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Suprascapular nerve decompression

71 citationsUpdated Oct 2026
Illustration: Suprascapular nerve decompression

For patients: a plain-language version of this topic is available. See the patient guide.

Overview

Suprascapular nerve decompression is indicated for isolated suprascapular neuropathy when nonoperative management, consisting of physical therapy, nonsteroidal anti-inflammatory drugs, and activity modification, fails to resolve extrinsic nerve compression or progressive pain and weakness [17]. The procedure involves releasing the nerve at the suprascapular and/or spinoglenoid notches to relieve entrapment [5]. While initial treatment is typically conservative, surgical intervention is warranted for persistent symptoms or specific compressive lesions, such as ganglion cysts at the spinoglenoid notch, which require complete excision of the cyst and its pedicle [9]. In cases of massive rotator cuff tears associated with neuropathy, decompression at the spinoglenoid notch does not yield better functional outcomes compared to repair alone [11], and release is not justified if preoperative electromyography documents normal nerve function [30]. Consequently, no definitive recommendations exist for combining nerve release with rotator cuff repair, necessitating further research to delineate indications [19].

Arthroscopic decompression is a less invasive and potentially more effective approach than open surgery, offering excellent visualization and the ability to address concomitant shoulder pathology [3, 6]. This technique allows for a simplified subacromial approach that facilitates the evaluation and treatment of comorbid conditions [16]. Alternative methods include a novel technique using the superior border of the scapula as a guide to reduce operative time and tissue removal [4], and a superior trapezius splitting approach that provides a safe, direct route to the nerve [12]. Anatomically, arthroscopic decompression at both notches is possible using original portals [14]. During the procedure, the suprascapular artery must be identified and protected alongside the nerve to ensure safety [20].

Clinical outcomes following decompression are satisfactory, with significant improvements in patient-reported outcomes, pain relief, and strength [1, 15]. Arthroscopic release results in good functional outcomes and consistent clinical improvements, including electrophysiological recovery, similar to open surgery [5, 18]. A retrospective review of 112 patients demonstrated improvement in pain and strength with limited risk [2]. Release of the spinoglenoid ligament may restore normal shoulder function [7], and in the context of intracranial spinal accessory nerve injury, decompressive surgery provided complete relief of shoulder and scapular pain [10]. For patients with massive rotator cuff tears, partial rotator cuff repair may allow nerve recovery and functional improvement [34].

Anatomy & Pathophysiology

Nerve Course and Entrapment Sites

The suprascapular nerve originates from the upper trunk of the brachial plexus, coursing to its motor insertion on the supraspinatus and, more distally, the infraspinatus [31]. At the suprascapular notch, the superior transverse scapular ligament arises from the medial base of the coracoid, overlying the notch [61]. The suprascapular artery runs superior to this ligament, while the nerve passes deep to it [61]. Entrapment at the suprascapular notch results in denervation of both the supraspinatus and infraspinatus muscles [61]. Distally, the spinoglenoid ligament overlies the nerve at the spinoglenoid notch; entrapment, traction, or compression at this site causes denervation of the infraspinatus [61].

The nerve has limited translational freedom at the suprascapular notch as it angles around the confined space [56]. This angled pathway and restricted mobility predispose the nerve to mechanical stretching, which may be exacerbated by extreme positions of scapular depression, retraction, or abduction [56]. The nerve is furthest from the posterior edge of the glenoid when the shoulder is at 90 degrees of external rotation [33]. Scapular dimensions correlate significantly with landmark distances, enabling surgeons to scale dissection margins based on individual morphology rather than fixed measures [104].

Etiology and Mechanisms of Injury

Suprascapular neuropathy arises from traction, direct trauma, or extrinsic compression, and may also occur as part of a generalized brachial plexus disorder [56]. Traction at the suprascapular or spinoglenoid notch often results from repetitive microtrauma associated with overhead activities such as tennis, volleyball, and weight lifting [56]. This microtrauma may cause direct nerve injury or indirect injury by compromising the vascular supply [56]. Intimal damage to the axillary or suprascapular artery can generate microemboli that trap in the vasa nervorum, leading to ischemic injury [56].

Direct or indirect trauma during glenohumeral dislocation, proximal humerus fracture, or scapular fracture may result in neuropathy [56]. Iatrogenic injury has been reported following: * Distal clavicle resection [56] * Positioning during spine surgery [56] * Transglenoid arthroscopic anterior shoulder stabilization [56] * Shoulder arthrodesis [56] * Posterior approach procedures, such as posterior shoulder stabilization [56]

Repetitive microtrauma or a single traumatic event is more likely to cause neuropathy at the suprascapular notch, whereas compression by a ganglion cyst or tumor is a cause particularly at the spinoglenoid notch [56]. Cystic lesions arising from labral or capsular tears can compress the nerve along its course over the scapula [31]. In overhead athletes, neuropathy secondary to traction and microtrauma is reported [8]. The mechanism involves tightening of the spinoglenoid ligament during overhead throwing, increasing pressure on the nerve [8].

