BACKGROUND
Shoulder pain is a common type of pain syndrome, disturbing from 18 to 26% of adult population, causing limitation of self-service and working capacity. Reasons of pain can be caused by shoulder joint pathology (rotator cuff rupture, adhesive capsulitis, shoulder joint instability) and also by extraarticular pathology (post-stroke pain, radiculopathy of cervical spine nerves, suprascapular nerve neuropathy). In case of conservative treatment failure surgical methods are applied. Basic methods of surgical treatment of pain syndrome and suprascapular nerve neuropathy are radiofrequency ablation and endoscopic decompression of suprascapular nerve at scapular notch area, however, there was still no comparison of these methods, what determined the relevance of our study.
OBJECTIVE
Compare efficacy of methods of radiofrequency ablation and endoscopic decompression of suprascapular nerve in aspect of chronic shoulder pain treatment in adults.
MATERIAL AND METHODS
In our study were included 46 patients, which were operated due to shoulder pain syndrome. First group included 20 patients (14 male, 6 female), which were performed shoulder joint arthroscopy, subacromial decompression and endoscopic suprascapular nerve decompression. Mean age was 49±5.1 years. Second group included 26 patients (11 male, 15 female), which were performed radiofrequency ablation of suprascapular nerve. Mean age was 57±2.2 years. The study was retrospective.
RESULTS
Final follow-up in both groups was made at 6 months after surgery. Positive results of treatment were achieved in first group in 90% of cases. Pain according to NRS decreased from 7.2±0.3 cm to 1.7±0.4 cm., flexion increased from 151±7.5° to 169±2.7°, abduction increased from 148.5±7° to 170±2.9°, external rotation increased from 18±2.2° to 52±2.8°. Positive results of treatment in second group were achieved in 69% of cases. Pain according to NRS decreased from 8.5±0.2 cm to 3.5±0.5 cm, flexion increased from 128.8±4.1° to 156.1±3.7°, abduction increased from 130.5±3.6° to 160±2.7°, external rotation increased from 22.7±1.6° to 53±2°. Three patients of the second group after surgery noticed weakness and numbness at shoulder area, but these symptoms completely disappeared in 3 weeks after surgery. There were no complications in both groups after surgery.
CONCLUSION
Radiofrequency ablation and endoscopic decompression of suprascapular nerve are effective methods of shoulder pain treatment. Method of endoscopic decompression in association with shoulder arthroscopy in our study showed more favourable results comparing to method of radiofrequency ablation.
