Suprascapular nerve block in rotator cuff injuries

Abstract

Rotator cuff is defined to the set of muscles, tendons, ligaments and joint capsule that surrounds the shoulder joint, keeping the head of the humerus firm in the glenoid cavity. The main symptom in the rotator cuff injury is pain associated with functional limitation. The usual treatment consists in the surgical repair of the structures involved with the purpose of restoring their continuity and restoring their function. In patients with various comorbidities, who contraindicate surgical treatment; they can be treated orthopedically with analgesics, temporary immobilization and rehabilitation. It is described as a therapeutic alternative, suprascapular nerve block (SNB), a technique described for symptomatic relief in shoulder pathologies.

The aim of this work was to present the results obtained in patients with rotator cuff injury treated with SNB, whose clinical conditions contraindicated a surgical intervention.

A retrospective study that included 17 patients (11 female and 6 male), with an average age of 77 years (range 75-80) with rotator cuff injury; including injuries of a mild, moderate and severe type (according to the classification of Constant). Magnetic resonance imaging (MRI) was used for diagnosis. The minimum follow-up was six months. SNB was performed with 2% lidocaine and betamethasone, a procedure that was repeated twice, with intervals of three weeks each. In addition, it was complemented with a specific rehabilitation plan. For the clinical evaluation the UCLA scale was used, which includes pain, function, strength and patient satisfaction. This scale establishes a score from 0 to 35 (from 0 to 20 bad, from 21 to 27 regular, from 28 to 33 good and 34 to 35 excellent).

The type of injury was in 9 cases moderate, 5 severe and 3 mild. The clinical evaluation showed in 12 patients a good result (6 cases with moderate, 4 serious and 3 minor), in 4 regular patients (3 moderate and one severe); We did not get bad or excellent results.

Symptomatic treatment of rotator cuff ruptures with suprascapular nerve block is a valid therapeutic option in patients with comorbidities that contraindicate surgical repair.