神经松解术及肩胛上横韧带切除治疗肩胛上神经卡压综合征

Neurolysis combined with scapular transverse ligament incision to treat suprascapular nerve entrapment syndrome

目的 探讨肩胛上神经卡压综合征的诊断和治疗方法,以期提高该病的诊治水平.方法 对2011年11月-2014年3月收治的10例肩胛上神经卡压病例进行分析,均存在肩外展起始30°时,冈上、下肌肌力明显下降;同时双上肢在伸直位、肩关节前屈90°位,交叉于胸前时可诱发肩胛部疼痛.肌电图显示肩胛上神经慢性损伤.10例给予手术治疗,全部行肩胛上横韧带切除,7例行神经松解术.结果 术后随访4~24个月,平均13个月,症状完全消失,未发现复发者,但肌萎缩均无明显改善.结论 对于肩胛上神经卡压的患者,经保守治疗效果不佳时,应积极手术治疗,但对于有肌萎缩的患者并不能恢复已萎缩的肌肉.

Objective To discuss the diagnosis and therapy of suprascapular enerapment syndrome, in order to improve medicare level for this disease. Methods From November 2011 to March 2014, 10 cases of suprascapular entrapment were analyzed, all cases had obvious muscle weakness of supraspinatus and infraspinatus. When shoulder abducted 30° , at the same time, scapular pain couldbe irritted when both upper extremities were in extention position and the shoulders were buckled across the chest with anterion flextion 90° . EMG indicated chroinc injury of suprascapular nerve. 10 cases were operated by scapular transverse ligament incision, 7 cases were operated by neurolysis. Results Postoperative follow-up was for 4~24 months, with the average of 13 months, the sympton completely disappeared, without recurrence, but muscle atrophy had no obvious improvement. Conclusion Patients with suprascapular nerve entrapment should committ active surgical treatment. When conservative treatment is invalid. But it can＇t restore the trophy muscle.