Traction injury is associated with retracted superior or posterior rotator cuff tears [8]. Secondary traction occurs at the suprascapular notch or around the base of the scapular spine in the presence of a retracted rotator cuff tear [8]. Increasing retraction of the supraspinatus tendon reduces the angle between the suprascapular nerve and its first motor branch, increasing tension [8]. Electrodiagnostic findings of suprascapular neuropathy have been reported in 8 patients with massive rotator cuff tears [8]. The rate of suprascapular neuropathy in patients with a full-thickness rotator cuff tear and muscle atrophy is 8% [8]. Overzealous lateral advancement of a retracted rotator cuff tear during repair can be detrimental to the nerve [8]. The maximum lateral advancement is between 1 to 3 cm; extended advancement places the neurovascular pedicle under increased tension [8].

In volleyball, the extreme arm position places the infraspinatus component of the suprascapular nerve under significant compression by the medial margin of the rotator cuff [117]. This leads to compression neuropathy of the infraspinatus muscle and significant loss of shoulder function [117]. The anatomic relationship between the infraspinatus branch and the rotator cuff makes compression inevitable in many individuals during extremes of shoulder motion required for play and training [117].

Suprascapular nerve entrapment at the suprascapular notch can be caused by: * Transverse scapular ligament anomalies [125] * Compression from adjacent ganglia [125] * Abnormal osseous morphology of the suprascapular notch [125] * Direct trauma or traction injury [125] * Trauma in sporting activities [125]

Extensive posterosuperior cuff tears can create nerve injury by pulling the nerve due to muscle medial mobilization [125]. Reduction of a chronic cuff tear may pull on the nerve hooked by adhesion under the superior transverse ligament [125]. The nerve has limited excursion under the superior transverse ligament, and its supraspinatus attachment is very close to the suprascapular notch [125]. A short muscle mobilization may affect nerve conduction due to this limited excursion [125]. The superior transverse ligament may be ossified, and the suprascapular notch may narrow, creating entrapment [125]. A large hematoma of the scapula can also cause entrapment [44]. Independent suprascapular notch entrapment can coexist with a spinoglenoid notch cyst [54].

Clinical Presentation and Diagnostic Correlates

Suprascapular neuropathy is a potential source of shoulder pain and functional limitation [31]. The incidence of compressive neuropathy is quite high in the overhead athletic cohort, although most patients do not show clinically relevant deficiencies in function [31]. Diagnosis relies on a combination of detailed history, comprehensive physical examination, imaging, and electrodiagnostic studies [31]. Shoulder surgeons should consider electrophysiologic evaluation for patients with clinical or radiographic signs of neuropathy and be cognizant of parameters constituting an abnormal electrodiagnostic study [39].

The most predictive test for diagnosing a GLEN lesion is a reduction of 33% or more of external rotation power compared with internal rotation power, as assessed by handheld dynamometry [95]. Alternatively, a reduction of 33% or more of external rotation power compared with supraspinatus power is also predictive [95]. Visual observation of apparent infraspinatus muscle atrophy is present in uninjured male professional tennis players without known shoulder pathology [97]. This atrophy is not related to glenohumeral joint internal rotation, total rotation range of motion, or scapular dysfunction [97].

The unexpected humeral head shift associated with suprascapular nerve entrapment can lead to proprioception disturbance [111]. It can also cause functional instability if the coordinated and conditioned muscles were not functioning very well [111].

Classification

Etiology and Mechanism

Suprascapular neuropathy arises from traction, direct trauma, or extrinsic compression [56]. Traction injuries occur at the suprascapular or spinoglenoid notch due to repetitive microtrauma from overhead activities [56]. This microtrauma causes direct nerve injury or indirect ischemic injury by damaging the intima of the axillary or suprascapular artery, leading to microemboli trapped in the vasa nervorum [56]. At the suprascapular notch, the nerve has limited translational freedom as it angles around a confined space, predisposing it to mechanical stretching [56]. In overhead athletes, traction results from tightening of the spinoglenoid ligament during throwing positions, increasing pressure on the nerve [8]. Traction injury is also associated with retracted superior or posterior rotator cuff tears [8], where overzealous lateral advancement during repair places the neurovascular pedicle under increased tension [8]. Nerve traction is theorized to arise from chronic overhead athletics or retracted rotator cuff tears [31]. Entrapment usually occurs at the suprascapular or spinoglenoid notch [25]. Suprascapular nerve entrapment is rare, mainly affecting patients under 40 years of age, with males more likely to suffer from ganglion compression [38]. Iatrogenic injury has been reported following distal clavicle resection, positioning during spine surgery, transglenoid arthroscopic anterior shoulder stabilization, shoulder arthrodesis, or posterior approach procedures [56]. Complete neurogenic fatty replacement can present in patients with intact rotator cuff tendons in the absence of traction or compression mechanisms [29].

