SLAP repair with arthroscopic decompression of spinoglenoid cyst

Abstract

Introduction: A spinoglenoid cyst with suprascapular nerve disorders is highly associated with superior labrum anterior posterior (SLAP) lesion. Conservative or surgical treatment is applied to relieve pain and neurological symptoms. The purpose of this study was to evaluate clinical outcomes of patients treated by arthroscopic surgery for SLAP lesion with a spinoglenoid cyst.

Methods: The subjects of this study were six patients with SLAP lesion with a spinoglenoid cyst who underwent arthroscopic surgery. There was one female and five males with a mean age of 48.5 years. SLAP lesion was found in all the patients at arthroscopy. A small tear of the rotator cuff was found in the two patients. The SLAP lesion was repaired using suture anchors, and the rotator cuff tears were repaired by suture-bridge fixation. The spinoglenoid cyst was decompressed through the torn labrum in three patients, and through the released superior to posterior portion of the capsule in the other three patients.

Results: All patients showed excellent improvement in pain and muscle strength at the final follow-up examination. The mean Constant score was improved from 60.5 points preoperatively to 97.2 points postoperatively. The mean visual analog scale (VAS) score decreased from 4.5 on the day of the surgery to 2.5 within one week postoperatively. Postoperative MRI showed disappearance or reduction of the spinoglenoid cyst in four and two patients, respectively. There were no complications from the surgical intervention and in the postoperative period.

Discussion: The patients treated by decompression through the released capsule obtained pain relief at an early period after the surgery. Arthroscopic treatment for a spinoglenoid cyst can provide a satisfactory clinical outcome. Arthroscopic decompression of a spinoglenoid cyst through the released capsule is recommended for a safe and reliable procedure for patients with suprascapular nerve disorders.

Keywords: Arthroscopic decompression; Labral tear; SLAP repair; Spinoglenoid cyst; Suprascapular nerve.

Figure 1.

Atrophy of the left infraspinatus muscle caused by suprascapular neuropathy with a spinoglenoid cyst.

Figure 2.

T2-weighted MRI scans of a left shoulder demonstrating a spinoglenoid cyst on the coronal image (a), the axial image (b), and the sagittal image (c). The sagittal image shows edema and atrophy of the infraspinatus muscle.

Figure 3.

Arthroscopic imaging demonstrating decompression of the spinoglenoid cyst through the released superoposterior capsule (a), and partial removal of the cyst using an arthroscopic punch (b).

Figure 4.

Postoperative T2-weighted MRI scan demonstrating disappearance of the spinoglenoid cyst.

Figure 5.

The VAS score of the three patient (no. 3, 5, 6) treated by decompression of the cyst through the released capsule decreased earlier than those through the torn labrum.