About high scapula

What is high scapula?

Sprengel Deformity is a rare congenital disorder in which the shoulder blade is displaced upward. The elevated shoulder blade causes a lump in the back of the base of the neck and may limit movement of the arm on the affected side. This disorder typically appears at birth for no apparent reason although there have been cases in which the disorder was inherited as an autosomal dominant trait. Other skeletal and muscular abnormalities have been found in association with Sprengel Deformity.

What are the symptoms for high scapula?

Often, only one shoulder blade (i.e. one side of the body) is affected. However, in some cases both shoulder blades can be affected. Generally, these abnormalities tend to be painless. The degree of elevation and displacement in Sprengel deformity can vary greatly from one person to another and can range from very mild, in which the abnormality cannot be seen when wearing clothes, to severe cases in which the shoulder is noticeably elevated. Milder cases can go undiagnosed until adolescence. The reported range of displacement of the shoulder blade is 2-10 centimeters, or approximately a half an inch to 4 inches.

The main signs and symptoms of Sprengel deformity are limited or restricted movement of the arm and shoulder blade on the affected side as well as the cervical spine. Some affected individuals have neck deformities as well, ranging from mild tilting (torticollis) to severe spine deformity. In severe cases, the neck may be abnormally Short (brevicollis) and webbed.

In approximately 75% of cases, Sprengel deformity is associated with additional abnormalities, most commonly Klippel-Feil syndrome, but also scoliosis, spina bifida, hemivertebrae, rib segmentation abnormalities, clavicular abnormalities, and underdevelopment (hypoplasia) of neck or shoulder muscles.

What are the causes for high scapula?

The exact underlying cause is unknown. Most cases occur randomly, for no apparent reason (sporadically).

Researchers believe that the disorder occurs early during fetal development. In a developing fetus, the shoulder blade initially forms near the vertebrae of the cervical spine. During the third month of pregnancy, the shoulder blade moves or ‘migrates’ down to its normal position. In individuals with Sprengel deformity this migration fails to occur. The developing shoulder blade remains too high and often fails to fully form. In some cases, an abnormal connection made up of fibrous bands of tissue develops between the displaced shoulder blade and the spine (omovertebral bar), which can severely limit movement of the shoulder. This structure may harden (ossify) and become known as the omovertebral bone.

In extremely rare cases, Sprengel deformity has run in families suggesting that in these cases the disorder may occur as a genetic defect inherited in an autosomal dominant manner.

What are the treatments for high scapula?

The mainstay of treatment for Sprengel deformity is surgery. However, many affected individuals will not require surgical intervention because they have a mild form of the disorder with minimal restriction of movement. Children between 3-8 years of age are the best candidates for surgical intervention, which is based on significant cosmetic or functional (i.e. significant restriction of movement) concerns. In some cases, shoulder blade position and/or shoulder range of motion can still be abnormal even after surgery. The presence of additional abnormalities can affect the outcome of surgery. An omovertebral bone or its fibrous equivalent must be removed during surgery.

There are several surgical procedures used to treat individuals with Sprengel deformity. The main two are the modified Green scapuloplasty and the Woodward procedure. Decisions concerning the specific surgical technique to use is best made with physicians and other members of the healthcare team in close consultation with the family based upon the specifics of the individual case, a thorough discussion of potential discussion of the potential benefits and risks, including long-term effects and other appropriate factors.

Is there a cure/medications for high scapula?

The high scapula, also known as Scapula Elevata, or Sprengel Deformity, is a rare congenital disorder.

There isn’t any cure for this disease; however, treatments can help.

1. Surgery is the standard treatment for Sprengel deformity. However, many affected individuals will not require surgical intervention because they have a mild form of the disorder with minimal restriction of movement.
2. Children between 3-8 years of age are the best candidates for surgical intervention based on significant cosmetic or functional concerns.
3. In some cases, shoulder blade position and/or shoulder range of motion can still be abnormal even after surgery. The presence of additional abnormalities can affect the outcome of surgery. An omovertebral bone or its fibrous equivalent must be removed during surgery.
4. There are several surgical procedures used to treat individuals with Sprengel deformity. The main two are the modified Green scapuloplasty and the Woodward procedure.
5. Decisions concerning the specific surgical technique to use are decided by physicians and other members of the healthcare team in close consultation with the family based upon the specifics of the individual case, a thorough discussion of potential benefits and risks, including long-term effects and other appropriate factors.

Symptoms
Limited or restricted movement of the arm and shoulder blade on the affected side as well as the cervical spine
Conditions
Shoulder and spine deformity
Drugs
Surgery

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