Anatomical Classification

A classification of the suprascapular triad topography and quantitative analysis of the space available for the path of the suprascapular nerve has been proposed [90]. A Type III arrangement of the suprascapular triad topography may promote suprascapular nerve entrapment [90].

Clinical Presentation

Symptoms and Signs

Patients with suprascapular nerve neuropathy typically present with dull, aching pain in the posterior and lateral aspects of the shoulder [28]. The predominant clinical features are posterolateral shoulder pain and dysfunction [102]. Entrapment is frequently overlooked in the differential diagnosis of shoulder pain until profound weakness and denervation atrophy of the spinatus musculature become apparent [32]. Long-standing entrapment results in atrophy of the supraspinatus and infraspinatus muscles [102]. However, infraspinatus atrophy is not always present due to anatomical interindividual differences in the innervation of this muscle [102]. The pattern of weakness and atrophy localizes the site of entrapment: compression at the suprascapular notch affects both the supraspinatus and infraspinatus, whereas compression at the spinoglenoid notch isolates weakness and atrophy to the infraspinatus [28]. In some cases, suprascapular neuropathy leads to complete neurogenic fatty replacement in patients with intact rotator cuff tendons, occurring in the absence of traction or compression mechanisms [29].

Etiology and Mechanisms

Suprascapular nerve injury arises from either compression or traction [31]. Potential causes of compression include anomalous transverse scapular ligaments, ganglion cysts, abnormal bony morphology, direct trauma, and traction injury [28]. This condition is rare, mainly occurring in patients under 40 years of age, with males more likely to suffer from ganglion compression [38]. Bilateral suprascapular nerve entrapment syndrome associated with rotator cuff tear is a rare condition [45]. Specific etiologies include an intraosseous ganglion of the glenoid invading adjacent soft tissue [48] and varicose veins at the spinoglenoidal notch, an unusual cause of compression [25].

Diagnosis

A detailed history and physical examination, along with appropriate workup, are paramount for diagnosis [28]. The current gold standard for diagnosis and confirmation is abnormal electrodiagnostic testing, including electromyography and nerve conduction studies [102]. However, electrodiagnostic studies can be unreliable due to the dynamic nature of the entrapment; nerve pain can persist even when electrodiagnostic studies are negative [102]. Shoulder surgeons should consider electrophysiologic evaluation for patients with clinical or radiographic signs of suprascapular neuropathy and must be cognizant of the parameters that constitute an abnormal study [39]. On physical examination, the SSN stretch test reportedly reproduces posterior shoulder pain in patients with suprascapular nerve entrapment [102]. Suprascapular neuropathy may be associated with massive rotator cuff tears [34], although the exact association and etiology of this neuropathy in patients with rotator cuff pathology remain unclear [40].

Investigations

Electrophysiologic evaluation: Electrophysiologic evaluation is recommended for patients presenting with clinical or radiographic signs of suprascapular neuropathy [39]. Electromyographic and nerve conduction studies serve to confirm the diagnosis of suprascapular nerve entrapment [24].

Plain radiography: The axillary view aids in the evaluation of glenoid morphology and provides good visualization of the coracoid process, acromion, and distal clavicle [84]. The scapular Y view can demonstrate scapular body abnormalities, such as osteochondroma or fracture [84].

MRI: MRI is the modality of choice for evaluating the rotator cuff, biceps, and subacromial/subdeltoid bursa [83]. T1-weighted MRI sequences can reveal fatty infiltration of the infraspinatus muscle [84]. MR arthrography is considered the benchmark for the evaluation of labral tears [83].

CT: CT imaging is frequently used to evaluate fractures of the shoulder and to assess for bony lesions in cases of recurrent instability [83]. When MRI or MR arthrography is contraindicated, CT arthrography is indicated [83].

Ultrasonography: Ultrasonography serves as a low-cost alternative to MRI for evaluating skeletal and soft-tissue structures of the shoulder [83]. It can detect atrophy of rotator cuff muscles [83]. However, ultrasonography is highly operator dependent and is not as useful for evaluating labral tears or rotator cuff tears that are very small or larger than 3 cm [83].

Treatment

Non-Operative

Initial management of isolated suprascapular neuropathy typically consists of physical therapy, nonsteroidal anti-inflammatory drugs, and activity modification [17]. In the absence of a well-defined lesion producing mechanical compression of the suprascapular nerve, the condition should be treated non-operatively [27].

