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February 20, 2026Journal of Shoulder and Elbow Surgery

Combined Serratus Anterior Plication and Pectoralis Minor Release Improves Clinical Outcomes in Refractory Scapular Dyskinesis with Neurological Involvement

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Authors

CKChristos KoukosFMFredy MontoyaAMAlejandro Marty

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Overview

Observational study improved outcomes in patients with scapular dyskinesis and neurogenic thoracic outlet syndrome, suggesting effective surgical intervention.

Key Points

  • The study aims to evaluate the effectiveness of the SAPPER technique for managing scapular dyskinesis associated with neurological symptoms.
  • Included patients with lower brachial plexus dysfunction and without peripheral nerve injury or rotator cuff tears
  • Evaluated clinical outcomes at least 6 months postoperatively
  • Performed subgroup analysis for the effect of preoperative medical treatment on outcomes.
  • Significant improvement in Constant Score, Subjective Shoulder Value, Numeric Rating Scale, and shoulder flexion (p < 0.0001)
  • All patients reported recovery of neurological symptoms
  • Lesions identified included SLAP (77.5%), rotator interval (27.5%), and medial pulley (70%) lesions.

Cite This Study

Koukos et al. (2026) studied this question.

synapsesocial.com/papers/6997b911baf9c852d8c25fb3https://doi.org/10.1016/j.jse.2026.01.018
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