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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

Type I arrangement of the suprascapular nerve, artery and vein at the suprascapular notch. a Structures at the cadaver, b schematic arrangements. 1 suprascapular artery, 2 suprascapular vein, 3 suprascapular nerve, 4 superior transverse scapular ligament. La lateral, Me medial
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Fig2: Type I arrangement of the suprascapular nerve, artery and vein at the suprascapular notch. a Structures at the cadaver, b schematic arrangements. 1 suprascapular artery, 2 suprascapular vein, 3 suprascapular nerve, 4 superior transverse scapular ligament. La lateral, Me medial

Mentions: Four types of suprascapular vein, artery and nerve location were distinguished in relation to the superior transverse scapular ligament. In type I (65/106–61.3 %), the suprascapular artery runs above the superior transverse scapular ligament, while the suprascapular vein and nerve run below it (Fig. 2). Type II (18/106–17 %) included specimens in which two vessels pass above the superior transverse scapular ligament, while the nerve is situated beneath it (Fig. 3). In type III (13/106–12.3 %), the suprascapular vessels and nerve lay directly under the ligament (Fig. 4). Type IV (10/106–9.4 %) comprised the other variants of these structures: among others, the occurrence of the accessory suprascapular veins, and the cases in which the analysed structures pass under the anterior coracoscapular ligament (Fig. 5). Double suprascapular veins were found on two extremities (2.4 %) (Fig. 5): in the first case, it passed above the superior transverse scapular ligament (Fig. 5a), and in the second case, below the anterior coracoscapular ligament (Fig. 5b).Fig. 2


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)

Type I arrangement of the suprascapular nerve, artery and vein at the suprascapular notch. a Structures at the cadaver, b schematic arrangements. 1 suprascapular artery, 2 suprascapular vein, 3 suprascapular nerve, 4 superior transverse scapular ligament. La lateral, Me medial
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Type I arrangement of the suprascapular nerve, artery and vein at the suprascapular notch. a Structures at the cadaver, b schematic arrangements. 1 suprascapular artery, 2 suprascapular vein, 3 suprascapular nerve, 4 superior transverse scapular ligament. La lateral, Me medial
Mentions: Four types of suprascapular vein, artery and nerve location were distinguished in relation to the superior transverse scapular ligament. In type I (65/106–61.3 %), the suprascapular artery runs above the superior transverse scapular ligament, while the suprascapular vein and nerve run below it (Fig. 2). Type II (18/106–17 %) included specimens in which two vessels pass above the superior transverse scapular ligament, while the nerve is situated beneath it (Fig. 3). In type III (13/106–12.3 %), the suprascapular vessels and nerve lay directly under the ligament (Fig. 4). Type IV (10/106–9.4 %) comprised the other variants of these structures: among others, the occurrence of the accessory suprascapular veins, and the cases in which the analysed structures pass under the anterior coracoscapular ligament (Fig. 5). Double suprascapular veins were found on two extremities (2.4 %) (Fig. 5): in the first case, it passed above the superior transverse scapular ligament (Fig. 5a), and in the second case, below the anterior coracoscapular ligament (Fig. 5b).Fig. 2

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