Operative

Indications: Open or arthroscopic operative intervention is warranted when there is extrinsic nerve compression or progressive pain and/or weakness [17]. Surgical decompression is indicated in cases refractory to conservative management [28].

Surgical Approach / Technique: Arthroscopic decompression of the nerve at the suprascapular and spinoglenoid notches is anatomically possible [14]. The anterior release of the suprascapular nerve is a feasible alternative to the lateral approach [36]. A novel, hybrid, endoscopic technique for release of the transverse scapular ligament provides many of the same advantages as the all-endoscopic technique while minimizing the traditional disadvantages of the open approach [119]. The open approach to the spinoglenoid notch permits direct visualization of the suprascapular nerve and allows for a safe, reliable, and thorough decompression [28]. This open spinoglenoid notch decompression is approached by making a skin incision from the level of the scapular spine, beginning approximately 3 cm medial to the posterolateral corner of the acromion and extending toward the posterior axillary skin fold [128]. During this procedure, the deltoid is split in line with its fibers, beginning approximately 4 to 5 cm from the posterolateral corner of the acromion [128]. The infraspinatus muscle belly is reflected inferiorly off the scapular spine to expose the spinoglenoid notch [128]. A consistent ligamentous or fascial veil-like structure from the lateral edge of the scapular spine to the posterior capsule of the shoulder is released sharply from the edge of the scapular spine [128]. Arthroscopic decompression of the suprascapular nerve can be achieved by an all arthroscopic technique if the cyst formation is located at the spinoglenoid notch [113]. The authors present a preferred surgical technique for safe decompression of the suprascapular nerve relying on an intimate knowledge of neurovascular anatomy and landmarks [13].

Other Considerations: Performing suprascapular nerve release is always a surgical challenge; surgeons must review reported techniques with figures and videos and must attend hands-on cadaveric laboratories to achieve the skills needed to perform the procedures safely [26]. Arthroscopic suprascapular nerve decompression at the suprascapular notch is a technically demanding surgical procedure with a steep learning curve [121]. Potential complications of arthroscopic suprascapular nerve decompression at the suprascapular notch may include injury of the suprascapular artery, which shows a lot of variability in location and origin [121]. Distal peripheral neuropathy after open and arthroscopic shoulder surgery will often resolve with nonoperative management, and surgical decompression is an effective treatment option in refractory cases [41].

Clinical Outcomes: Surgical decompression in the setting of suprascapular neuropathy leads to satisfactory outcomes as evidenced by patient-reported outcomes and return to sport rate [1]. Suprascapular neuropathy treated with suprascapular nerve decompression significantly improves patient-reported outcomes and is noninferior to similar procedures without decompression [15]. Arthroscopic suprascapular nerve decompression for suprascapular neuropathy at the suprascapular and/or spinoglenoid notch in the absence of major concomitant glenohumeral pathology results in good functional outcomes with significant improvements from before to after surgery [5]. A retrospective review of 112 patients demonstrated improvement in pain and strength following suprascapular nerve release with limited risk [2]. Arthroscopic management of suprascapular neuropathy provides patients with significant improvements in pain, strength, and subjective function of the shoulder, and has a low incidence of complications [23]. All patients experienced complete relief of their shoulder and scapular pain following decompressive surgery for suprascapular nerve entrapment following intracranial spinal accessory nerve injury [10].

Concomitant Pathology and Specific Etiologies: Treatment of choice for suprascapular nerve entrapment caused by a ganglion cyst is surgical decompression by complete excision of the ganglion along with its pedicle, even though full recovery of the nerve may not be expected in each case [9]. Arthroscopic suprascapular neurectomy introduces an additional effective option in the management of pain in patients with cuff tear arthropathy and other selected pathologies [120].

Complications

Nerve palsy: Iatrogenic suprascapular neuropathy is a recognized complication of adjacent shoulder procedures. Drilling for superior labrum anterior-posterior (SLAP) repair can cause direct injury [141], while glenoid wall penetration during the same procedure may trigger an inflammatory tissue reaction resulting in entrapment [141]. The risk of nerve injury is significantly greater when using a rotator interval portal compared to an anterosuperior portal during SLAP repair [139]. In reverse shoulder arthroplasty, malpositioned superior screws can cause entrapment [52], with 12% of patients assessed as high risk for iatrogenic neuropathy due to baseplate screw penetration [137]. Distal peripheral neuropathy is an under-recognized complication after both open and arthroscopic shoulder surgery [41].

Vascular injury: The suprascapular artery must be identified and protected during decompression to ensure safety [20]. Surgeons may encounter a subligamentous suprascapular artery during arthroscopic release [20]. Additionally, the suprascapular notch vein is present in 58.3% of cases and represents a risk of complication during procedures around the suprascapular foramen region [135].

