Annals of Rehabilitation Medicine

Comparison of Blind and Ultasonography Guided Approach of Suprascapular Nerve Block.: Lee, Jong Hwa , Kim, Sang Beom , Lee, Kyeong Woo , Joe, Yang Lae , Kim, Young Dong; J Korean Acad Rehabil Med 2009;33(2):219-224.

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Objective
To compare ultrasonography guided versus blind approach in a randomized trial examining the efficacy of suprascapular nerve block in patients with non-specific shoulder pain. Method: A total of 20 patients with shoulder pain lasting for more than 1 month were included in this study. After 1:1 randomization, patients were included either in the blind group (n=10) or in the ultrasonography guided group (n=10) of suprascapular nerve block. All patients were evaluated before and after treatment, in terms of shoulder pain and disability index (SPADI) and nerve conduction study. Results: Significant improvements were seen in all pain scores and disability after both types of nerve block, with no significant difference in the improvement of pain and disability between the two approaches. However, amplitude changes of nerve conduction study were larger in ultrasono-graphy guided approach than blind approach. Conclusion: This study suggests ultrasonography guided approach of suprascapular nerve block could place the needle closer to the nerve compared to blind approach. (J Korean Acad Rehab Med 2009; 33: 219-224)

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Suggestion of Safer and Easier Technique of Suprascapular Nerve Block based on Cadaver Study.: Hong, Hyun taek , Lee, Jong In , Lee, Won Il , Kim, Joon Sung , Sung, Nam Suk , Choi, Hang Joon , Won, Sun Jae , Ko, Young Jin; J Korean Acad Rehabil Med 2005;29(6):630-634.

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Objective
To suggest a safer and easier technique of suprascapular nerve block by assessing anatomical relationship of the suprascapular notch from a view point of surface anatomy. Method: Fourteen shoulders of seven cadavers were dissected in prone position. The scapular notch was exposed and the articular branch of suprascapular nerve was observed. The length and depth of spine, height and relative position of scapular notch were measured for all of the specimen. Results: The length of the spine was 11.45⁑0.72 cm. The injection point was measured as relative position of scapular notch on the spine. The ratio between distance from medial border of the spine to injection point and from the injection point to posterior angle of acromion was 1.89⁑0.2：1. The depth of the spine, which was defined as the shortest vertical distance from the injection point to the scapula was 2.69⁑0.43 cm, and the vertical distance from this contact point to the base of the scapular notch, e.g. the height of the scapular notch, was 1.18⁑0.1 cm. Conclusion: We expect we could perform suprascapular nerve block easily and safely with suggested surface landmarks and measured data in this study. (J Korean Acad Rehab Med 2005; 29: 630-634)

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Suprascapular Nerve Conduction Study: Comparative Analysis between Surface and Needle Recording Methods in Normal Subjects.: Kim, Chang Hwan , Roh, Gill Ho; J Korean Acad Rehabil Med 2005;29(4):383-386.

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An electromyographic examination is often utilized to confirm the diagnosis of suprascapular neuropathy in patients with shoulder pain and dysfunction. The purpose of this study was to compare two recording methods (surface and monopolar needle electrode recordings) for the evaluation of suprascapular nerve. Method: Twenty-two healthy subjects were tested with each method. Differences between the recording methods were compared for compound muscle action potential (CMAP) latencies and amplitudes. And the parameters obtained from two recording methods were correlated. Results: The mean age was 43.6⁑12.4 years (range: from 23 to 72 years old). The surface recordings appeared to give a more reproducible latency and amplitude of CMAP of the infraspinatus. The surface recorded CMAP latency and amplitude were 2.58⁑0.46 ms, and 12.6⁑2.7 mV, respectively. Those of the needle electrode recording were 2.49⁑0.41 ms and 27.6⁑6.55 mV, respectively. The two recordings were significantly correlated in latency (r=0.876, p＜0.05) and amplitude(r=0.484, p＜0.05). Conclusion: Considering the invasiveness of study and compliance of the patient, the surface electrode recording may be prudent for the convenient assessment and follow up studies in suprascapular nerve conduction study. (J Korean Acad Rehab Med 2005; 29: 383-386)

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Suprascapular Nerve Injury Restricted to the Infraspinatus Muscle by a Ganglion Cyst: A case report.: Shim, Dae Seop , Rah, Ueon Woo , Moon, Hae Won , Lee, Il Yung , Eom, Jae Ho; J Korean Acad Rehabil Med 2002;26(6):819-821.

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Suprascapular nerve injury restricted to the infraspinatus muscle is an uncommon condition. We present a 29 year-old man who complained of right shoulder pain and weakness for 8 months. Physical examination revealed atrophy of right infraspinatus muscle and T2 weighted MRI of the right shoulder revealed a mass with homogeneous high intensity at the spinoglenoid notch and atrophy of right infraspinatus muscle. EMG study revealed abnormal spontaneous activities and reduced recruitment pattern of motor units in right infraspinatus muscle. Symptoms improved after the excision of a mass which was a ganglion cyst by pathologic examination. We were reporting a case of suprascapular nerve injury restricted to the infraspinatus muscle. (J Korean Acad Rehab Med 2002; 26: 819-821)

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Cystic Entrapment of Infraspinatus Branch of Suprascapular Nerve Confirmed by Ultrasonography: Case report.: Kang, Kyong Ju , Lee, Sam Gyu , Jung, Ju Chan , Seon, Kwang Jin; J Korean Acad Rehabil Med 1999;23(3):660-663.

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Cystic entrapment of infraspinatus branch of suprascapular nerve is a rare cause of shoulder pain with infraspinatus atrophy. We discuss the ultrasonographic diagnosis and ultrasonography- guided aspiration of the cyst as a treatment.

Case: A 37-year-old, ship-yard laborer had experienced left shoulder discomfort and pain without trauma history. Physical examination showed profound selective atrophy of left infraspinatus muscle. Simple X-ray of shoulder showed normal findings. Electrodiagnostic examination revealed delayed motor latency of infraspinatus branch of suprascapular nerve and denervation potentials of infraspinatus muscle exclusively. Ultrasonographic finding showed 13.5⁓21.5 mm sized cystic mass around left infraspinatus notch. Ultrasonography-guided aspiration was done, and then electrical stimulation therapy and strengthening exercise of left shoulder were performed. Symptoms were improved.

We report a rare case of cystic entrapment of infraspinatus branch of suprascapular nerve in a patient without traumatic insult.

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The Clinical and Electrophysiological Study of the Suprascapular Nerve Palsy.: Sohn, Min Kyun , Yune, Seung Ho , Leem, Jeong Su; J Korean Acad Rehabil Med 1997;21(2):362-367.

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The medical records of twenty-one patients with suprascapular nerve palsy were reviewed retrospectively. Nine patients had isolated suprascapular nerve lesions and twelve patients accompanied axillary nerve lesions. In trauma cases, combined nerve lesions were common and severe. In three cases isolated suprascapular nerve lesions were noted spontaneously. Isolated infraspinatus muscle lesions were noted in four cases which were due to compressions of suprascapular nerves at the spinoglenoid notch, and in one case from ganglionic cyst was diagnosed by ultrasonography. At initial examination, three patients showed complete and eighteen patients showed incomplete lesion. Eight patients with incomplete lesion and one patient with complete lesion were followed up. Seven patients with incomplete lesion showed regeneration between 1∼7 months after injury. Therefore electrodiagnostic study is necessary to evaluate severity and level of nerve lesion and regeneration.