Compresión del Nervio Supraescapular por Quiste Para-Labral Posterior en el Hombro
Secundario a quiste para labral posterio, este paciente presenta atrofia del musculo infraespinoso, el cual hace parte del manguito rotador, causada por una compresión del nervio supraescapular.
Este se localizaba inferior a la fosa supraescapular y distal a la salida de la rama que inerva al músculo supraespinoso, también parte del manguito.
El paciente consultó por debilidad y dolor en el hombro. Dos días antes había presentado un trauma menor en este sitio, observando la espina de la escapula muy prominente, por lo cual consultó. Dicha prominencia no se debió al trauma sino a la atrofia antigua del músculo infraespinoso. Lo llevé a cirugía y le realicé artroscopia drenaje y desbridamiento del quiste, con reparación del labrum posterior. Lo habitual en este tipo de quistes es encontrar una lesión del labrum, siendo esta la causante del problema. Por esta se filtra líquido articular que se acumula y forma el quiste.
Este tipo de quistes al comprimir el nervio supra escapular quien lleva la inervación al manguito rotador, puede producir un cuadro clínico con síntomas de lesión del manguito rotador, la diferencia es que se presenta una atrofia muscular importante y el tratamiento conservador con fisioterapia falla y se hace necesario el manejo quirúrgico.
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