Arthroscopic suprascapular nerve decompression at the suprascapular notch.

Abstract

Release of a transverse scapular ligament (TSL) is indicated for the entrapment of the suprascapular nerve (SSN). Previous arthroscopic techniques use step-wise reference landmarks leading to the notch to identify a TSL, and the key landmarks are the conoid ligament of the coracoclavicular ligament and the coracoid. This technique needs considerable amount of fibro-fatty tissue removal, which is time-consuming procedure. The technique described herein uses the superior border of scapula as a key landmark. A lateral portal is used as a viewing portal, and an anterolateral portal, SSN portal, and accessory portal are required for the working portals. To identify the superior border of the scapula, dissection proceeds along the anterior border of the supraspinatus and advances medially into the supraspinatus fossa. Then, the TSL could be identified by palpating laterally along the superior border of scapula as a dimpling portion.