Suprascapular Nerve Injection—In-Plane Approach: Ultrasound Guidance




Abstract


The suprascapular nerve (SSN) is a mixed nerve formed primarily by the C5 and C6 nerve roots and the upper trunk of the brachial plexus. The SSN travels deep to the trapezius (Trap) muscle and then enters the supraspinatus fossa. It then courses through the suprascapular notch underneath the superior transverse scapular ligament (STSL). Here motor branches innervate the supraspinatus muscle and sensory branches are provided to the posterior glenohumeral joint capsule, acromioclavicular joint, subacromial bursa, and the coracoclavicular and coracoacromial ligaments. The SSN then passes through the spinoglenoid notch to the infraspinatus fossa where terminal motor branches are given to the infraspinatus muscle.




Keywords

Shoulder, Ultrasound

 



Note: Please see pages ii , iii for a list of anatomic terms/abbreviations used throughout this book.


The suprascapular nerve (SSN) is a mixed nerve formed primarily by the C5 and C6 nerve roots and the upper trunk of the brachial plexus. The SSN travels deep to the trapezius (Trap) muscle and then enters the supraspinatus fossa. It then courses through the suprascapular notch underneath the superior transverse scapular ligament (STSL). Here motor branches innervate the supraspinatus muscle and sensory branches are provided to the posterior glenohumeral joint capsule, acromioclavicular joint, subacromial bursa, and the coracoclavicular and coracoacromial ligaments. The SSN then passes through the spinoglenoid notch to the infraspinatus fossa where terminal motor branches are given to the infraspinatus muscle.


A suprascapular nerve block (SSNB) may be used for postoperative pain control after shoulder surgery. SSNB has also been used for chronic shoulder pain related to osteoarthritis, rheumatoid arthritis, adhesive capsulitis, and rotator cuff lesions.


This chapter describes an in-plane technique, short axis to the SSN in the suprascapular notch, with out-of-plane confirmation. Safety considerations will also be highlighted including the use of Doppler imaging to avoid intravascular injection.




In-Plane Technique ( Fig. 34E.1 )



Jan 27, 2019 | Posted by in RHEUMATOLOGY | Comments Off on Suprascapular Nerve Injection—In-Plane Approach: Ultrasound Guidance
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