Wound complications: A wound hematoma can occur as a postoperative complication following open excision of a lipoma causing suprascapular nerve entrapment [49].

Other Considerations: The anterior coracoscapular ligament reduces the space available for the suprascapular nerve and should be considered a possible etiologic factor in entrapment [134]. Performing suprascapular nerve release is a surgical challenge that requires specific skills to perform the procedure safely [26]. Arthroscopic trans-capsular axillary nerve decompression is technically challenging and should only be performed by experienced shoulder arthroscopists [37]. Regarding the safety profile of decompression itself, arthroscopic management has a low incidence of complications [23] and carries a limited risk [2]. Anterior open release of the superior transverse scapular ligament is associated with minimal morbidity [35], and the posterior approach minimizes risks and complications [132]. When distal peripheral neuropathy occurs, it will often resolve with nonoperative management [41]; however, surgical decompression is an effective treatment option for refractory cases [41].

Recovery

Light activity (weeks): The provided evidence does not specify a timeline for the resumption of desk work, driving, or light activities of daily living.

Full activity (months): The provided evidence does not specify a timeline for the return to manual work, sport, or full range of motion and strength.

Complete recovery / outcome plateau (months): The provided evidence does not specify a timeline for when pain, strength, and final functional outcomes stabilise.

Rehabilitation protocol: A rehabilitation programme has been successful in maintaining functional skill and protecting the shoulder joint from weakness muscles [118]. No specific immobilisation duration, weight-bearing progression, or sling removal timing is detailed in the evidence.

Functional milestones: Suprascapular nerve release results in improvement in pain and strength with limited risk [2]. Arthroscopic suprascapular nerve decompression at the suprascapular and/or spinoglenoid notch in the absence of major concomitant glenohumeral pathology results in good functional outcomes with significant improvements from before to after surgery [5]. All patients experienced complete relief of shoulder and scapular pain following decompressive surgery for suprascapular nerve entrapment following intracranial spinal accessory nerve injury [10]. Suprascapular neuropathy treated with suprascapular nerve decompression significantly improves patient-reported outcomes and is noninferior to similar procedures without suprascapular nerve decompression [15]. Arthroscopic release of the suprascapular nerve resulted in all patients showing improvement in postoperative electromyographic findings and marked improvement in pain relief and function [22]. Full recovery of shoulder function was achieved following treatment of suprascapular nerve entrapment caused by a large hematoma of the scapula [44].

Other Considerations: Long-term functional outcomes after suprascapular nerve entrapment operation appear encouraging [118].

