Suprascapular Nerve: Anatomical and Clinical Study (original) (raw)
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Morphometry of the suprascapular nerve in the supraspinous fossa
European journal of anatomy, 2016
We describe the supraescapular region’s anatomy providing distances between osseous landmarks (supraglenoid tubercle, suprascapular notch, glenoid rim, scapular spine) and measuring the total length of the suprascapular nerve (ssn), to determine ideal places or safe zones for shoulder surgery. Fifty shoulders from cadavers belonging to the Human Anatomy and Embryology donated under consent of the Spanish law were studied. The course of the nerve in each shoulder has been defined by measuring the distances from the supraglenoid tubercle to the suprascapular notch and to the scapular spine, the distance from the midpoint of the posterior glenoid rim to the base of the scapular spine, and finally the total length of the nerve. After leaving the suprascapular notch, the ssn courses posteriorly and laterally deep to the supraspinatus muscle to reach the base of the scapular spine. The distance from the supraglenoid tubercle to the notch averaged 3.54 cm (range 3 - 4.1 cm) and the distanc...
Original portals for arthroscopic decompression of the suprascapular nerve: An anatomic study
Journal of Shoulder and Elbow Surgery, 2008
Operative treatment of suprascapular nerve entrapment consists of decompression of the nerve, either at the suprascapular notch or the spinoglenoid notch. The aim of this study was to describe new arthroscopic portals to approach these 2 notches at the same time. Twenty shoulders in 10 fresh frozen cadavers were investigated. Four portals were used in line with the scapular spine (S1, S2, S3, S4). The suprascapular pedicle was visualized passing under the supraspinatus muscle. The technique was performed for each specimen. The efficacy and safety of the technique were assessed by open dissection. No injury to the nerve was identified after performing the technique. Decompression was complete in 18 of 20 cases at the suprascapular notch and in all cases at the spinoglenoid notch. With this technique, arthroscopic decompression of the nerve at the suprascapular and spinoglenoid notches is anatomically possible. (J Shoulder Elbow Surg 2008;17:616-623.) The suprascapular nerve is a motor and sensory nerve that supplies innervation to the supraspinatus and infraspinatus muscles. Injuries of the nerve cause shoulder pain and weakness in abduction and external rotation. There are several possible causes, but entrapment of the nerve is the most common and can be treated surgically. Entrapment can occur in 2 locations, the suprascapular and the spinoglenoid notches ( ). Decompression of the nerve consists of release of the superior (suprascapular) or inferior (spinoglenoid) transverse ligaments, or both, or resection of a compressing lesion.
International Journal of Anatomy and Research, 2016
Suprascapular notch is the common site for entrapment of supra scapular nerve. SSN compression usually presents with vague pain across the scapula or dull shoulder ache. It is more common in overhead athletes like volleyball players. Better knowledge of the suprascapular notch anatomy may help to prevent and to assess more accurately suprascapular nerve entrapment syndrome. The regional variations in the incidence of complete absence of suprascapular notch and its involvement in suprascapular nerve entrapment neuropathy should be kept in mind during surgical or arthroscopic shoulder procedures. Materials and Methods: The present study is done on the basis of classification proposed by Iqbal and Natis et al. 126 scapulae of North Indian origin were taken for the study. Morphometric measurement and shape of each supra scapular notch was studied. Results: The present study showed Type II supra scapular notch (TD>VL) as the most common Type which was found in 47.6%.of specimens. The most common shape of SSN found was U shaped (46%) followed by V shaped & J shaped at 24.6%& 15.9% respectively. Complete ossification of STSL leading to formation of bony foramen was observed in 2.4% while both notch and a bony foramen together was not found even in a single scapula in our study. Conclusion: The shape & dimensions of SSN and complete ossification of STSL has been shown to be associated with increased risk of supra scapular nerve entrapment, resulting in weakness and wasting of supraspinatus and infraspinatus muscles. Anatomical knowledge of such variations should be kept in mind during surgical and arthroscopic shoulder procedures.
The suprascapular nerve and its articular branch to the acromioclavicular joint: an anatomic study
Journal of Shoulder and Elbow Surgery, 2011
Hypothesis: The suprascapular nerve and its articular branch innervate the acromioclavicular (AC) joint. Documenting the detailed anatomy of this innervation in the AC joint, including the pertinent surgical and anatomic relationships of the suprascapular nerve and its branches to the AC joint, will aid in the prevention of injury and the reduction of risk of denervation during shoulder surgery. Materials and methods: Twelve shoulders from 6 embalmed human cadavers were bilaterally dissected to study the course of the suprascapular nerve and its motor and sensory branches. Results: The sensory branch runs superiorly to the supraspinatus muscle towards the AC joint. The average distance from the supraglenoid tubercle to the nerve at the coracoid base was 15 mm. The average distance from the coracoclavicular ligaments to the nerve at the coracoid base was 6 mm. The average distance from the spinoglenoid notch to the sensory branch at the suprascapular notch was 22 mm. The average length of the sensory branch was 30 mm. In half of the specimen shoulders, the suprascapular artery accompanied the nerve at the suprascapular notch under the transverse scapular ligament. Discussion: The innervation of the AC joint by the suprascapular nerve has been described, along with pertinent distances to anatomic landmarks. The sensory branch of the suprascapular nerve, which passed through the scapular notch inferior to the transverse scapular ligament, was found in 100% of the study specimens. Conclusion: The sensory branch of the suprascapular nerve runs superiorly to the supraspinatus muscle towards the AC joint. The detailed information can be used to help decrease the risk of nerve injury during shoulder surgery and to aid in effectively diagnosing and treating AC joint-related disorders. Level of evidence: Anatomic Notes.
