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Research Article
Clément Prénaud
Assistance Publique – Hôpitaux de Paris
Corresponding Author
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Background: Decompression of the suprascapular nerve (SSNe) at the superior scapular notch (SSNo) is usually performed with an arthroscopic procedure. This technique is well described but locating the nerve is complex because it is deeply buried and surrounded by soft tissue. We propose to combine ultrasound and arthroscopy (US-arthroscopy) to facilitate nerve localization, exposure and release. The main objective of this study was to assess the feasibility of this technique.
Methods: This is an experimental, cadaveric study, carried out on shoulders. The first step of our technique is to locate the SSNo using an ultrasound scanner. Then an arthroscope is introduced under ultrasound control to the SSNo. A second portal is then created to dissect the pedicle and perform the ligament release.
Results: Ultrasound identification of the SSNo, endoscopic dissection and decompression of the nerve were achieved in 100% of cases. Ultrasound identification of the SSNo took an average of min (+/-4) while dissection and endoscopic release time took an average of min (+/-5).
Conclusion: Ultrasound is an extremely powerful tool for non-invasive localization of nerves through soft tissues, but it is limited by the fact that tissue visualization is limited to the ultrasound slice plane, which is two-82 dimensional. On the other hand, arthroscopy (extra-articular) allows three-dimensional control of the surgical steps performed, but the locating of the nerve involves significant tissue detachment and a risk of damaging the nerve with the dissection. The combination of the two (US-arthroscopy) offers the possibility of combining the advantages of both techniques.
Keywords
Suprascapular, nerve, decompression, arthroscopic, ultrasound
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The full text of this article is available to read as a PDF.
No competing interests reported.
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CURRENT STATUS: Under Review
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Posted 17 May, 2021
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Editorial decision: Major revision
On 10 Aug, 2021
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Received 07 Aug, 2021
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On 04 Aug, 2021
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Editor assigned
On 04 Aug, 2021
Editor invited
On 13 May, 2021
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On 13 May, 2021
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This preprint is under consideration at Scientific Reports. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Clément Prénaud
Assistance Publique – Hôpitaux de Paris
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 2
Posted 17 May, 2021
No community comments so far
Editorial decision: Major revision
On 10 Aug, 2021
Reviews received
Received 07 Aug, 2021
Reviewers agreed
On 04 Aug, 2021
Reviewers invited
Invitations sent on 04 Aug, 2021
Editor assigned
On 04 Aug, 2021
Editor invited
On 13 May, 2021
Submission checks complete
On 13 May, 2021
First submitted
On 22 Apr, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Decompression of the suprascapular nerve (SSNe) at the superior scapular notch (SSNo) is usually performed with an arthroscopic procedure. This technique is well described but locating the nerve is complex because it is deeply buried and surrounded by soft tissue. We propose to combine ultrasound and arthroscopy (US-arthroscopy) to facilitate nerve localization, exposure and release. The main objective of this study was to assess the feasibility of this technique.
Methods: This is an experimental, cadaveric study, carried out on shoulders. The first step of our technique is to locate the SSNo using an ultrasound scanner. Then an arthroscope is introduced under ultrasound control to the SSNo. A second portal is then created to dissect the pedicle and perform the ligament release.
Results: Ultrasound identification of the SSNo, endoscopic dissection and decompression of the nerve were achieved in 100% of cases. Ultrasound identification of the SSNo took an average of min (+/-4) while dissection and endoscopic release time took an average of min (+/-5).
Conclusion: Ultrasound is an extremely powerful tool for non-invasive localization of nerves through soft tissues, but it is limited by the fact that tissue visualization is limited to the ultrasound slice plane, which is two-82 dimensional. On the other hand, arthroscopy (extra-articular) allows three-dimensional control of the surgical steps performed, but the locating of the nerve involves significant tissue detachment and a risk of damaging the nerve with the dissection. The combination of the two (US-arthroscopy) offers the possibility of combining the advantages of both techniques.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7
The full text of this article is available to read as a PDF.
No competing interests reported.
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