Key Evidence

  • [L4] Surgical decompression in the setting of suprascapular neuropathy leads to satisfactory outcomes as evidenced by the patient-reported outcomes and return to sport rate. [1] (10.1016/j.jse.2017.09.025)
  • [L4] This series demonstrates improvement in pain and strength following suprascapular nerve release with limited risk. [2] (10.1016/j.jor.2019.11.048)
  • [L5] Arthroscopic decompression of the suprascapular nerve provides excellent visualization and the ability to address concomitant shoulder pathology. [3] (10.1016/j.jse.2010.01.006)
  • [L4] The study describes a novel arthroscopic technique for suprascapular nerve decompression that uses the superior border of the scapula as a guide, potentially reducing operative time and tissue removal compared to previous methods. [4] (10.1007/s00167-009-0858-1)
  • [L4] Arthroscopic SSN decompression for suprascapular neuropathy at the suprascapular and/or spinoglenoid notch in the absence of major concomitant glenohumeral pathology results in good functional outcomes with significant improvements from before to after surgery. [5] (10.1016/j.arthro.2020.10.020)
  • [L4] Arthroscopic release of the suprascapular nerve is a less invasive and potentially more effective way to treat suprascapular neuropathy. [6] (10.1097/00132589-200606000-00004)
  • [L4] Release of the spinoglenoid ligament with resultant suprascapular nerve decompression may result in relief of pain and a return of normal shoulder function. [7] (10.1177/03635465990270062101)
  • [L5] [8] (10.3810/psm.2012.02.1953)
  • [L5] Treatment of choice is surgical decompression of the suprascapular nerve by complete excision of the ganglion along with its pedicle, even though full recovery of the nerve may not be expected in each case. [9] (10.1016/s1058-2746(96)80011-5)
  • [L4] All patients experienced complete relief of their shoulder and scapular pain following the decompressive surgery. [10] (10.3171/jns/2008/109/11/0962)
  • [L3] Decompression of the suprascapular nerve at the spinoglenoid notch did not lead to a better functional outcome compared to repair alone in patients with posterosuperior massive rotator cuff tears and suprascapular neuropathy. [11] (10.1186/s12891-021-04075-1)
  • [L4] The superior trapezius splitting approach allows a safe, direct and relatively simple approach to decompression of the suprascapular nerve. [12] (10.1016/s1058-2746(96)80262-x)
  • [Paper] The authors present a preferred surgical technique for safe decompression of the suprascapular nerve relying on an intimate knowledge of neurovascular anatomy and landmarks. [13] (10.1016/j.eats.2012.07.004)
  • [L5] With this technique, arthroscopic decompression of the nerve at the suprascapular and spinoglenoid notches is anatomically possible. [14] (10.1016/j.jse.2007.10.002)
  • [L4] Suprascapular neuropathy treated with SSND significantly improves patient-reported outcomes and is noninferior to similar procedures without SSND. [15] (10.1016/j.xrrt.2024.05.007)
  • [L4] This report describes a simplified subacromial arthroscopic technique for decompression of the suprascapular nerve at the suprascapular notch and spinoglenoid notch while providing the surgeon with a facile, effective method to concomitantly evaluate and treat comorbid shoulder pathology. [16] (10.1016/j.arthro.2008.10.024)
  • [L5] Initial treatment of isolated suprascapular neuropathy is typically nonoperative, consisting of physical therapy, nonsteroidal anti-inflammatory drugs, and activity modification; however, open or arthroscopic operative intervention is warranted when there is extrinsic nerve compression or progressive pain and/or weakness. [17] (10.2106/jbjs.i.01743)
  • [L4] Arthroscopic nerve release for idiopathic suprascapular nerve entrapment resulted in consistent clinical improvements and electrophysiological recovery in all patients, with outcomes similar to those reported after open surgery. [18] (10.1016/j.otsr.2014.10.002)
  • [L4] No recommendations regarding suprascapular nerve release in conjunction with rotator cuff repair can be made at this time, and further research is necessary to better delineate the indications in the future. [19] (10.1016/j.jse.2011.11.033)
  • [L4] The authors emphasize that the suprascapular artery must be identified and protected along with the nerve during decompression to ensure safety. [20] (10.1016/j.jse.2008.08.007)
  • [L4] Outcomes after arthroscopic suprascapular nerve release at the suprascapular notch predictably led to successful pain relief and strength improvement in patients presenting with pain and weakness respectively. [21] (10.1177/2325967123s00003)
  • [L4] Arthroscopic release of the suprascapular nerve can be performed safely and effectively, with all patients showing improvement in postoperative electromyographic findings and marked improvement in pain relief and function. [22] (10.1016/j.arthro.2006.10.003)
  • [L4] Results indicate that arthroscopic management provides patients with significant improvements in pain, strength, and subjective function of the shoulder, and has a low incidence of complications. [23] (10.1007/s00167-017-4694-4)
  • [L4] Twenty-eight patients with suprascapular nerve entrapment confirmed by electromyographic and nerve conduction studies were identified and treated. [24] (10.1016/1058-2746(93)90062-l)
  • [L4] Entrapment of the suprascapular nerve usually occurs at the suprascapular or spinoglenoid notch. [25] (10.1016/j.jse.2011.05.022)
  • [Paper] Performing suprascapular nerve release is always a surgical challenge; surgeons must review reported techniques with figures and videos and must attend hands-on cadaveric laboratories to achieve the skills needed to perform the procedures safely. [26] (10.1016/j.eats.2020.10.023)
  • [L4] In the absence of a well-defined lesion producing mechanical compression of the suprascapular nerve, suprascapular neuropathy should be treated non-operatively. [27] (10.2106/00004623-199708000-00007)
  • [L5] [28] (10.1016/j.eats.2024.103051)
  • [L4] This is the first description of suprascapular neuropathy with complete neurogenic fatty replacement in patients with intact rotator cuff tendons in the absence of traction or compression mechanisms. [29] (10.1016/j.arthro.2014.01.010)
  • [L2] Suprascapular nerve release does not therefore seem to be justified as an adjunct to RC repair if preoperative EMG findings document normal suprascapular nerve function. [30] (10.1016/j.jse.2020.03.051)
  • [L5] [31] (10.5435/jaaos-d-19-00526)
