Arthroscopic aspiration and labral repair for treatment of spinoglenoid notch cysts

Spinoglenoid notch cysts are a relatively uncommon cause of shoulder pain and weakness, are often associated with labral tears, and commonly result in compression of the suprascapular nerve. Open and arthroscopic treatments have been described. In an attempt to limit potential suprascapular nerve injury during arthroscopic excision, we have used a technique of arthroscopic cyst aspiration followed by labral repair. Routine glenohumeral arthroscopy is performed in preparation for superior labral repair. A 17-gauge spinal needle is then inserted 1 cm lateral to the posterior portal directed just lateral to the labrum in the region of the cyst (usually posterior-superior quadrant of glenoid). The cyst material is aspirated (commonly 5-15 mL), and the labral tear is repaired without violating the glenohumeral capsule. For all 4 patients described in this report, magnetic resonance imaging showed complete cyst resolution at a minimum of 6 months after surgery. Cyst aspiration followed by labral repair limits the potential for nerve injury while increasing the likelihood of complete cyst resolution during arthroscopic treatment of spinoglenoid notch cysts.