Dr. Ebraheim’s educational animated video describes blind and ultrasound guided injection of the suprascapular nerve.
The Meier’s Method is explained as well.
The suprascapular nerve arises from the upper trunk of the brachial plexus (C5-C6). The suprascapular nerve passes through the suprascapular notch under the superior transverse ligament. the nerve then passes through the spinoglenoid notch under the inferior transverse ligament.
The nerve gives innervation to the supraspinatus muscle, subacromial bursa, AC joint, the shoulder joint and ends by innervating the infraspinatus muscle.
Injection block can be helpful to treat shoulder pain. Block of the suprascapular nerve can be given either blind or through ultrasound guidance.
Block of the suprascapular nerve is given at the area of the suprascapular notch.
Before injection of the suprascapular nerve the scapular spine is identified and marked.
The site of injection is marked by using the Meier method. The line marking the scapular line is halved. The injection site is marked 2 cm cranial and then 2 cm medial to the spine of the scapula.
The needle is inserted down to the scapula. The direction of the needle should be approximately 45 degrees.
Walk the needle to the suprascapular notch and inject fluid.
Patient position: the patient should sit upright.
First the probe is placed parallel to the scapular spine. Move the probe cephalad to identify the suprascapular notch.
The notch is seen covered by the trapezius and supraspinatus muscles as well as the transverse scapular ligament.
Check the blood flow by ultrasound to identify and avoid the suprascapular artery.
The position of the needle: the needle comes from the medial side along the long axis of the probe and penetrates approximately 5 cm.
Aspirate before injection to make sure that the needle is not inserted into the artery.
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