dorsal scapular nerve entrapment
Introduction
Introduction to the scapular nerve compression syndrome The dorsal scapular nerve is the nerve from the nerve root of the neck 5 and the long nerve of the thoracic nerve. The compression of the dorsal scapular nerve is the soreness and discomfort of the neck, shoulders, back, sputum and lateral chest wall. Kevin (1993) reported that the scapular nerve closure can treat neck and shoulder pain. In 1994, Chen Desong reported the disease in detail and proposed a surgical treatment plan with good results. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: septic shock
Cause
Causes of scapular nerve compression syndrome
Cause (30%):
It is because the scapular nerve or the cervical nerve root is compressed by anatomical factors in its path. The scapular nerve is mostly present in the thoracic outlet syndrome, but it can also exist alone.
Pathogenesis (25%):
There are two reasons for the compression of the scapular nerves: one is the cervical nerve root, especially the nerve root of the neck 5, which is involved in the scapular nerve of the scapula as its branch. The other reason is that the scapular nerve in the scapular nerve Subject to anatomical factors.
Prevention
Scapular nerve compression syndrome prevention
The disease is caused by the direct action of trauma, such as falls, falls, and emergency braking caused by riding. Therefore, pay attention to living habits, high-risk workers, such as construction workers, mining workers, and teachers and workers are likely to cause damage, and should pay attention to protect themselves during the work process. Pay attention to calmness and avoid emotional conflicts leading to the disease. Secondly, early detection, early diagnosis and early treatment are also important for the prevention of this disease.
Complication
Scapulohumeral nerve compression complications Complications septic shock
Some patients may have a loss of forearm sensation, and a small number of patients have lower limb muscle strength, especially shoulder abduction muscle strength. There was a significant tender point at the midpoint of the posterior margin of the sternocleidomastoid and at the 3cm of the third and fourth thoracic spinous processes.
Symptom
Scapular scapular nerve compression symptoms Common symptoms Back pain, hand numbness, weakness, arm numbness
(1) Frequent symptoms: The disease is common in young and middle-aged women. All patients have neck and back discomfort and soreness as the main symptoms. Neck discomfort is related to the weather, it is aggravated in rainy days and winters, and can be aggravated after exertion. The upper arm is stretched back and the neck is pulled when lifting. The soreness of the neck and shoulders often prevents the patient from falling asleep. The patient feels uncomfortable with the affected limb, but cannot clearly indicate the location of the pain.
(2) less symptoms: a few cases may have shoulder weakness, occasional hand numbness, mainly for the forearm and hand sputum side numbness.
Examine
Examination of scapular nerve compression syndrome
1. Electromyography examination: no abnormalities were found in the supraspinatus, infraspinatus muscle, deltoid muscle and rhomboid muscle. In 7 cases, the first dorsal interosseous muscle and the small finger muscle had fibrillation potential, and the rhomboid muscle may be due to deep position. It was not found that the nerve conduction velocity was not abnormal.
2. X-ray films of the cervical spine: no abnormalities were found in 22 cases, 8 cases of the 7th cervical vertebrae were too long, and 4 cases of cervical degenerative changes.
Diagnosis
Diagnosis and diagnosis of scapular nerve compression syndrome
The compression of the shoulder and instep nerves is easily confused with other diseases: it should be differentiated from inflammation around the shoulder joint, thoracic outlet syndrome, trapezius muscle strain, bone hyperplasia, and cervical spondylotic radiculopathy. Especially with nerve root type cervical spondylosis is confusing. The key to identification is that the disease has a limited and fixed tenderness point, especially when the spine is pressed to induce ipsilateral upper limb soreness, and the symptoms can be completely or partially disappeared after the pain point is closed, and the disease can be clearly diagnosed.