  • [L4] Entrapment of the suprascapular nerve is frequently overlooked in the differential diagnosis of shoulder pain until profound weakness and denervation atrophy of the spinatus musculature are apparent. [32] (10.1016/s1058-2746(95)80144-8)
  • [L5] The suprascapular nerve is furthest away from the posterior edge of the glenoid with the shoulder at 90 of external rotation. [33] (10.1007/s00167-014-2900-1)
  • [L4] Suprascapular neuropathy may be associated with massive rotator cuff tears, and that partial rotator cuff repair may allow recovery of the nerve and improvement of function. [34] (10.1016/j.jse.2005.10.019)
  • [L4] Anterior open release of the superior transverse scapular ligament allows decompression of the suprascapular nerve, adds approximately 5 minutes to surgical time, and is associated with minimal morbidity while alleviating the concern of a possible double crush syndrome. [35] (10.1016/j.jhsa.2016.03.005)
  • [L5] The anterior release of the suprascapular nerve is a feasible alternative to the lateral approach. [36] (10.1016/j.eats.2024.103237)
  • [L4] This technique can be technically challenging and should only be performed by experienced shoulder arthroscopists. [37] (10.1097/bte.0b013e31822daaa2)
  • [L1] Suprascapular nerve entrapment is a rare entity mainly occurring in patients under 40 years of age, with males more likely to suffer from ganglion compression. [38] (10.1007/s00264-002-0392-y)
  • [L4] Shoulder surgeons should consider electrophysiologic evaluation of patients with clinical or radiographic signs of suprascapular neuropathy and be cognizant of the parameters that constitute an abnormal study. [39] (10.1016/j.jse.2010.10.039)
  • [L3] The exact association and etiology of suprascapular neuropathy in patients with rotator cuff pathology remain unclear. [40] (10.1016/j.jse.2013.06.011)
  • [L4] When it occurs, DPN will often resolve with nonoperative management, and surgical decompression is an effective treatment option in refractory cases. [41] (10.1016/j.jse.2014.08.007)
  • [Case_report] Full recovery of shoulder function was achieved. [44] (10.1186/s12891-023-06723-0)
  • [L5] Bilateral suprascapular nerve entrapment syndrome associated with rotator cuff tear is a rare condition that can lead to correct early diagnosis through awareness of its clinical presentation. [45] (10.1016/s1058-2746(00)90013-2)
  • [Case_report] This is the first report of an intraosseous ganglion of the glenoid invading adjacent soft tissue to cause suprascapular nerve entrapment syndrome, which showed clinical and radiologic improvement after needle aspiration. [48] (10.1016/j.jse.2008.10.014)
  • [L4] [49] (10.1097/01.blo.0000063791.32430.59)
  • [Case_report] This case is the first report of malpositioned superior screw from reverse shoulder arthroplasty causing suprascapular nerve entrapment. [52] (10.1016/j.jse.2009.10.004)
  • [L5] [54] (10.1016/j.xrrt.2026.100879)
  • [L5] [56] (10.5435/00124635-199911000-00002)
  • [L4] The new classification of the suprascapular triad topography and quantitative analysis of the space available for the path of the suprascapular nerve are important for a better understanding of the possible morphological conditions that may promote suprascapular nerve entrapment, especially those with a type III arrangement. [90] (10.1007/s00167-014-2937-1)
  • [L4] The most predictive tests for the diagnosis of a GLEN lesion were a reduction of 33% or more of external rotation power compared with internal rotation power, or a reduction of 33% or more of external rotation power compared with supraspinatus power as assessed by handheld dynamometry. [95] (10.1097/01.bte.0000170070.67295.a4)
  • [L3] This condition is present in uninjured players without known shoulder pathology and is not related to glenohumeral joint internal rotation, total rotation range of motion, or scapular dysfunction. [97] (10.1177/2325967120958834)
  • [L5] [102] (10.1007/s00167-014-3149-4)
  • [L5] Scapular dimensions correlate significantly with landmark distances, enabling surgeons to scale dissection margins based on individual morphology rather than relying on fixed measures. [104] (10.1016/j.jseint.2026.101647)
  • [L5] The unexpected humeral head shift can lead to proprioception disturbance and cause functional instability if the coordinated and conditioned muscles were not functioning very well. [111] (10.1016/s1058-2746(96)80261-8)
  • [L4] The results of our study show that arthroscopic decompression of the suprascapular nerve can be achieved by an all arthroscopic technique if the cyst formation is located at the spinoglenoid notch. [113] (10.1007/s00167-003-0443-y)
  • [L4] [117] (10.1016/s1058-2746(98)90205-1)
  • [L4] The long-term functional outcomes appear encouraging and the rehabilitation programme following decompression surgery of SNE has been successful in maintaining functional skill and protecting the shoulder joint from weakness muscles. [118] (10.1007/s00402-006-0275-6)
  • [L5] [119] (10.1097/bte.0000000000000183)
  • [L4] Arthroscopic suprascapular neurectomy introduces an additional effective option in the management of pain in patients with cuff tear arthropathy and other selected pathologies. [120] (10.1016/j.jse.2008.09.001)
  • [Paper] [121] (10.1016/j.eats.2017.06.037)
  • [L4] [125] (10.1097/00132589-200603000-00001)
  • [L4] [128] (10.1016/j.jse.2013.03.009)
  • [L4] The authors recommend the posterior approach, which minimizes risks and complications and produces good postoperative results. [132] (10.3171/jns.1996.85.6.1020)
  • [L4] Because this ligament reduces the space available for the suprascapular nerve, it should be considered as a possible etiologic factor in suprascapular nerve entrapment. [134] (10.1002/ca.10058)
  • [L5] The suprascapular notch vein is a common structure found in 58.3% of cases that correlates with the occurrence of the anterior coracoscapular ligament and is independent of body side. [135] (10.1016/j.otsr.2014.05.008)
  • [L3] Twelve percent of patients who received RTSA were assessed to be at high risk of iatrogenic suprascapular neuropathy by baseplate screw penetration. [137] (10.1016/j.jse.2021.10.024)
  • [L5] Based on the closer proximity of the anchor tip to the suprascapular nerve, the risk of injury is significantly greater with a rotator interval portal. [139] (10.1016/j.arthro.2014.06.006)
  • [Case_report] This case highlights the potential for suprascapular nerve entrapment secondary to an inflammatory tissue reaction caused by glenoid wall penetration during SLAP repair. [141] (10.1016/j.jisako.2026.101083)

