A Novel Technique for Endoscopic Release of the Transverse Scapular Ligament in the Setting of Suprascapular Neuropathy: Case Report and Technique

Abstract

Suprascapular neuropathy is a well-known cause of shoulder pain and dysfunction. Common locations for suprascapular nerve (SSN) entrapment are the suprascapular notch and the spinoglenoid notch. Multiple authors have described both open and arthroscopic approaches for SSN decompression; however, to our knowledge, there is no description of decompression of the SSN at the suprascapular notch using a hybrid endoscopic approach to maximize the advantages of both. The patient was a 27-year-old, white male laborer, who presented with a 6-month history of left shoulder pain and decreased function without a history of trauma. A standard course of conservative treatment including nonsteroidal antiinflammatory drugs, activity modification, and physical therapy was attempted but failed to result in symptomatic improvement. Magnetic resonance imaging and electromyography were subsequently ordered and demonstrated a subacute muscle denervation pattern indicating the SSN as the most probable site of compression. Given the patient’s clinical examination, failure of nonoperative management, age, and his activity level, he was offered surgical intervention. The technique described in this report utilizes a novel, safe, effective, and facile approach for the release of the transverse scapular ligament. We present our hybrid endoscopic technique along with a case report demonstrating a good patient outcome to emphasize the successful application of our technique following appropriate utilization of history, physical examination, and diagnostic tests when deciding to operatively treat a patient with isolated suprascapular neuropathy.