Treatment of Patients With Spinoglenoid Cysts Associated With Superior Labral Tears Without Cyst Aspiration, Debridement, or Excision

Purpose: To describe a case series of 10 consecutive patients with spinoglenoid cysts and associated superior labral tears treated by labral repair performed by the same surgeon without formal cyst aspiration, debridement, or excision. Methods: Ten patients with spinoglenoid cysts and associated superior labral tears demonstrated on preoperative magnetic resonance imaging (MRI) were retrospectively reviewed. Evidence of weakness on examination was further evaluated through nerve conduction studies. All 10 patients underwent surgical repair of the labral tear performed by the same surgeon without formal cyst aspiration, debridement, or excision. Postoperatively, detailed shoulder and neurologic examinations were performed, and follow-up nerve conduction studies and MRIs were obtained. Results: Ten patients were evaluated clinically at a mean of 10.2 months after surgical repair (range, 6 to 27 months). In all, 8 males and 2 females of average age 47.7 years (range, 35 to 56 years) were studied. Preoperative examination revealed that 6 patients had external rotation weakness. Nerve conduction studies performed in these 6 patients confirmed suprascapular neuropathy in 4 of them. Labral repair without formal cyst excision resulted in successful outcomes for all 10 patients after spinoglenoid cysts associated with superior labral tears had been diagnosed. All 4 patients with suprascapular neuropathy recovered strength and demonstrated normal nerve conduction studies postoperatively. In 8 of 10 patients, MRIs performed postoperatively demonstrated complete resolution of the cyst, along with labral healing. All patients were able to return to work with no restrictions on activities, and all were satisfied with their outcomes. Conclusions: This study demonstrated successful clinical, electromyographic, and MRI outcomes for patients with spinoglenoid cysts and superior labral tears, who were treated by labral repair without formal cyst excision. Treatment given for intra-articular disease is the key component of surgical management. Level of Evidence: Level IV, case series study.

Key Words:  Spinoglenoid cyst , Superior labrum , SLAP tear