Ultrasound-guided Pulsed Radiofrequency of the Suprascapular Nerve for Chronic Shoulder Pain: A Retrospective Cohort Study Comparison of the Suprascapular and Spinoglenoid Notch Approaches.

Abstract

Pulsed radiofrequency of the suprascapular nerve is an established treatment for chronic shoulder pain, commonly targeting the suprascapular notch. An alternative approach targets the spinoglenoid notch, but the comparative efficacy of these 2 distal targets remains unclear. To compare the efficacy and safety of ultrasound-guided distal suprascapular nerve pulsed radiofrequency performed at the suprascapular vs the spinoglenoid notch in patients with chronic shoulder pain. A retrospective, observational cohort study. The pain medicine outpatient clinic of a tertiary care center. We examined the records of 95 patients with chronic unilateral shoulder pain who underwent suprascapular nerve pulsed radiofrequency. Patients were categorized into 2 groups based on the pulsed radiofrequency target: the suprascapular notch (Group 1) or the spinoglenoid notch (Group 2). Outcomes were assessed using the Shoulder Pain and Disability Index (SPADI) and the Visual Analog Scale (VAS) at baseline, and at 4 and 12 weeks postprocedure. Both groups demonstrated a statistically significant reduction in VAS and SPADI scores at 4 and 12 weeks postprocedure compared to baseline (P < 0.05). However, Group 2 showed statistically significant lower (better) scores than Group 1 for activity-related VAS and nighttime VAS at 4 weeks, as well as for activity-related VAS and total SPADI scores at the 12-week follow-up (P < 0.05 for all). The retrospective nature of our study contributing to bias and the short-term follow-up are the primary limitations. Both distal suprascapular nerve pulsed radiofrequency approaches were statistically significant for improving pain and disability scores in patients with chronic shoulder pain. Our findings indicate that pulsed radiofrequency performed at the spinoglenoid notch may yield superior outcomes according to some evaluations compared to the suprascapular notch approach. Therefore, suprascapular nerve pulsed radiofrequency at the spinoglenoid notch appears to be at least as effective and safe as, and potentially a more advantageous alternative to, the conventional suprascapular notch technique.