International Journal of Anatomy and Research, 2017
Background: The scapula is a large, flat, triangular bone which lies on the postero-lateral aspect of the chest wall Suprascapular nerve entrapment depends on the size and shape of suprascapular notch. Purpose of the study: Aim of the present study is to classify SSN based on morphometry according to Michal Polguj and to obtain a safe zone which would be useful to avoid iatrogenic nerve lesion and to verify the reliability of the existing data for the management of entrapment neuropathy. Materials and Methods: Study included 60 dried human scapulae obtained from the Department of Anatomy, Pondicherry institute of medical sciences. Three measurements were defined and collected for each SSN, Maximum depth (MD), Superior transverse diameter (STD) and Middle transverse diameters (MTD) based on which suprascapular notch was classified. Results: In the present study type IIIC was the most common type with 83.3%. The mean of maximum depth was 6.87mm in type I whereas in type III it was 5.3mm. The mean of STD was 1.98mm in type I whereas in type III it was 10.03mm. The mean of MTD was 2mm in type I whereas in type III it was 6. 56mm.The distance between the SSN and the supraglenoid tubercle (AB) and the distance between posterior rim of glenoid cavity and the base of scapular spine (CD) were larger in Type V followed by type IV, III and Type I. The mean distance of AB for all the types were 24.79mm and for CD mean was 13.07mm. Conclusion: Our study with morphometric variations of SSN may be helpful for the surgeons performing SN decompression especially by means of endoscopic techniques and measurements of safe zone may be helpful in the preoperative evaluations of patients with suprascapular neuropathies.
Knee Surgery, Sports Traumatology, Arthroscopy, 2014
Purpose The most common place for suprascapular nerve entrapment is the suprascapular notch. The aim of the study was to determine the morphological variation of the location of the suprascapular nerve, artery and vein, and measure the reduction in size of the suprascapular opening in each type of the passage. Methods A total of 106 human formalin-fixed cadaveric shoulders were included in the study. After dissection of the suprascapular region, the topography of the suprascapular nerve, artery and vein was evaluated. Additionally, the area of the suprascapular opening was measured using professional image analysis software. Results Four arrangements of the suprascapular vein, artery and nerve were distinguished with regard to the superior transverse scapular ligament: type I (61.3 %) (suprascapular artery was running above ligament, while suprascapular vein and nerve below it), type II (17 %) (both vessels pass above ligament, while nerve passes under it), type III (12.3 %) (suprascapular vessels and nerve lie under ligament) and type IV (9.4 %), which comprises the other variants of these structures. Statistically significant differences regarding the suprascapular opening were observed between the specimens with types II and III. Anterior coracoscapular ligaments were present in 55 from 106 shoulders. Conclusion The morphological variations described in this study are necessary to better understand the possible anatomical conditions which may promote suprascapular nerve entrapment (especially type III). They may be useful during open and endoscopic procedures at the suprascapular notch to prevent such complications as unexpected bleeding.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2009
Suprascapular nerve entrapment can cause disabling shoulder pain. Suprascapular nerve release is often performed for compression neuropathy and to release pressure on the nerve associated with arthroscopic labral repair. This report describes a novel all-arthroscopic technique for decompression of the suprascapular nerve at the suprascapular notch or spinoglenoid notch through a subacromial approach. Through the subacromial space, spinoglenoid notch cysts can be visualized between the supraspinatus and infraspinatus at the base of the scapular spine. While viewing the subacromial space through the lateral portal, the surgeon can use a shaver through the posterior portal to decompress a spinoglenoid notch cyst at the base of the scapular spine. To decompress the suprascapular nerve at the suprascapular notch, a shaver through the posterior portal removes the soft tissue on the acromion and distal clavicle to expose the coracoclavicular ligaments. The medial border of the conoid ligament is identified and followed to its coracoid attachment. The supraspinatus muscle is retracted with a blunt trocar placed through an accessory Neviaser portal. The transverse scapular ligament, which courses inferior to the suprascapular artery, is sectioned with arthroscopic scissors, and the suprascapular nerve is decompressed.
Anatomy of Suprascapular Notch (SSN), Suprascapular Nerve Entrapment and its Clinical Significance
The suprascapular notch is located on the lateral part of the superior border of the scapula, medial to the coracoid process. It is covered by the superior transverse scapular ligament which gives passage to suprascapular nerve to supraspinous fossa. Suprascapular nerve entrapment may occur due to the different morphology of the suprascapular notch or due to ossification of the superior transverse scapular ligament. The suprascapular nerve passes through several osseoligamentous structures and can be compressed in several locations. Morphometric studies of suprascapular notch have been done in various studies. The aim of the present study is to review the morphometric studies of suprascapular notch, identify the most common type of notch. The suprascapular notch (SSN) is important, as it is major risk factor for suprascapular nerve entrapment syndrome. The study was conducted at Apollo Institute of Medical Sciences,Hyderabad,Telangana State,India. Fifty scapulae were used for the study of the suprascapular notch anatomy which may help to prevent and to assess more accurately suprascapular nerve entrapment syndrome.