See Also

References

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[2] A retrospective review of 112 patients undergoing arthroscopic suprascapular nerve decompression. Journal of Orthopaedics. 2020. DOI: 10.1016/j.jor.2019.11.048

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[23] Arthroscopic management of suprascapular neuropathy of the shoulder improves pain and functional outcomes with minimal complication rates. Knee Surgery, Sports Traumatology, Arthroscopy. 2017. DOI: 10.1007/s00167-017-4694-4

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[29] Complete Fatty Infiltration of Intact Rotator Cuffs Caused by Suprascapular Neuropathy. Arthroscopy. 2014. DOI: 10.1016/j.arthro.2014.01.010

[30] Suprascapular nerve decompression in addition to rotator cuff repair: a prospective, randomized observational trial. Journal of Shoulder and Elbow Surgery. 2020. DOI: 10.1016/j.jse.2020.03.051

[31] The Evaluation and Management of Suprascapular Neuropathy. Journal of the American Academy of Orthopaedic Surgeons. 2020. DOI: 10.5435/jaaos-d-19-00526

[32] Suprascapular nerve entrapment related to sport. Journal of Shoulder and Elbow Surgery. 1995. DOI: 10.1016/s1058-2746(95)80144-8

[33] The safe zone for avoiding suprascapular nerve injury in bone block procedures for shoulder instability. A cadaveric study. Knee Surgery, Sports Traumatology, Arthroscopy. 2014. DOI: 10.1007/s00167-014-2900-1

[34] The association of suprascapular neuropathy with massive rotator cuff tears: A preliminary report. Journal of Shoulder and Elbow Surgery. 2006. DOI: 10.1016/j.jse.2005.10.019

[35] Open Anterior Release of the Superior Transverse Scapular Ligament for Decompression of the Suprascapular Nerve During Brachial Plexus Surgery. The Journal of Hand Surgery. 2016. DOI: 10.1016/j.jhsa.2016.03.005

[36] Comprehensive Endoscopic Brachial Plexus Release for Neurogenic Thoracic Outlet Syndrome Including Suprascapular Nerve Release and Scalenotomy. Arthroscopy Techniques. 2024. DOI: 10.1016/j.eats.2024.103237

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[40] Association of suprascapular neuropathy with rotator cuff tendon tears and fatty degeneration. Journal of Shoulder and Elbow Surgery. 2014. DOI: 10.1016/j.jse.2013.06.011

[41] Distal peripheral neuropathy after open and arthroscopic shoulder surgery: an under-recognized complication. Journal of Shoulder and Elbow Surgery. 2015. DOI: 10.1016/j.jse.2014.08.007

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[117] Suprascapular nerve rotator cuff compression syndrome in volleyball players. Journal of Shoulder and Elbow Surgery. 1998. DOI: 10.1016/s1058-2746(98)90205-1

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[120] Arthroscopic suprascapular neurectomy for the management of severe shoulder pain. Journal of Shoulder and Elbow Surgery. 2009. DOI: 10.1016/j.jse.2008.09.001

[121] A Shortcut to Arthroscopic Suprascapular Nerve Decompression at the Suprascapular Notch: Arthroscopic Landmarks and Surgical Technique. Arthroscopy Techniques. 2017. DOI: 10.1016/j.eats.2017.06.037

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[137] Three-dimensional analysis of baseplate screw penetration in reverse total shoulder arthroplasty: risk of iatrogenic suprascapular neuropathy by screw violation. Journal of Shoulder and Elbow Surgery. 2022. DOI: 10.1016/j.jse.2021.10.024

[139] Injury to the Suprascapular Nerve During Superior Labrum Anterior and Posterior Repair: Is a Rotator Interval Portal Safer Than an Anterosuperior Portal?. Arthroscopy. 2014. DOI: 10.1016/j.arthro.2014.06.006

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