Anterior shoulder denervation

Shoulder pain is a complaint most commonly seen by Orthopedic Surgeons trained to identify and correct the musculoskeletal problems of the shoulder joint. Traditional operative approaches to correct painful shoulders due to rotator cuff tears or impingement syndrome have a failure rate related to pain of about 20%, whether done arthroscopically or with open approaches. In 1994, the innervation of the shoulder joint was described, permitting a approach to the treatment of anterior shoulder pain by partial shoulder denervation. Now, the results, of resecting the branch from the lateral pectoral nerve to the anterior shoulder capsule, in order to denervate the anterior shoulder, is reported. Each of the 23 patients who had this surgery was a failure of the traditional musculoskeletal operative approach. The operative procedure for partial anterior shoulder denervation is described. The first procedure was done in 1996, and patients are included through the end of 2004. Each patient had a positive response of pain relief and increased shoulder range of motion after a local anesthetic block of this nerve at the coracoid process. Post-operatively, there was an improvement in the visual analog scale level of pain from a mean of 8.7 to 1.6. The range of pain-free shoulder motion in the anterior plane increased from 63 to 124 degrees. Excellent results were obtained in 76%, good results in 16% and fair results in 8% of the patients. It is concluded that anterior shoulder denervation can relieve pain predictably in patients who respond to a local anesthetic block of this nerve at the coracoid process.