Retrospective Comparison of Landmark Based and Ultrasound Guided Suprascapular Nerve Steroid Injections in a Patient

Abstract

Background: Suprascapular nerve steroid injections are performed for the relief of chronic shoulder pain. This retrospective comparison between landmark based and ultrasound guidance was undertaken to see the advantages of using ultrasound guidance for the performance of these injections.

Methods: After institutional review board approval a chart review of all the suprascapular nerve steroid injections performed between 2005 and 2009 was done. Statistical analysis was performed using T-test and Wilcoxon Rank-Sum test and Mann-Whitney test for the confidence interval.

Results: There were a total of 12 suprascapular nerve steroid injections performed. The mean decrease in VAS from pre-procedure for the landmark based was -2.67 ± 0.577 and for ultrasound guidance was -4.50 ± 1.173. There was a statistically significant difference of changes in VAS between the landmark based and ultrasound guidance (P = 0.0409). The median difference in the change in VAS was 2 points, and the 95% median confidence interval was 0.0 and 3.0. In addition, there was a 50% reduction in the volume of injectate and dose of methylprednisolone using the ultrasound guidance technique.

Conclusions: This study shows that there is a possibility for using lesser injectate volume and steroid for suprascapular nerve blocks along with a marginal increase in pain relief with ultrasound guidance. Larger prospective studies are needed to further validate the utility of ultrasound guidance in chronic shoulder pain.

J Neurol Res. 2011;1(2):43-47
doi: https://doi.org/10.4021/jnr19e