and left open. The results of our study show that arthroscopic decompression of the suprascapular nerve can be achieved by an all arthroscopic technique if the cyst formation is located at the spinoglenoid notch.


Arthroscopy Ganglion cyst Spinoglenoid notch Suprascapular nerve entrapment 


  1. 1.
    Ajmani ML (1994) The cutaneous branch of the human suprascapular nerve. J Anat 185:439–442PubMedGoogle Scholar
  2. 2.
    Alon M, Weiss S, Fishel B, Dekel S (1988) Bilateral suprascapular nerve entrapment syndrome due to an anomalous transverse scapular ligament. Clin Orthop 234:31–33PubMedGoogle Scholar
  3. 3.
    Antoniadis G, Richter HP, Rath S, Braun V, Moese G (1996) Suprascapular nerve entrapment: experience with 28 cases. J Neurosurg 85:1020–1025PubMedGoogle Scholar
  4. 4.
    Antoniou J, Tae, SK, Williams GR, Bird S, Ramsey ML, Ianotti JP (2001) Suprascapular neuropathy. Clin Orthop 386:131–138PubMedGoogle Scholar
  5. 5.
    Biedert RM (1996) Atrophy of the infraspinatus muscle caused by a suprascapular ganglion. Clin J Sport Med 6:262–264PubMedGoogle Scholar
  6. 6.
    Bigliani LU, Dalsey RM, McCann PD, April EW (1990) An anatomical study of the suprascapular nerve. Arthroscopy 6:301–306PubMedGoogle Scholar
  7. 7.
    Bryan WJ, Wild JJ Jr (1989) Isolated infraspinatus atrophy. A common cause of posterior shoulder pain and weakness in throwing athletes. Am J Sports Med 17:130–131PubMedGoogle Scholar
  8. 8.
    Chocole MH, Senker W, Meznik C Breienseher MJ (1997) Glenoid-labral cyst entrapping the suprascapular nerve: dissolution after arthroscopic debridement of an extended SLAP-lesion. Arthroscopy 13:753–755PubMedGoogle Scholar
  9. 9.
    Cohen SB, Dines DM, Moorman CT (1997) Familial calcification of the superior transverse scapular ligament causing neuropathy. Clin Orthop 334:131–135PubMedGoogle Scholar
  10. 10.
    Cummins CA, Anderson K, Bowen M, Nuber G, Roth SI (1998) Anatomy and histological characteristics of the spinoglenoid ligament. J Bone Joint Surg Am 80:1622–1625PubMedGoogle Scholar
  11. 11.
    Cummins CA, Bowen M, Anderson K, Messer T (1999) Suprascapular nerve entrapment at the spinoglenoidnotch in a professional baseball pitcher. Am J Sports Med 27:810–812PubMedGoogle Scholar
  12. 12.
    DeMulder K, Maynissen H, Van Laere C, et al (1998) Arthroscopic transglenoid suture of Bankart lesion. Acta Orthop Belg 64:160–166PubMedGoogle Scholar
  13. 13.
    Edeland HG, Zachrisson BE (1975) Fracture of the scapular notch associated with lesion of the suprascapular nerve. Acta Orthop Scand 46:758–763PubMedGoogle Scholar
  14. 14.
    Edelson JG (1995) Bony bridges and other variants of the supraglenoid notch. J Bone Joint Surg Br 77:505–506PubMedGoogle Scholar
  15. 15.
    Fehrman DA, Orwin JF, Jennings RM (1995) Suprascapular nerve entrapment by ganglion cyst: a report of six cases with arthoscopic findings and review of the literature. Arthroscopy 11:727–734PubMedGoogle Scholar
  16. 16.
    Ferretti A, Cerullo G, Russo G (1987) Suprascapular neuropathy in volleyball players. J Bone Joint Surg Am 69:260–263PubMedGoogle Scholar
  17. 17.
    Ferretti A, De Carli A, Fontana M (1998) Injury of the suprascapular nerve at the spinoglenoid notch: the natural history of infraspinatus atrophy in volleyball players. Am J Sports Med 26:759–763PubMedGoogle Scholar
  18. 18.
    Ferrick MR, Marzo JM (1997) Ganglion cyst of the shoulder associated with a glenoid labral tear and symptomatic glenohumeral instability. Am J Sports Med 25:717–719PubMedGoogle Scholar
  19. 19.
    Fritz RC, Helms CA, Steinbach LS, Genant HK (1992) Suprascapular nerve entrapment: evaluation with MRI imaging. Radiology 182:437–444PubMedGoogle Scholar
  20. 20.
    Garcia G, McQueen D (1981) Bilateral suprascapular-nerve entrapment syndrome. Case report and review of the literature. J Bone Joint Surg Am 63:491–492PubMedGoogle Scholar
  21. 21.
    Goss TP, Aronow MS, Coumas JM (1994) The use of MRI to diagnose suprascapular entrapment caused by a ganglion. Orthopedics 17:359–362PubMedGoogle Scholar
  22. 22.
    Hashimoto BE, Hayes AS, Ager JD (1994) Sonographic diagnosis and treatment of ganglion cysts causing suprascapular nerve entrapment. J Ultrasound Med 13:671–674PubMedGoogle Scholar
  23. 23.
    Helms CA, Martinez S, Speer KP (1998) Acute brachial neuritis (Parsonage-Turner syndrome): MR imaging appearance—report on three cases. Radiology 207:255–259PubMedGoogle Scholar
  24. 24.
