Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 12, Issue 2 , Pages 182-186, April 1996

Neurohistology of the subacromial space

  • Todd B. Soifer, M.D.

      Affiliations

    • Anatomy Laboratory, Kingsbrook Jewish Medical Center, Brooklyn, New York U.S.A.
  • ,
  • Howard J. Levy, M.D.

      Affiliations

    • Corresponding Author InformationAddress correspondence and reprint requests to Howard J. Levy, M.D., Beth Israel Orthopaedic Associates, 10 Union Square East, New York, NY 10003, U.S.A.
    • Division of Orthopaedic Surgery, Beth Israel Medical Center, New York, New York U.S.A.
  • ,
  • Felice Miller Soifer, M.D.

      Affiliations

    • Anatomy Laboratory, Kingsbrook Jewish Medical Center, Brooklyn, New York U.S.A.
  • ,
  • Fredric Kleinbart, M.D.

      Affiliations

    • Anatomy Laboratory, Kingsbrook Jewish Medical Center, Brooklyn, New York U.S.A.
  • ,
  • Vincent Vigorita, M.D.

      Affiliations

    • Anatomy Laboratory, Kingsbrook Jewish Medical Center, Brooklyn, New York U.S.A.
  • ,
  • Eli Bryk, M.D.

      Affiliations

    • Anatomy Laboratory, Kingsbrook Jewish Medical Center, Brooklyn, New York U.S.A.

Abstract 

Subacromial decompression is one of the most commonly performed shoulder procedures. Debridement of the subacromial soft tissues is a critical part of the procedure. However, the extent of soft tissue debridement is not well defined. The purpose of this study was to identify neural elements within the soft tissues composing the subacromial space. Using special immunohistochemical stains and electron microscopy, neural elements were identified within the subacromial bursa, rotator cuff tendon, biceps tendon and tendon sheat, and transverse humeral ligament. There was a significantly richer supply of free nerve fibers in the bursa compared with the other tissues. The nociceptive information relayed by these fibers may be responsible for the pain associated with impingement syndrome.

Keywords:  Subacromial bursa, Neural elements

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 Presented at the American Academy of Orthopaedic Surgeons 61st Annual Meeting, New Orleans, Louisiana, February, 1994, and the Arthroscopy Association of North America 13th Annual Meeting, Orlando, Florida, April 1994.

PII: S0749-8063(96)90008-0

Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 12, Issue 2 , Pages 182-186, April 1996