肩甲切痕で絞扼障害された肩甲上神経麻痺に対する鏡視下手術の 2 例

概要

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Several authors have reported a variety of causes for suprascapular nerve (SSN) entrapment. We have treated two interesting cases which showed severe muscle atrophy with shoulder pain.<BR>Case 1: A 47 year old female who played badminton for years suffered from right shoulder pain since 2006. She was diagnosed as having SSN neuropathy with a rotator cuff tear at a different institute and had open surgery. She came to our hospital after the surgery without improvement of the shoulder pain. After the conservative therapy failed,arthroscopic surgery was indicated. At the surgery, pseud neuroma of the SSN was observed after removing the transverse scapular ligament. Three and half years after the second surgery, she can play badminton. However, the muscle atrophy and fatty infiltration were still observed in her supra and infraspinatus.<BR>Case 2: A sixty-four year old woman suffered from left shoulder pain for four months. Preoperative MRI showed atrophy of the supra and infraspinatus muscle. Bony entrapment at the supra scapular notch was observed during the arthroscopic surgery. After removing the bone bed, mobility of the SSN was improved.<BR>We reported two rare cases which were successfully treated with an arthroscopic surgery. Although clinical symptoms were improved after the surgery, severe atrophy of the cuff muscles was persistent. Surgical treatment should be indicated, before the completion of the muscle atrophy.
日本肩関節学会の論文