Suprascapular Nerve Decompression Using MIS Spine Tubular Retractors: A Technical Note

Introduction: Compression of the suprascapular nerve within the spinoglenoid notch can result in enduring muscle atrophy in the infraspinatus, accompanied by posterior shoulder discomfort and muscle weakness. While uncommon, this condition is predominantly observed in individuals engaged in repetitive overhead tasks or in those with a remote history of trauma to the notch. Although nonoperative treatment is usually recommended, surgical intervention is an option for cases that fail to respond. The senior author describes a decompression technique for surgically indicated cases using a tubular retractor system commonly employed for minimally invasive spine surgery.

Methods: This technical note includes both a written description of the operative technique as well as a video demonstration of suprascapular decompression using tubular retractors. The nuances regarding incision planning, use of operative table, boney landmarks, and surgical landmarks for decompression of the nerve are described in detail.

Results: Successful decompression of the suprascapular nerve in the spinoglenoid or suprascapular notch was achieved through a tubular retractor. After identification of the suprascapular nerve and artery superior to the spine of the scapula, these structures were followed in an inferior to superior direction leading to the notch. After adjusting the placement of the retractor superiorly, the medial and lateral margins of the notch were clearly identified with good visualization of the transverse scapular ligament. This structure was then cut sharply taking care to not injure the underlying suprascapular artery and nerve.

Conclusion : In conclusion, our study presents a detailed description of the tubular retractor system's application in suprascapular nerve decompression. This technique offers a viable option for surgeons already proficient in the use of tubular retractors within their routine spine practice. Its adoption can facilitate precise and minimally invasive management of suprascapular nerve compression, potentially improving patient outcomes and expanding the armamentarium of experienced spinal surgeons.