Long Term Follow-Up of Arthroscopic Treatment of Spinoglenoid Ganglion Cysts Causing Suprascapular Nerve Palsy
Authors:
Kenneth J. Westerheide MD, Central
Ohio Orthopaedic Group, Columbus, OH
Ronald P. Karzel MD, Southern California Orthopedic Institute, Van Nuys,
CA
Stephen J. Snyder MD, Southern California Orthopaedic Institute, Van Nuys,
CA
Objective: The objective was to clinically evaluate the outcome of patients who had previously underwent arthoroscopic treatment of a shoulder ganglion cyst that was compressing the suprascapular nerve. All of the the patients included in this study had a suprascapular nerve palsy as a result of the spinoglenoid cyst.Methods: Fourteen cases were reviewed with an average follow up of fifty-one months and an average patient age of forty-one years. The most common presenting symptoms were pain and weakness that lasted an average of eight months. Ten of fourteen patients were noted to have atrophy on exam, and all the patients had weakness of the infraspinatus muscle. MRI demonstrated an average cyst size of three cm, and signal change within the infraspinatus in eight of fourteen cases. MRI revealed labral pathology in twelve of fourteen cases. Eleven patients had EMGs performed and they were all positive for denervation of the infraspinatus.
All patients underwent arthroscopic cyst decompression and labral pathology was found in all fourteen patients. Seven of these required fixation while the other seven required debridement.Results: All fourteen patients returned for follow up and were evaluated with the Constant- Murley Score, Simple Shouder Test and Hawkins Shoulder Evaluation Form. The average Constant- Murley score was 94 (100 maximum) and the average SST Score was 11.5 (12 maximum). Eight patients rated their activity as equal to their pre-operative level, four patients rated their activity as above their pre-operative level and two patients rated their activity as slightly below their pre-operative level. The overall satisfaction for all fourteen patients was excellent. Eleven of fourteen patients recorded the highest score for satisfaction and the other three were within two points of the highest score. No complications were reported, and there were no recurrences.Conclusions: This is the first long-term follow-up study of arthroscopic excision of ganglion cysts. Arthroscopic techniques allow decompression of the cysts and treatment of intraarticular pathology concurrently. Arthroscopic ganglion cyst excision is a safe and effective alternative treatment which avoids the morbidity associated with open excision.