    Holzgraefe M, Kukowski B, Eggert S (1994) Prevalence of latent and manifest suprascapular neuropathy in high-performance volleyball players. Br J Sports Med 28:177–179PubMedGoogle Scholar
  25. 25.
    Ianotti JP, Ramsey ML (1996) Arthroscopic decompression of a ganglion cyst causing suprascapular nerve compression. Arthroscopy 12:739–745PubMedGoogle Scholar
  26. 26.
    Jackson DL, Farrage J, Hynninen BC, Cabom DN (1995) Suprascapular neuropathy in athletes: case reports. Clin J Sport Med 5:134–137PubMedGoogle Scholar
  27. 27.
    King ESJ (1932) The pathology of ganglion. Aust N Z J Surg 1:367–381Google Scholar
  28. 28.
    Kopell HP, Thompson WAL (1959) Pain and the frozen shoulder. Surg Gynecol Obstet 109:92–96PubMedGoogle Scholar
  29. 29.
    Kukowski B (1993) Suprascapular nerve lesion as an occupational neuropathy in a semiprofessional dancer. Arch Phys Med Rehabil 74:768–769PubMedGoogle Scholar
  30. 30.
    Lee HY, Chung IH, Sir WS, Kang HS, Lee HS, Ko JS, Lee MS, Park SS (1992) Variations of the ventral rami of the brachial plexus. J Korean Med Sci 7:19–24PubMedGoogle Scholar
  31. 31.
    Mesdagh H, Drizenko A, Ghestem P (1981) Anatomical bases of suprascapular nerve syndrome. Anat Clin 3:67–71Google Scholar
  32. 32.
    Misamore GW, Lehman DE (1996) Parsonage-Turner syndrome (acute brachial neuritis). J Bone Joint Surg Am 78:1405–1408PubMedGoogle Scholar
  33. 33.
    Moore TP, Fritts HM, Quick DC, Buss DD (1997) Suprascapular nerve entrapment caused by supraglenoid cyst compression. J Shoulder Elbow Surg 6:455–462PubMedGoogle Scholar
  34. 34.
    Ogino T, Minami A, Kato H et al (1991) Entrapment neuropathy of the suprascapular nerve by a ganglion. A report of three cases. J Bone Joint Surg Am 73:141–147PubMedGoogle Scholar
  35. 35.
    Ozer Y, Grossman JA, Gilbert A (1995) Anatomic observations on the suprascapular nerve. Hand Clin 11:539–544PubMedGoogle Scholar
  36. 36.
    Rachbauer F, Sterzinger W, Frischhut B (1996) Suprascapular nerve entrapment at the spinoglenoid notch caused by a ganglion cyst. J Shoulder Elbow Surg 5:150–152PubMedGoogle Scholar
  37. 37.
    Rengychary SS, Neff JP, Singer PA, Brackett CE (1979) Suprascapular entrapment neuropathy: a clinical, anatomical and comparative study. I. Clinical study. Neurosurgery 5:441–446PubMedGoogle Scholar
  38. 38.
    Rengachary SS, Burr D, Lucas S, et al (1979) Suprascapular entrapment neuropathy: a clinical, anatomical and comparative study. II. Anatomical study. Neurosurgery 5:447–451PubMedGoogle Scholar
  39. 39.
    Ringel SP, Treihaft M, Carry M, Fisher R, Jacobs P (1990) Suprascapular neuropathy in pitchers Am J Sports Med 18:80–86Google Scholar
  40. 40.
    Sandow MJ, Ilic J (1998) Suprascapular nerve rotator cuff compression syndrome in volleyball players. J Shoulder Elbow Surg 7:516–521PubMedGoogle Scholar
  41. 41.
    Sjoden GO, Movin T, Guntner P, Ingelman-Sundberg H (1996) Spinoglenoid bone cyst causing suprascapular nerve compression. J Shoulder Elbow Surg 5:147–149PubMedGoogle Scholar
  42. 42.
    Soren A (1966) Pathogenesis and treatment of ganglion. Clin Orthop 48:173–179PubMedGoogle Scholar
  43. 43.
    Thomas A (1936) La paralysie du muscle sous-épineux. Presse Med 64:1283–1284Google Scholar
  44. 44.
    Thompson RC Jr, Schneider W, Kennedy T (1982) Entrapment neuropathy of the inferior branch of the suprascapular nerve by ganglia. Clin Orthop 166:185–187PubMedGoogle Scholar
  45. 45.
    Ticker JB, Djurasovic M, Strauch RJ, April EW, Pollock RG, Flatow EL, Bigliani LU (1998) The incidence of ganglion cysts and other variations in anatomy along the course of the suprascapular nerve. J Shoulder Elbow Surg 7:472–478PubMedGoogle Scholar
  46. 46.
    Tirman PF, Feller JF, Janzen DL, Peterfy CG, Bergman GA (1994) Association of glenoid labral cysts with labral tears and glenohumeral instability: radiologic findings and clinical significance. Radiology 190:653–658PubMedGoogle Scholar
  47. 47.
    Warner JJP, Krushell RJ, Masquelet A, Gerber C (1992) 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 74:36–45PubMedGoogle Scholar
  48. 48.
    Vastmäki M, Göransson H (1993) Suprascapular nerve entrapment. Clin Orthop 297:135–143PubMedGoogle Scholar
  49. 49.
    Zuckerman JD, Polonsky L, Edelson G (1993) Suprascapular nerve palsy in a young athlete. Bull Hosp Jt Dis 53:11–12Google Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Sven Lichtenberg
    • 1
  • Petra Magosch
    • 1
  • Peter Habermeyer
    • 1
  1. 1.ATOS-KlinikHeidelbergGermany

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