RT Journal Article
SR Electronic
T1 Evaluation of suprascapular nerve radiofrequency ablation protocols: 3D cadaveric needle placement study
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP 1021
OP 1025
DO 10.1136/rapm-2019-100739
VO 44
IS 11
A1 John Tran
A1 Philip Peng
A1 Anne Agur
YR 2019
UL http://rapm.bmj.com/content/44/11/1021.abstract
AB Background and objectives Image-guided intervention of the suprascapular nerve is a reported treatment to manage chronic shoulder joint pain. The suprascapular nerve is conventionally targeted at the suprascapular notch; however, targeting of its branches, the medial and lateral trunks, which are given off just posterior to the notch has not been considered. Since the lateral trunk supplies the posterior supraspinatus and articular branches to the glenohumeral joint capsule, while the medial trunk provides motor innervation to the anterior region, it may be possible to preserve some supraspinatus activation if the medial trunk is spared. The main objective was to investigate whether midpoint between suprascapular and spinoglenoid notches is the optimal target to capture articular branches of lateral trunk while sparing medial trunk.Methods In 10 specimens, using ultrasound guidance, one 17 G needle was placed at the suprascapular notch and a second at midpoint between suprascapular and spinoglenoid notches. The trunks and needles were exposed in the supraspinous fossa, digitized and modeled in 3D. Lesion volumes were added to the models to asses medial and lateral trunk capture rates. Mean distance of needle tips to origin of medial trunk was compared.Results Conventional notch technique captured both lateral and medial trunks, whereas a midpoint technique captured only lateral trunk. Mean distance of needles from the origin of medial trunk was 5.10±1.41 mm (notch technique) and 14.99±5.53 mm (midpoint technique).Conclusions The findings suggest that the midpoint technique could spare medial trunk of suprascapular nerve, while capturing lateral trunk and articular branches. Further clinical investigation is required.