What is a Suprascapular Nerve Release?
Suprascapular nerve release, also known as suprascapular nerve decompression, is a surgical procedure that is usually performed in a minimally invasive arthroscopic technique to release the compressed suprascapular nerve.
The suprascapular nerve can be compressed or injured at a couple of common locations in the shoulder, either the spinoglenoid notch or the suprascapular notch. If the nerve becomes compressed, it frequently results in atrophy (weakness and shrinking) of the rotator cuff muscles along with shoulder pain and dysfunction.
Any injury or trauma to the suprascapular nerve results in suprascapular neuropathy. Suprascapular neuropathy is a condition of shoulder pain associated with weakness. It is a common problem in overhead athletes who perform repetitive overhead motions or throwing such as with swimming, volleyball, tennis, and weightlifting.
The purpose of suprascapular nerve release is to relieve shoulder pain and dysfunction by decompressing the nerve.
Anatomy of the Suprascapular Nerve
The suprascapular nerve is a mixed (sensory and motor) nerve that arises from the upper trunk of the brachial plexus. The nerve travels through the suprascapular notch beneath the superior transverse scapular ligament (STSL) of the shoulder and supplies the supraspinatus and infraspinatus muscles. Both muscles are part of a group of muscles called the “rotator cuff.” The primary function of these muscles is to help with arm movements at the shoulder joint.
Indications for Suprascapular Nerve Release
Your surgeon may recommend a suprascapular nerve release for the following conditions:
- Entrapment of the nerve at the suprascapular and spinoglenoid notch
- Nerve compression due to traction injury of the nerve from blunt trauma, broken scapula bones, or a rotator cuff tear
- An underlying ganglion cyst may be exerting pressure on the nerve
- Repetitive stretching of the nerve
- Chronic shoulder pain and weakness
- Atrophy of the shoulder muscles
- Failed conservative treatment measures
Preparation for Suprascapular Nerve Release
Preparation for suprascapular nerve release may involve the following steps:
- A review of your medical history and a physical examination to check for any medical issues that need to be addressed prior to surgery.
- Depending on your medical history, social history, and age, you may need to undergo tests such as blood work and imaging to help detect any abnormalities that could compromise the safety of the procedure.
- You will be asked if you have allergies to medications, anesthesia, or latex.
- You should inform your doctor of any medications or supplements you are taking or any conditions you have such as heart or lung disease.
- You may be asked to stop taking blood-thinners, anti-inflammatories, aspirin, or other supplements for a week or two.
- You should refrain from alcohol and tobacco at least a few days prior to surgery and several weeks after, as it can hinder the healing process.
- You should not consume any solids or liquids at least 8 hours prior to surgery.
- You should arrange for someone to drive you home after surgery.
- A signed informed consent form will be obtained from you after the pros and cons of the surgery have been explained.
Procedure for Suprascapular Nerve Release
Suprascapular nerve decompression surgery is commonly performed with an arthroscopic technique under general anesthesia.
An arthroscope is a small fiber-optic viewing instrument made up of a tiny lens, light source, and a video camera. The camera attached to the arthroscope displays the image of the joint on a monitor, allowing the surgeon to view the nerve and ligament (tough band of fibrous connective tissue that connects one bone to another).
The approach for surgery is from the front (anterior) aspect of the shoulder. Your surgeon makes a few small incisions (arthroscopic portals) on the top of the shoulder. In one incision, the arthroscope is introduced to view the suprascapular nerve, artery, and superior transverse scapular ligament. The other portal is used for the insertion of surgical instruments. Your surgeon will then release the tissue, bands, and/or cyst compressing the nerve by removing it to allow the nerve to recover. Your surgeon will also look for any labral tears or other associated shoulder pathology and perform any required repairs. After confirming sufficient decompression, the instruments and scope are withdrawn, and the tiny incisions are closed and covered with a bandage.
The benefits of arthroscopy are smaller incisions, faster healing, a more rapid recovery, a shorter rehabilitation period, and less scarring. It is often performed on an outpatient basis where the patient is able to return home on the same day.
It is much less traumatic to the muscles, ligaments, and tissues than the traditional method of surgically opening the shoulder with long incisions (open techniques).
Postoperative Care and Recovery
Following the surgery, your surgeon may recommend you follow certain measures for a successful outcome, including:
- You may experience pain, swelling, and discomfort around the operated area. Pain and anti-inflammatory medications are provided as needed to address these.
- You may apply ice-packs wrapped in a towel over the operated area for about 20 minutes, 3 to 4 times a day to help reduce post-operative swelling and pain.
- You will have to wear a shoulder sling for 2 to 3 weeks following surgery to rest your shoulders and promote healing.
- Keep a pillow under the operated area while sleeping to support the shoulder.
- Instructions on incision site care and bathing will be provided to keep the wound clean and dry.
- Refrain from strenuous activities and lifting heavy weights for at least a couple of months. A gradual increase in activities is recommended.
- Your surgeon will develop a rehabilitation program after surgery to improve the shoulder strength and range of motion.
- Return to normal activities once you feel comfortable and a follow-up appointment should be scheduled 8 to 10 days after surgery to examine your progress.
Risks and Complications
Suprascapular nerve release surgery is a relatively safe procedure; however, as with any surgery, some risks and complications may occur, such as:
- Damage to nerves or blood vessels
- Adverse reactions to anesthesia
- Blood clots
- Delayed healing
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