Dorsal scapular nerve compression. Atypical thoracic outlet syndrome

Area of Science:

• Anatomy
• Surgical Anatomy
• Nerve Compression Syndromes

Background:

• The dorsal scapular nerve (DSN) and long thoracic nerve (LTN) are crucial for shoulder and scapular function.
• Compression of these nerves can lead to significant pain and dysfunction in the neck, shoulder, and back.
• Understanding the anatomical course and potential compression points is vital for effective treatment.

Purpose of the Study:

• To anatomically investigate the relationship between the dorsal scapular nerve and the long thoracic nerve.
• To identify the anatomical basis for dorsal scapular nerve compression.
• To evaluate the clinical efficacy of surgical decompression for DSN compression.

Main Methods:

• Anatomical dissection of 10 cadavers (20 sides).
• Clinical study of 36 patients diagnosed with dorsal scapular nerve compression.
• Surgical intervention and follow-up in 22 patients.

Main Results:

• The DSN and LTN frequently share a common origin trunk.
• The DSN courses through the scalenus medius muscle, with tendinous tissues posing a risk for compression.
• Compression near the origin causes neck, shoulder, and back pain.
• Surgical decompression, particularly involving the scalenus medius and its tendinous tissues, relieved symptoms in 19 out of 22 patients.

Conclusions:

• The anatomical relationship between the DSN and LTN, especially within the scalenus medius, predisposes the DSN to compression.
• Surgical decompression targeting the scalenus medius and associated tendinous structures is an effective treatment for DSN compression syndrome.