Bilateral Complete Ossification of the Superior Transverse Scapular Ligament (original) (raw)
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BioMed Research International, 2014
The suprascapular notch is covered superiorly by the superior transverse scapular ligament. This region is the most common place of suprascapular nerve entrapment formation. The study was performed on 812 specimens: 86 dry scapulae, 104 formalin-fixed cadaveric shoulders, and 622 computer topography scans of scapulae. In the cases with completely ossified superior transverse scapular ligament, the following measurements were performed: proximal and distal width of the bony bridge, middle transverse and vertical diameter of the suprascapular foramen, and area of the suprascapular foramen. An ossified superior transverse scapular ligament was observed more often in men and in the right scapula. The mean age of the subjects with a completely ossified superior transverse scapular ligament was found to be similar than in those without ossification. The ossified band-shaped type of superior transverse scapular ligament was more common than the fan-shaped type and reduced the space below the ligament to a significantly greater degree. The ossified band-shaped type should be taken into consideration as a potential risk factor in the formation of suprascapular nerve entrapment. It could explain the comparable frequency of neuropathy in various populations throughout the world despite the significant differences between them in occurrence of ossified superior transverse scapular ligament.
Complete Ossification of the Superior Transverse Scapular Ligament in an Turkish Male Adult
International Journal of Morphology, 2013
Scapula has three margins and angles and located posterolateral of thorax. One of the anatomical structures of scapula is suprascapular notch located medial to coracoid process base. Suprascapular notch can be seen in different shapes and depths. Suprascapular notch is surrounded by transverse scapular ligament which is a short and strong ligament. Suprascapular notch creates an osteofibrosis passage with this structure within suprascapular nerve passes. It has been reported that this osteofibrosis structure can intirely or partially ossify. All lesions of nerves occured in course as result of exposure to compression, tension and bending are called entrapment neuropathy. Like other peripheral nerves, suprascapular nerve can be exposed to compression while passing suprascapular notch. As a result of this compression suprascapular entrapment neuropathy may occur. There are direct trauma, repetitive microtrauma, neurit, progressive compressive lesions in suprascapular entrapment neuropathies etiology. A suprascapular notch taken foramen shape can be a predisposing factor to entrapment neuropathy. In the retrospective screening from Necmettin Erbakan University, Meram Medical Faculty, Department of Radiology archive, a male patient at age 68 with suprascapular notch variation has been detected. This patient's right suprascapular notch had became foramen by an osseous bridge. Diameters of foramen has been measured as 5.27 mm transverse 6.48 mm vertical. We believe having detailed knowledge of suprascapular notch is significant as a possible course of back and shoulder pain is entrapment of suprascapular nerve in suprascapular notch causing nerve paralyses, and it will give a right direction to clinicians in surgical practices.
2013
Scapula has three margins and angles and located posterolateral of thorax. One of the anatomical structures of scapula is suprascapular notch located medial to coracoid process base. Suprascapular notch can be seen in different shapes and depths. Suprascapular notch is surrounded by transverse scapular ligament which is a short and strong ligament. Suprascapular notch creates an osteofibrosis passage with this structure within suprascapular nerve passes. It has been reported that this osteofibrosis structure can intirely or partially ossify. All lesions of nerves occured in course as result of exposure to compression, tension and bending are called entrapment neuropathy. Like other peripheral nerves, suprascapular nerve can be exposed to compression while passing suprascapular notch. As a result of this compression suprascapular entrapment neuropathy may occur. There are direct trauma, repetitive microtrauma, neurit, progressive compressive lesions in suprascapular entrapment neuropathies etiology. A suprascapular notch taken foramen shape can be a predisposing factor to entrapment neuropathy. In the retrospective screening from Necmettin Erbakan University, Meram Medical Faculty, Department of Radiology archive, a male patient at age 68 with suprascapular notch variation has been detected. This patient's right suprascapular notch had became foramen by an osseous bridge. Diameters of foramen has been measured as 5.27 mm transverse 6.48 mm vertical. We believe having detailed knowledge of suprascapular notch is significant as a possible course of back and shoulder pain is entrapment of suprascapular nerve in suprascapular notch causing nerve paralyses, and it will give a right direction to clinicians in surgical practices.
International Journal of Anatomy and Research, 2019
Supra scapular notch is present on the superior border of the scapula. It gives passage to the suprascapular nerve. The supra scapular notch is bridged by the superior transverse scapular ligament and converted into supra scapular foramen. Ossification of this superior transverse scapular ligament may compress or entrap the suprascapular nerve which is passing through the foramen. The present study was undertaken to find out the incidence of occurrence of the ossification of superior transverse scapular ligament. Materials and methods: 89 scapulae were collected from the Department of Anatomy, Deccan College of Medical Sciences, Hyderabad. Damaged scapulae were excluded. All the scapulae were examined to note the incidence of occurrence of the ossification of the transverse scapular ligament and also any variations of it. Results: 15 scapulae were bearing ossified superior transverse scapular ligament in which 6 were of the right side and 6 were of the left side. Duplication of the superior transverse scapular ligament was observed in one left scapula. Incomplete ossification was observed in 2 scapulae 1 on the right and another on the left side. Conclusion: Based on the results of the present study, ossification of the transverse scapular ligament is not very rare in this populations group. So, the knowledge about the ossification of superior transverse scapular ligament and the risk of supra scapular nerve entrapment is very much essential for the physicians and the surgeons while dealing with these cases.
