Evaluation, treatment, and outcomes of suprascapular neuropathy: a 5-year review.

ABSTRACT

OBJECTIVE: To report our diagnostic and treatment experiences, and patient outcomes, in patients with suprascapular neuropathy (SSN). DESIGN: Retrospective cohort study. SETTING: A tertiary medical center. PATIENTS 65 patients with electromyographically (EMG)-confirmed SSN. METHODS: A 5-year retrospective chart review of patients with EMG-confirmed SSN. MAIN OUTCOME MEASURES: Descriptive statistics were used to summarize demographics, risk factors, causes, EMG findings, diagnostic evaluation, treatments, and self-reported outcomes. Exact Mantel-Haenszel χ(2) tests and Fisher exact tests were used to assess correlation between these measures. RESULTS: The 3 most common causes of SSN were trauma (32 patients), an inflammatory process (ie, brachial neuritis) (14), and the presence of a cyst (13). Remaining cases were related to a rotator cuff tear or were due to overuse. No cases were attributed to notch abnormalities. At the time of follow-up (a mean of 50 months [range, 15-84 months] after EMG), 50% of subjects returned to activity with no restrictions (excellent outcome) and 40% returned to activity with restrictions (good outcome), regardless of cause and treatment. EMG findings, specifically the presence/absence of fibrillation potentials, did not predict recovery. CONCLUSIONS: SSN should be considered in patients with shoulder pain and weakness. Magnetic resonance imaging and ultrasound help to exclude a structural process. Identifying a structural cause, specifically a cyst or rotator cuff tear, is important because it appears that these patients have improved recovery with return to normal activities when treated surgically. Although EMG data did not have prognostic value in this study, the data were limited and further study is warranted. Regardless of cause or treatment, most patients with SSN returned to activities in some capacity.