T2-weighted magnetic resonance imaging scans demonstrating coronal (Fig. 1-A), axial (Figs. 1-B and 1-C), and sagittal (Figs. 1-D and 1-E) images of a left shoulder with a contiguous suprascapular and spinoglenoid notch cyst. On the coronal image, the cyst is easily visualized occupying the suprascapular notch. The sagittal images reveal supraspinatus and infraspinatus atrophy (asterisks).
Superior view of a left shoulder identifying the surface landmarks of the shoulder, including the Neviaser portal (A), the acromioclavicular joint (B), the coracoid (C), the anterior border of the acromion (D), and the posterior border of the acromion (E). The accessory Neviaser portal (G), or G portal, is 2 cm medial to the standard Neviaser portal. The proposed anterior, posterior, and accessory lateral portals are marked with solid red lines in their respective locations. A cutaneous approximation of the course of the suprascapular nerve is marked with a solid yellow line.
Arthroscopic imaging demonstrating decompression of the suprascapular notch cyst. A grasper is used to preliminarily open the cyst further after initial penetration. Synovial fluid extravasation can be seen thereafter (Fig. 6-A). Following this, a standard arthroscopic shaver can be used to evacuate septations and remove the bulbous edges of the cyst (Figs. 6-B and 6-C).
Arthroscopic images demonstrating blunt dissection of the decompressed cyst and suprascapular nerve (Fig. 7-A), while the suprascapular neurovascular bundle is protected using blunt probes placed through a Neviaser portal (Fig. 7-B). TSL = transverse scapular ligament.