Subracromial decompression is a type of surgical procedure adopted to cure shoulder impingement syndrome. This complication surfaces with aging. It was first described by Charles Neer in the year 1972. It occurs due to scarring of the bursa lying between the undersurface of the acromion and the superior surface of rotator cuff. Shoulder impingement syndrome occurs due to the osteophytes formation on both the undersurfaces of distal clavicle as well as the anterior aspect of the acromion. The patient starts developing irritation in the subacromial space. Rotator cuff starts degenerating, which over time, can lead to rotator cuff tears.
How is Shoulder Impingement Syndrome diagnosed?
X-rays, MRI, ultrasonography, and arthrography help to detect rotator cuff joint pathology and bone variations. Besides, physical assessment is performed by qualified doctors before surgical intervention.
What is the Treatment for Impingement Syndrome?
In initial stages, rotator cuff and shoulder strengthening program are advised. This treatment is usually recommended for the first 3 to 6 months. In severe cases, subracromial lidocaine and steroid injection is administered in the subacromial spaces to reduce pain. Rehabilitation program is carried out in a more focused manner. If patients do not respond to primary treatments, degenerated tissues are removed from the subacromial space. Surgeries that involve repair of such symptoms usually have a success rate of 85-90%. However, over 80% of patients get better with an exercise program alone.
What are the Different procedures in Subacromial Decompression?
Past Surgical Procedure : Earlier, subacromial decompression was executed through open incision technique. Deltoid muscle was removed from the anterior portion of the acrmion. With the help of of arthroscopic scissors and other ancillary equipments, scarred and thickened bursa was also removed. Rotator cuff was thoroughly checked for any signs of wear and tear. This technique was successful to some extent. It took more than 3 to 6 weeks for complete healing. Moreover, sometimes, the patient had to face shoulder disability for lifetime as the deltoid muscle remained detached from the anterior acromion.
Present Surgical Procedure : Arthroscopic technique is the latest method of performing subacromial decompression. A qualified surgeon pierces the shoulder joint (glenohumeral) with the help of an arthroscope. This equipment investigates reason for the impingement syndrome pain. The scar is taken off and the site under the surface of bone is cleaned with the help of arthroscopic coagulators and shavers. Bone spurs or osteophytes, located below the acromion, are removed with the help of arthroscopic bur. They can be safely and completely removed by excision. Post surgery, the patient is encouraged to use their shoulder. If it is not done, the patient may develop shoulder pain due to stiffness.
What is the recovery period for Subacromial Decompressions?
Recovery period depends upon the extent of injury. Dysfunctional shoulder muscles may take several months to regain their normal strength.