Morphometry of the suprascapular nerve in the supraspinous fossa (original) (raw)
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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.
A note on the anatomy of the supraspinatus muscle
Archives of Orthopaedic and Trauma Surgery, 1992
The muscles and tendons of the rotator cuff of 37 fixed cadaver shoulder joints were dissected. In ten shoulder joints devoid of gross pathological lesions it was found that the supraspinatus muscle was inserted at two points-mainly into the major tubercle and partly into the lesser tubercle of the humerus. In one case of six, an additional insertion clearly occurred in a shoulder joint with rotator cuff tear.
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.
Suprascapular Nerve: Anatomical and Clinical Study
The suprascapular nerve arises from the upper trunk (Erb's point) of the brachial plexus in the posterior triangle of the neck.This research was conducted to study the anatomy of the suprascapular nerve in the scapular region and its relation to both suprascapular and spinoglenoid notches. This data is very important in suprascapular nerve block and suprascapular nerve surgical decompression. Dissection of 20 scapular regions of 10 formalin preserved male cadavers was done. Also thirty three adult patients; 26 males and 7 females suffering from vague shoulder pain subjected to suprascapular nerve surgical decompression. In all cadaveric specimens, careful dissection and anatomical study of suprascapular nerve regarding its course, distribution and relations was carried out. Origin of the nerve was demonstrated from upper trunk of the brachial plexus. Passage of the nerve through a narrow medial compartment of supraglenoid canal in all cases has been identified. Measurements of two important diameters relevant to suprascapular notch were also reported. The transverse scapular ligament was identified to be of uniform thickness. In the clinical study of all cases with suprascapular nerve entrapment regardless its etiology whether idiopathic or not, conservative therapy by means of the exercise was of limited value especially for the motor affection. All of the cases were subjected to surgical maneuverer to decompress the nerve. It is concluded that the anatomical findings allow better choice of the surgical procedure, more precise surgical dissection, better results and fewer complications.
Surgical and Radiologic Anatomy, 2007
Background The supraclavicular (intermediate) and supraacromial (lateral) branches of supraclavicular nerves contribute to the innervation of the thorax, shoulder, and neck. Despite their clinical and surgical interest, they are not often considered for descriptive anatomy. The goal of this work was to clarify the morphometric knowledge of these two branches and to discuss the clinical relevance of the anatomical features. Methods Intermediate and lateral branches of supraclavicular nerves of 14 necks (8 embalmed cadavers) were dissected using magnifying glasses. Macroscopic parameters were measured and nerve relationships were recorded. Results In 12 cases, the intermediate and lateral branches arose from a common trunk behind the posterior border of the sternocleidomastoideus muscle, at a mean distance of 96 mm (70-137) from the sternal angle. The intermediate branch divided into two or three secondary rami. Its most internal ramus crossed the middle third of the clavicle and its most external ramus crossed the second lateral quarter of the bone. The distance between the two farthest nerve endings of this branch was at mean of 98 mm (85-125). The mean distance of the most distal nerve ending from the clavicle was 46 mm (30-63). The lateral branch divided into two or three rami in eight cases and did not divide in six cases. Its most anterior rami crossed the trapezius muscle at a mean distance from the clavicular insertion of 17 mm (12-24). In 13 cases, these rami ended posteriorly or at the level of the anterior border of the acromion process and in 12 cases, they ended laterally or at the level of the acromion process with a mean distance 10.4 mm (0-24). Conclusion In case of deWciency of these nerves, pain or sensitive deWcit can occur without motor trouble. The factors of acute or chronic injury are direct compression, nerve stretching, repetitive stresses, and direct wound. Moreover, several neck or shoulder surgical approaches are dangerous for these nerves.
Journal of Shoulder and Elbow Surgery, 2011
Hypothesis/background: Suprascapular nerve injury may be a complication during shoulder arthroscopy. Our aim was to verify the reliability of the existing data, assess the differences between scapulae in the 2 genders and in the same subject, obtain a safe zone useful to avoid iatrogenic nerve lesions, and analyze the existing correlations between the scapular dimensions and the safe zone. Methods: We examined 500 dried scapulae, measuring 6 distances for each one, referring to the scapular body, glenoid, and the course of the suprascapular nerve, also catalogued according to gender and side. Differences due to gender were assessed comparing mean AE sd of each distance in males and females; paired t test was used to compare distances deriving from each couple. Successively, we calculated our safe zone and Pearson's correlation. Results: We found nonsignificant differences between the right and left distances deriving from each couple; differences due to gender were stated. We defined 3 kinds of safe zones referring to: 500 scapulae; males (139 scapulae) and females (147 scapulae). The correlation indexes calculated between the axis of the scapular body and glenoid, and the posterosuperior distance (referring to the suprascapular nerve) were 0.624, 0.694, 0.675, 0.638; while those with the posterior distance were 0.230, 0.294, 0.232, 0.284. Discussion/conclusions: Knowledge of the safe zone, for avoiding suprascapular nerve injury, is important; gender and specific scapular dimensions should be evaluated, as they influence the dimensions of the safe zone. The linear predictors should be used to obtain specific values of the posterosuperior limit in each patient.
Anatomical considerations of the suprascapular nerve in rotator cuff repairs
Anatomy research international, 2014
Introduction. When using the double interval slide technique for arthroscopic repair of chronic large or massive rotator cuff tears, the posterior interval release is directed toward the scapular spine until the fat pad that protects the suprascapular nerve is reached. Injury to the suprascapular nerve can occur due to the nerve's proximity to the operative field. This study aimed to identify safe margins for avoiding injury to the suprascapular nerve. Materials and Methods. For 20 shoulders in ten cadavers, the distance was measured from the suprascapular notch to the glenoid rim, the articular margin of the rotator cuff footprint, and the lateral border of the acromion. Results. From the suprascapular notch, the suprascapular nerve coursed an average of 3.42 cm to the glenoid rim, 5.34 cm to the articular margin of the rotator cuff footprint, and 6.09 cm to the lateral border of the acromion. Conclusions. The results of this study define a safe zone, using anatomic landmarks, ...
Knee Surgery, Sports Traumatology, Arthroscopy, 2014
Purpose The purpose of the study is to identify the safe zone in which the surgeon can place the screws for fixation of the coracoid graft during the Latarjet procedure to avoid injuries of the suprascapular nerve with the shoulder in internal and external rotation. Methods The dissection on twelve fresh-frozen shoulders was performed according to a standard posterior approach to the gleno-humeral joint. The suprascapular nerve and its branches for the infraspinatus muscle were identified at the spinoglenoid notch region. Then, the distance between the glenoid and the suprascapular nerve at the spinoglenoid notch region was measured by using a ruler with the shoulder at 90°internal rotation and at 90°of external rotation.
Innervation of the Human Shoulder Joint and Its Implications for Surgery
Clinical Orthopaedics and Related Research, 1996
The distribution and variability of the nerves innervating the shoulder joint were determined in 25 fresh human adult cadavers using 3.5x magnification for dissection. The results showed that 100% of the specimens had dual innervation of the coracoclavicular ligaments, the subacromial bursa, and the acromioclavicular joint. This dual innervation was from the articular branches of the suprascapular nerve and of the lateral pectoral nerve. Constant relationship of these 2 nerves to bony landmarks will permit anesthetic blocks for diagnosis and possible therapeutic intervention. A consistent pattern of innervation of the posterior and inferior shoulder joints also is described.