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The variable morphology of suprascapular nerve and vessels at suprascapular notch: a proposal for classification and its potential clinical implications.

Polguj M, Rożniecki J, Sibiński M, Grzegorzewski A, Majos A, Topol M - Knee Surg Sports Traumatol Arthrosc (2014)

Bottom Line: 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.They may be useful during open and endoscopic procedures at the suprascapular notch to prevent such complications as unexpected bleeding.

View Article: PubMed Central - PubMed

Affiliation: Department of Angiology, Medical University of Łódź, Narutowicza 60, 90-136, Łódź, Poland, michal.polguj@umed.lodz.pl.

ABSTRACT

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.

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Related in: MedlinePlus

Schematic arrangement of measurements of the suprascapular opening in different types of suprascapular nerve, artery and vein arrangement. 1 suprascapular artery, 2 suprascapular vein, 3 suprascapular nerve, 4 superior transverse scapular ligament, aSSO area of the suprascapular opening
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Fig1: Schematic arrangement of measurements of the suprascapular opening in different types of suprascapular nerve, artery and vein arrangement. 1 suprascapular artery, 2 suprascapular vein, 3 suprascapular nerve, 4 superior transverse scapular ligament, aSSO area of the suprascapular opening

Mentions: To normalize measurements, all photographic documentation was obtained from a standardized position of the camera and shoulder. The same scale was used for all measurements. The shoulders were fixed with an adjustable clamp and ring stand at the same distance from the camera for each observation. Digital photographic documentation was processed in MultiScanBase v.18.03 software (Computer Scanning System II, Warsaw, Poland) to obtain the area of the suprascapular opening (aSSO) in various location of the suprascapular triad (Fig. 1). Each measurement was taken three times by one investigator, and the mean of the values was calculated. For the sake of the investigation, the area of the suprascapular opening was defined as the area limited superiorly by the inferior border of the superior transverse scapular ligament, laterally and medially by the osseous walls of the suprascapular notch, and inferiorly by the superior border of the anterior coracoscapular ligament or inferior border of the suprascapular notch for specimens without an anterior coracoscapular ligament. The diameters of the suprascapular nerve and artery were also measured.Fig. 1


The variable morphology of suprascapular nerve and vessels at suprascapular notch: a proposal for classification and its potential clinical implications.

Polguj M, Rożniecki J, Sibiński M, Grzegorzewski A, Majos A, Topol M - Knee Surg Sports Traumatol Arthrosc (2014)

Schematic arrangement of measurements of the suprascapular opening in different types of suprascapular nerve, artery and vein arrangement. 1 suprascapular artery, 2 suprascapular vein, 3 suprascapular nerve, 4 superior transverse scapular ligament, aSSO area of the suprascapular opening
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4555201&req=5

Fig1: Schematic arrangement of measurements of the suprascapular opening in different types of suprascapular nerve, artery and vein arrangement. 1 suprascapular artery, 2 suprascapular vein, 3 suprascapular nerve, 4 superior transverse scapular ligament, aSSO area of the suprascapular opening
Mentions: To normalize measurements, all photographic documentation was obtained from a standardized position of the camera and shoulder. The same scale was used for all measurements. The shoulders were fixed with an adjustable clamp and ring stand at the same distance from the camera for each observation. Digital photographic documentation was processed in MultiScanBase v.18.03 software (Computer Scanning System II, Warsaw, Poland) to obtain the area of the suprascapular opening (aSSO) in various location of the suprascapular triad (Fig. 1). Each measurement was taken three times by one investigator, and the mean of the values was calculated. For the sake of the investigation, the area of the suprascapular opening was defined as the area limited superiorly by the inferior border of the superior transverse scapular ligament, laterally and medially by the osseous walls of the suprascapular notch, and inferiorly by the superior border of the anterior coracoscapular ligament or inferior border of the suprascapular notch for specimens without an anterior coracoscapular ligament. The diameters of the suprascapular nerve and artery were also measured.Fig. 1

Bottom Line: 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.They may be useful during open and endoscopic procedures at the suprascapular notch to prevent such complications as unexpected bleeding.

View Article: PubMed Central - PubMed

Affiliation: Department of Angiology, Medical University of Łódź, Narutowicza 60, 90-136, Łódź, Poland, michal.polguj@umed.lodz.pl.

ABSTRACT

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.

Show MeSH
Related in: MedlinePlus