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. 2022 Aug 15:6:24715492221103518.
doi: 10.1177/24715492221103518. eCollection 2022.

Iatrogenic Injury to the Suprascapular Nerve Following Reverse Shoulder Arthroplasty: A Case Report

Jason Long  1 , Jordan Liles  1 , Oke Anakwenze  1 , Christopher Klifto  1
Affiliations

Iatrogenic Injury to the Suprascapular Nerve Following Reverse Shoulder Arthroplasty: A Case Report

Jason Long et al. J Shoulder Elb Arthroplast. .

Abstract

The location and course of the suprascapular nerve (SSN) to the glenohumeral joint places this nerve at risk when operating around the shoulder. Iatrogenic injury to the suprascapular nerve has been described in several different procedures including, rotator cuff repairs, posterior capsulorraphy, Bankart repairs, SLAP lesion repairs, Latarjet procedures, and shoulder arthroplasty. We present a case of iatrogenic suprascapular nerve injury due to superior glenoid baseplate screw placement following primary reverse shoulder arthroplasty (RSA), a novel approach to diagnosis of nerve injury, and treatment.

Keywords: arthroplasty; revision; shoulder.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Post-operative radiograph of right shoulder.
Figure 2.
Figure 2.
Coronal CT image of right shoulder.
Figure 3.
Figure 3.
Operative picture - The incision for exposure of supraspinatus fossa is approximately 7 cm in length and centered just superior to the scapular spine. This longitudinal incision allows for easy elevation of the supraspinatus muscle belly and visualization of suprascapular notch, suprascapular ligament, suprascapular nerve, and prominent hardware.
Figure 4.
Figure 4.
Operative picture - deep exposure of the supraspinatus fossa. The scapular spine is used as the main landmark to begin elevating the supraspinatus muscle belly, starting at the most distal, superior aspect of the scapular spine and elevating deep and towards midline. Care should be taken not to lacerate the suprascapular artery as you approach the suprascapular notch.
Figure 5.
Figure 5.
Operative picture - deep exposure of the supraspinatus fossa with visualization of prominent hardware, blue arrow. The suprascapular ligament, pink arrow, has been released for decompression of the suprascapular nerve, white arrow. The scapular spine is marked with a green arrow.
Figure 6.
Figure 6.
Operative picture - following hardware removal with a diamond tipped burr, the hardware is now below the cortical margin of the scapula, white arrow. The nerve was able to course around the lateral aspect of the scapular spine, black arrow, without continued bowstringing over the screw.
Figure 7.
Figure 7.
Post-operative radiographs of right shoulder.
See this image and copyright information in PMC

References

    1. Shishido H, Kikuchi S. Injury of the suprascapular nerve in shoulder surgery: an anatomic study. J Shoulder Elbow Surg. 2001;10(4):372–376. DOI: 10.1067/mse.2001.115988 - DOI - PubMed
    1. Wang J, Singh A, Higgins L, et al. Suprascapular neuropathy secondary to reverse shoulder arthroplasty: a case report. J Shoulder Elbow Surg. 2010;19(3):e5–e8. 20100113. DOI: 10.1016/j.jse.2009.10.004 - DOI - PubMed
    1. Tasaki A, Nimura A, Mochizuki T, et al. Anatomic observation of the running space of the suprascapular nerve at the suprascapular notch in the same direction as the nerve. Knee Surg Sports Traumatol Arthrosc. 2015;23(9):2667–2673. 20140613. DOI: 10.1007/s00167-014-3129-8 - DOI - PubMed
    1. Yang Y, Zuo J, Liu T, et al. Glenoid morphology and the safe zone for protecting the suprascapular nerve during baseplate fixation in reverse shoulder arthroplasty. Int Orthop. 2018;42(3):587–593. 20170927. DOI: 10.1007/s00264-017-3646-4 - DOI - PubMed
    1. Laumonerie P, Blasco L, Tibbo ME, et al. Sensory innervation of the subacromial bursa by the distal suprascapular nerve: a new description of its anatomic distribution. J Shoulder Elbow Surg. 2019;28(9):1788–1794. 20190426. DOI: 10.1016/j.jse.2019.02.016 - DOI - PubMed

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