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Anatomic observation of the running space of the suprascapular nerve at the suprascapular notch in the same direction as the nerve

  • Shoulder
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The configuration of suprascapular notch was previously analysed from the anteroposterior viewing. However, the approach direction of the suprascapular nerve (SSN) to the inlet of the suprascapular notch is consistently craniocaudal and mediolateral. We propose a new method to observe the suprascapular notch according to the running course of the SSN. We reviewed the anatomic characteristics of the suprascapular notch in relation to the nerve.

Methods

In 30 formalin-fixed cadaveric shoulders, the morphology of the suprascapular notch and the attachments of the superior transverse scapular ligament (STSL) were examined from both the anteroposterior and the nerve approach direction. The dimensions of the opening of the SSN passage were measured.

Results

By observing from the nerve approach direction, the inlet of the suprascapular notch was recognized to be a space-bordered by the medial wall of the coracoid process, the deep fascia of subscapularis, and the STSL. The STSL formed a sheet-like structure, which ran parallel to the nerve and also to the deep fascia of subscapularis. The attachment of the ligament to the coracoid process was located at the posteromedial corner rather than the medial side.

Conclusion

Based on the present study, the space between the STSL and deep fascia of the subscapularis formed the space for the nerve to run through. As a clinical implication, this new method to assess the suprascapular notch in the nerve approach direction might develop the imaging techniques for evaluation of SSN entrapment.

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References

  1. Bayramoglu A, Demiryurek D, Tuccar E, Erbil M, Aldur MM, Tetik O, Doral MN (2003) Variations in anatomy at the suprascapular notch possibly causing suprascapular nerve entrapment: an anatomical study. Knee Surg Sports Traumatol Arthrosc 11(6):393–398

    Article  CAS  PubMed  Google Scholar 

  2. Clein LJ (1975) Suprascapular entrapment neuropathy. J Neurosurg 43(3):337–342

    Article  CAS  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  4. Cummins CA, Messer TM, Nuber GW (2000) Suprascapular nerve entrapment. J Bone Joint Surg Am 82(3):415–424

    CAS  PubMed  Google Scholar 

  5. Duparc F, Coquerel D, Ozeel J, Noyon M, Gerometta A, Michot C (2010) Anatomical basis of the suprascapular nerve entrapment, and clinical relevance of the supraspinatus fascia. Surg Radiol Anat SRA 32(3):277–284

    Article  PubMed  Google Scholar 

  6. Edelson JG (1995) Bony bridges and other variations of the suprascapular notch. J Bone Joint Surg Br 77(3):505–506

    CAS  PubMed  Google Scholar 

  7. Ferretti A, Cerullo G, Russo G (1987) Suprascapular neuropathy in volleyball players. J Bone Joint Surg Am 69(2):260–263

    CAS  PubMed  Google Scholar 

  8. Ganzhorn RW, Hocker JT, Horowitz M, Switzer HE (1981) Suprascapular-nerve entrapment. J Bone Joint Surg Am 63(3):492–494

    CAS  PubMed  Google Scholar 

  9. Hirayama T, Takemitsu Y (1981) Compression of the suprascapular nerve by a ganglion at the suprascapular notch. Clin Orthop Relat Res 155:95–96

    PubMed  Google Scholar 

  10. Kannan U, Kannan NS, Anbalagan J, Rao S (2014) Morphometric study of suprascapular notch in Indian dry scapulae with specific reference to the incidence of completely ossified superior transverse scapular ligament. J Clin Diagn Res 8(3):7–10

    PubMed Central  PubMed  Google Scholar 

  11. Kibler WB (1998) The role of the scapula in athletic shoulder function. Am J Sports Med 26(2):325–337

    CAS  PubMed  Google Scholar 

  12. Natsis K, Totlis T, Tsikaras P, Appell HJ, Skandalakis P, Koebke J (2007) Proposal for classification of the suprascapular notch: a study on 423 dried scapulas. Clin Anat 20(2):135–139

    Article  CAS  PubMed  Google Scholar 

  13. Oizumi N, Suenaga N, Funakoshi T, Yamaguchi H, Minami A (2012) Recovery of sensory disturbance after arthroscopic decompression of the suprascapular nerve. J Shoulder Elbow Surg 21(6):759–764

    Article  PubMed  Google Scholar 

  14. Rengachary SS, Burr D, Lucas S, Brackett CE (1979) Suprascapular entrapment neuropathy: a clinical, anatomical, and comparative study. Part 3: comparative study. Neurosurgery 5(4):452–455

    Article  CAS  PubMed  Google Scholar 

  15. Rengachary SS, Burr D, Lucas S, Hassanein KM, Mohn MP, Matzke H (1979) Suprascapular entrapment neuropathy: a clinical, anatomical, and comparative study. Part 2: anatomical study. Neurosurgery 5(4):447–451

    Article  CAS  PubMed  Google Scholar 

  16. Ringel SP, Treihaft M, Carry M, Fisher R, Jacobs P (1990) Suprascapular neuropathy in pitchers. Am J Sports Med 18(1):80–86

    Article  CAS  PubMed  Google Scholar 

  17. Romeo AA, Ghodadra NS, Salata MJ, Provencher MT (2010) Arthroscopic suprascapular nerve decompression: indications and surgical technique. J Shoulder Elbow Surg 19(2 Suppl):118–123

    Article  PubMed  Google Scholar 

  18. Sandow MJ, Ilic J (1998) Suprascapular nerve rotator cuff compression syndrome in volleyball players. J Shoulder Elbow Surg 7(5):516–521

    Article  CAS  PubMed  Google Scholar 

  19. Shah AA, Butler RB, Sung SY, Wells JH, Higgins LD, Warner JJ (2011) Clinical outcomes of suprascapular nerve decompression. J Shoulder Elbow Surg 20(6):975–982

    Article  PubMed  Google Scholar 

  20. Thompson WA, Kopell HP (1959) Peripheral entrapment neuropathies of the upper extremity. N Engl J Med 260(25):1261–1265

    Article  CAS  PubMed  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(5):472–478

    Article  CAS  PubMed  Google Scholar 

  22. Wang HJ, Chen C, Wu LP, Pan CQ, Zhang WJ, Li YK (2011) Variable morphology of the suprascapular notch: an investigation and quantitative measurements in Chinese population. Clin Anat 24(1):47–55

    Article  PubMed  Google Scholar 

  23. Warner JP, Krushell RJ, Masquelet A, Gerber C (1992) Anatomy and relationships of the suprascapular nerve: anatomical constraints to mobilization of the supraspinatus and infraspinatus muscles in the management of massive rotator-cuff tears. J Bone Joint Surg Am 74(1):36–45

    CAS  PubMed  Google Scholar 

  24. Witvrouw E, Cools A, Lysens R, Cambier D, Vanderstraeten G, Victor J, Sneyers C, Walravens M (2000) Suprascapular neuropathy in volleyball players. Br Sports Med 34(3):174–180

    Article  CAS  Google Scholar 

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Acknowledgments

This study was partly supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports(C) (No. 24791525) and also by a Grant from NokyoKyosai Research Institute (Agricultural Cooperative Insurance Research Institute).

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Correspondence to Akimoto Nimura.

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Tasaki, A., Nimura, A., Mochizuki, T. et al. Anatomic observation of the running space of the suprascapular nerve at the suprascapular notch in the same direction as the nerve. Knee Surg Sports Traumatol Arthrosc 23, 2667–2673 (2015). https://doi.org/10.1007/s00167-014-3129-8

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  • DOI: https://doi.org/10.1007/s00167-014-3129-8

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