Top

Surgical and Radiologic Anatomy

Published in:

01-03-2010 | Original Article

Anatomical basis of the suprascapular nerve entrapment, and clinical relevance of the supraspinatus fascia

Authors: Fabrice Duparc, Dorothée Coquerel, Jocelyn Ozeel, Maxime Noyon, Antoine Gerometta, Chantal Michot

Published in: Surgical and Radiologic Anatomy | Issue 3/2010

Abstract

Introduction

The entrapment of the suprascapular nerve (SSN) is commonly considered at the level of the suprascapular notch and more rarely in the spinoglenoid notch. Recent per-operative findings showed a compression of the SSN along its course in the supraspinatus fossa. The removal of a fascia for releasing the nerve between the suprascapular notch and spinoglenoid notch led us to purchase an anatomical study.

Materials and methods

30 cadaver shoulders have been dissected. The morphological features about the suprascapular notch, the supraspinatus fascia, and the spinoglenoid notch have been observed. Histological studies of the fascia and the spinoglenoid ligament have been performed. Morphometric parameters such as shape of the suprascapular notch, diameters of the SSN before and after the suprascapular notch, distance between the two notches, length of the course of the SSN into the supraspinatus fossa, diameters of the spinoglenoid notch have been measured.

Results

The shape of the suprascapular notch could be seen as “U”- or “V” as previously reported. The fascia was quite constant (completely identified in 29 shoulders) and was the lateral extension of the supraspinatus fascia. The SSN coursed between the bone and the fascia and was surrounded by fat tissue. This fascia was thickened at the level of the spinoglenoid notch and joined the infraspinatus fascia. The spinoglenoid ligament was seen in 28 shoulders.

Discussion and conclusion

In pathologic and post-trauma conditions, the fascia can be retracted or thickened and the SSN may be entrapped along its course in the supraspinatus fossa, between the suprascapular notch and the spinoglenoid notch and without any compression in any notch. These anatomical data lead us to consider that a tunnel syndrome may concern the SSN.

Cummins CA, Anderson K, Bowen M, Nuber G, Roth SI (1998) Anatomy and histological characteristics of the spinoglenoid ligament. J Bone Joint Surg 80A:1622–1625

Demaio M, Drez D Jr, Mullins RC (1991) The inferior transverse scapular ligament as a possible cause of entrapment neuropathy of the nerve to the infraspinatus. J Bone Joint Surg 73A:1061–1062

Gardner E, Gray DJ, O’Rahilly R (1979) Anatomie. Doin, Paris, pp 71-102-105

Hovelacque A (1927) Anatomie des Nerfs Crâniens et Rachidiens et du Système Grand Sympathique. Doin, Paris, p 41

Lazorthes G (1971) Le Système Nerveux Périphérique. Masson, Paris, p 273

Matsumoto D, Suenaga N, Oizumi N, Hisada Y, Minami A (2009) A new nerve block procedure for the suprascapular nerve based on a cadaveric study. J Shoulder Elbow Surg 18:607–611CrossRefPubMed

Moriggl B (1997) Möglichkeiten und Grenzen des Sonographie osteofibröser Kanäle im Schulterbereich” Teil 1. Grundlagen Ann Anat 179:355–373

Olivier E, Dufour A (1947) Traité d’Ostéologie Humaine. Maloine, Paris, p 6

Paturet G (1951) Traité d’Anatomie Humaine. Tome II Masson, Paris, pp 12–16

10.

Rouvière H, Delmas A (2002) Anatomie humaine descriptive topographique et fonctionnelle, 15ème édition, tome 2. Masson, Paris, pp 220–221

11.

Soubeyran M, Bauer T, Billot N, Lortat-Jacob A, Gicquelet R, Hardy P (2008) Original portals for arthroscopic decompression of the suprascapular nerve: an anatomic study. J Shoulder Elbow Surg 17:616–623CrossRef

12.

Sunderland S (1968) Nerves and nerve injuries. E.& S. Livingstone LTD, Edinburgh/London, pp 1119–1120

13.

Ticker JB, Djuradovic M, Strauch RJ (1998) The incidence of ganglion cysts and other variations in anatomy along the course of the suprascapular nerve. J Shoulder Elbow Surg 7:472–477CrossRefPubMed

14.

Warner JJP, 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 74A:36–45

Title: Anatomical basis of the suprascapular nerve entrapment, and clinical relevance of the supraspinatus fascia
Authors: Fabrice Duparc
Dorothée Coquerel
Jocelyn Ozeel
Maxime Noyon
Antoine Gerometta
Chantal Michot
Publication date: 01-03-2010
Publisher: Springer-Verlag
Published in: Surgical and Radiologic Anatomy / Issue 3/2010
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-010-0631-7

At a glance: The STEP trials

Springer Medicine

Anatomical basis of the suprascapular nerve entrapment, and clinical relevance of the supraspinatus fascia

Abstract

Introduction

Materials and methods

Results

Discussion and conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Discussion and conclusion

Please log in to get access to this content

Other articles of this Issue 3/2010

Correlation between the lengths of the upper limb and cubital tunnel: potential use in patients with proximal ulnar nerve entrapment

Localization of motor entry points and terminal intramuscular nerve endings of the musculocutaneous nerve to biceps and brachialis muscles

Anatomical basis of the risk of radial nerve injury related to the technique of external fixation applied to the distal humerus

Teres minor innervation in the context of isolated muscle atrophy

Anatomical basis for ultrasound-guided regional anaesthesia at the junction of the axilla and the upper arm

Intramuscular communicating branches in the flexor digitorum profundus: dissection and Sihler’s staining