International Journal of Anatomy and Research
Background: Suprascapular notch is an indentation in the superior border of the scapula which is just medical to base of the coracoid process. The superior transverse scapular ligament (STSL) ossifies to form suprascapular foramen and serves as passage for suprascapular nerve. Morphological variations of SSN play a crucial role in the suprascapular neuropathy due to nerve entrapment. Objective: To study variations of suprascapular notch in dry scapulae and to find out and compare the incidence of ossified STSL/ suprascapular foramina with previous studies from different regions. Materials and Methods: The present study was conducted on 106 dry human scapulae of unknown age and sex in the Department of Anatomy, ACPM Medical College, Dhule. This was an observational study over a period of nine months from July 2016 to March 2017.The scapulae were examined to assess morphological variations of SSN and various types were classified as per Rengachary et al. The results of present work were compared with previous studies. Result: Complete ossification of STSL leading to foramina (Type VI) was observed in 09(8.5%) out of 106 scapulae. The most frequent type seen was Type III in 43(40.6%) scapulae, second most common-Type I-26.4%, and rest were Type II-17%,Type IV-4.7%, and Type V-2.8%. Conclusion: Better understanding and thorough knowledge of variations of suprascapular notch vis-à-vis ossified STSL leading to foramina is important for anatomists and clinicians (surgeons and orthopedics) for making proper diagnosis of suprascapular neuropathy and planning the most suitable surgical corrections.
Journal of Shoulder and Elbow Surgery, 2013
Background: The suprascapular region is the most common site of suprascapular nerve entrapment. The aim of the present study was to determine the morphologic variation of the superior transverse scapular ligament (STSL) and measure the reduction in size of the suprascapular opening. Other structures that might be potentially significant during open and arthroscopic procedures in this region are also described. Materials and methods: The study used 86 randomized formalin-fixed human cadaveric shoulders. After dissection of the suprascapular region, the following measurements were defined and collected for every STSL: length, proximal width, distal width, and thickness at the proximal and distal ends. Measurements were also taken of the area of the suprascapular opening (aSSO) and the middle width of the suprascapular opening (mwSSO). Results: Three types of STSL may be distinguished: a fan-shaped type (54.6%), a band-shaped type (41.9%), and a bifid type (3.5%). Statistically significant differences between the specimens with fanshaped and band-shaped types of STSL were observed in aSSO and mwSSO of the suprascapular opening. Anterior coracoscapular ligaments (ACSL) were present in 44 of 86 shoulders. The aSSO and mwSSO were smaller in specimens with an ACSL than in those without; however, this difference was only significant in the band-shaped type of STSL. Conclusion: Knowledge of the morphologic variations of STSL presented in this study is important for better understanding the possible anatomic conditions that can promote suprascapular nerve entrapment and should be taken into particular consideration during surgical and arthroscopic procedures around the suprascapular notch.
Ossification of the superior transverse scapular ligament and its clinical importance
2018
The ossification of the superior transverse scapular ligament and the morphological variantions of the scapular notch can lead to entrapment of the suprascapular nerve. During the study routine on the anatomy laboratory, it was found on a right scapula an ossification of the superior transverse scapular ligament, measuring 11.15 mm in lenght, 5.93 mm in height and 2.54 mm in depth. The ossification of the superior transverse scapular ligament surely seems to be an event responsable for the entrapment of the suprascapular nerve and some painful syndromes on the shoulder.
Anomalous Suprascapular Foramen in Adult Indian Scapula
MOJ Clinical & Medical Case Reports, 2017
The present study was conducted to highlight the variations of suprascapular foramen in an extensive osteological study of 100 dry scapulae. Attempt was also made to establish a comparison between osteological and radiological appearance of such variations. In only one scapula, an ossified superior transverse scapular ligament was discovered which converted the suprascapular notch into a suprascapular foramen. The ossified superior transverse scapular ligament presented as an oblique bony ridge, fan shaped in appearance. Conversion of suprascapular notch into a foramen is considered as a potential risk factor for the suprascapular nerve entrapment syndrome. The present day neurosurgeons, radiologists and orthopedic surgeons should be aware of such bony abnormalities, as these are imperative in preoperative radiological assessment and intraoperative modification of surgical procedures during arthroscopic decompression of suprascapular nerve.
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.