Skip to main content

Variations in anatomy at the suprascapular notch possibly causing suprascapular nerve entrapment: an anatomical study

Abstract

The purpose of the study was to determine anatomical variations at the suprascapular notch for better understanding of possible predisposing factors for suprascapular nerve entrapment. We dissected 32 shoulders of 16 cadavers between the ages of 39 and 74 years. We observed abnormally oriented superior fibers of the subscapularis muscle in five shoulders of the 16 cadavers, which were covering the entire anterior surface of the suprascapular notch and significantly reducing the available space for the suprascapular nerve. We also detected anterior coracoscapular ligament in six of the 32 shoulders, and calcified superior transverse scapular ligament in four of the shoulders. In this study, we classified the variations for the superior transverse scapular ligament. In conclusion, knowing the anatomical variations in detail along the course of the suprascapular nerve might be important for better understanding of location and source of the entrapment syndrome, especially for individuals who are involved in violent overhead sports activities such as volleyball and baseball. To our knowledge, close relationship of subscapularis muscle with the suprascapular nerve as a possible risk factor for suprascapular nerve entrapment has not been mentioned previously.

This is a preview of subscription content, access via your institution.

Fig. 1.
Fig. 2.
Fig. 3. a
Fig. 4.
Fig. 5.

References

  1. Alon M, Weiss S, Fishel B, Dekel S (1988) Bilateral suprascapular nerve entrapment syndrome due to an anomalous transverse scapular ligament. Clin Orthop 234:31–33

    PubMed  Google Scholar 

  2. Avery BW, Pilon FM, Barclay JK (2002) Anterior coracoscapular ligament and suprascapular nerve entrapment. Clin Anat 15:383–386

    Article  CAS  PubMed  Google Scholar 

  3. Callahan JD, Scully TB, Shapiro SA, Worth RM (1991) Suprascapular nerve entrapment. J Neurosurg 74:893–896

    CAS  PubMed  Google Scholar 

  4. Celberman RH, Verdeck WN, Broadhead WT (1975) Suprascapular nerve entrapment syndrome. J Bone Joint Surgery 57A:1192–1197

    Google Scholar 

  5. Clein LJ (1975) Suprascapular entrapment neuropathy. Neurosurgery 43:337–342

    CAS  Google Scholar 

  6. Cohen SB, Dines DM, Moorman CT (1997) Familial calcification of the superior transverse scapular ligament causing neuropathy. Clin Orthop 334:131–135

    PubMed  Google Scholar 

  7. Cummins CA, Messer TM, Nuber GW (2000) Suprascapular nerve entrapment. J Bone Joint Surg Am 82:415–424

    CAS  PubMed  Google Scholar 

  8. Demirhan M, Imhoff AB, Debski RE, Patel PR, Fu FL, Woo SL (1998) The spinoglenoid ligament and its relationship to the suprascapular nerve. J Shoulder Elbow Surg 7:238–243

    CAS  PubMed  Google Scholar 

  9. Ganzhorn RW, Hocker JT, Horowitz M, Switzer HE (1981) Suprascapular nerve entrapment; a case report. J Bone Joint Surgery 63A:492–494

    Google Scholar 

  10. Hadley MN, Sonntag VKH, Pittman HW (1986) Suprascapular nerve entrapment; a summary of seven cases. J Neurosurg 64:843–848

    CAS  PubMed  Google Scholar 

  11. Holzgraefe M, Kukowski B, Eggert S (1994) Prevalence of latent and manifest suprascapular neuropathy in high performance volleyball players. Br J Sports Med 28:177–179

    CAS  PubMed  Google Scholar 

  12. Kiss G, Komar J (1990) Suprascapular nerve compression at the spinoglenoid notch. Muscle Nerve 13:556–557

    CAS  PubMed  Google Scholar 

  13. Moriggle B, Jax P, Milz S, Büttner A, Benjamin M (2001) Fibrocartilage at the entheses of the suprascapular (superior transverse scapular) ligament of man-a ligament spanning two regions of a single bone. J Anat 199:539–545

    Article  PubMed  Google Scholar 

  14. Padua L, Lo Monaco M, Paduo R, Gregori B, Valente EM, Tonali P (1996) Suprascapular nerve entrapment; neurophysiological localization in six cases. Acta Orthop Scand. 67:482–484

    Google Scholar 

  15. Post M, Mayer J (1987) Suprascapular nerve entrapment. Clin. Orthop 223:126–136

    PubMed  Google Scholar 

  16. Post M (1999) Diagnosis and treatment of suprascapular nerve entrapment. Clin Orthop 368:92–100

    PubMed  Google Scholar 

  17. Prescher A (2000) Anatomical basics, variations, and degenerative changes of the shoulder joint and shoulder girdle. Eur J Radiol 35:88–102

    Article  CAS  PubMed  Google Scholar 

  18. Rengachary SS, Neff JP, Singer PA, Brackett CF (1979) Suprascapular nerve entrapment neuropathy; a clinical, anatomical and comparative study; part 1, clinical study. Neurosurgery 5:441–446

    CAS  PubMed  Google Scholar 

  19. Rengachary SS, Burr D, Lucas S, Hassanein KM, Mohn MP, Matszke H (1979) Suprascapular entrapment neuropathy; a clinical, anatomical and comparative study; part 2, anatomical study. Neurosurgery 5:447–451

    CAS  PubMed  Google Scholar 

  20. Thompson WPL, Kopel HB (1959) Peripheral entrapment neuropathies of the upper extremity. N Engl J Med 260:1261

    CAS  Google Scholar 

  21. Ticker JB, Djurasovic M, Strauch RJ, April EW, Pollock RG, Flatow EL, Bigliani LU (1998) The incidence of ganglion cysts and other variations in anatomy along the course of the suprascapular nerve. J Shoulder Elbow Surg 7:472–478

    CAS  PubMed  Google Scholar 

  22. Williams PL, Bannister LH, Bery MM, Collins P, Dyson M, Dussek JE, Ferguson MWJ (1995) Gray's Anatomy, 38th edn., Churchill-Livingstone, London

  23. Williamson DM, Wilson-Mc Donald J (1988) Bilateral avulsion fractures of the cranial margin of the scapula. J Trauma 28:713–714

    CAS  PubMed  Google Scholar 

  24. Zehetgruber H, Noske H, Lang T, Wurnig C. (2002) Suprascapular nerve entrapment; a meta-analysis. Int Orthop 26:339–343

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Bayramoğlu.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Bayramoğlu, A., Demiryürek, D., Tüccar, E. et al. Variations in anatomy at the suprascapular notch possibly causing suprascapular nerve entrapment: an anatomical study. Knee Surg Sports Traumatol Arthrosc 11, 393–398 (2003). https://doi.org/10.1007/s00167-003-0378-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-003-0378-3

Keywords

  • Suprascapular nerve
  • Entrapment
  • Anatomy
  • Variation