This retrospective case series reviews surgical decompression for scapulothoracic bursitis refractory to conservative care. Sixteen patients underwent one of five techniques, from open to arthroscopic to combined bursectomy plus superomedial scapular resection. It asks which approach best relieves refractory periscapular pain and snapping.
When a patient has chronic periscapular pain and snapping that fails months of axioscapular strengthening, the next step is a diagnostic injection. Temporary relief from local anesthetic and steroid placed into the scapulothoracic bursa confirms the pain source and identifies a surgical candidate. No relief means no surgery.
Remember that imaging is usually unhelpful here. CT and 3D reconstruction rarely show a bony lesion, so the diagnosis stays clinical and osteochondroma remains a rare but resectable exception.
The authors' preferred technique combines arthroscopic bursectomy with a small open superomedial resection, because judging bone removal arthroscopically is difficult and a small incision allows controlled resection plus muscle reattachment.
Key surgical safety points: stay about 2 cm off the medial edge to protect the dorsal scapular nerve, and keep resection away from the suprascapular notch. This is a satisfaction-driven operation, so counsel patients that roughly 1 in 5 may not improve.
This retrospective case series reviews surgical decompression for scapulothoracic bursitis refractory to conservative care. Sixteen patients underwent one of five techniques, from open to arthroscopic to combined bursectomy plus superomedial scapular resection. It asks which approach best relieves refractory periscapular pain and snapping.
When a patient has chronic periscapular pain and snapping that fails months of axioscapular strengthening, the next step is a diagnostic injection. Temporary relief from local anesthetic and steroid placed into the scapulothoracic bursa confirms the pain source and identifies a surgical candidate. No relief means no surgery.
Remember that imaging is usually unhelpful here. CT and 3D reconstruction rarely show a bony lesion, so the diagnosis stays clinical and osteochondroma remains a rare but resectable exception.
The authors' preferred technique combines arthroscopic bursectomy with a small open superomedial resection, because judging bone removal arthroscopically is difficult and a small incision allows controlled resection plus muscle reattachment.
Key surgical safety points: stay about 2 cm off the medial edge to protect the dorsal scapular nerve, and keep resection away from the suprascapular notch. This is a satisfaction-driven operation, so counsel patients that roughly 1 in 5 may not improve.