Suprascapular Nerve Entrapment by a Trifid Superior Transverse Scapular Ligament

AbstractAnatomical variations at the suprascapular notch may limit the available space for the suprascapular nerve (SSN), and cause its entrapment in the tight osseoligamentous tunnel. The author encountered the presence of a trifid superior transverse scapular ligament (STSL) while operating on a patient with SSN entrapment. Surgical division of the three bands resulted in complete regression of symptoms.

Ossification of the superior transverse ligament in a South African scapula: a factor to be considered in the diagnosis of suprascapular nerve entrapment

Journal of Morphological Sciences ◽

10.4322/jms.087415 ◽

2016 ◽

Vol 33 (03) ◽

pp. 155-156

Author(s):

O. Azu ◽

D. Ofusori ◽

E. Naidu ◽

J. Naidu

Keyword(s):

South African ◽

Critical Factor ◽

Suprascapular Nerve ◽

Nerve Entrapment ◽

Clinical Anatomy ◽

Shape Variation ◽

Suprascapular Notch ◽

Shoulder Region ◽

Abstract Introduction: Ossification of the superior transverse scapular ligament is one of the factors considered in the classification of the suprascapular notch based on shape. Variation in morphology of the superior transverse scapular ligament is always considered a critical factor in the diagnosis of suprascapular nerve entrapment syndrome. Case Report: This study reports the complete ossification of the superior transverse scapular ligament in a South African scapula and a note on its clinical anatomy. Conclusion: This anatomical knowledge is of extreme clinical relevance to surgeons in relation to various syndromes associated with the shoulder region in the South African population.

Morphological and Radiological Study of Ossified Superior Transverse Scapular Ligament as Potential Risk Factor of Suprascapular Nerve Entrapment

BioMed Research International ◽

10.1155/2014/613601 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 13

Author(s):

Michał Polguj ◽

Marcin Sibiński ◽

Andrzej Grzegorzewski ◽

Michał Waszczykowski ◽

Agata Majos ◽

...

Keyword(s):

Risk Factor ◽

Potential Risk ◽

Suprascapular Nerve ◽

Nerve Entrapment ◽

Potential Risk Factor ◽

Suprascapular Notch ◽

Suprascapular Foramen ◽

The Right ◽

The suprascapular notch is covered superiorly by the superior transverse scapular ligament. This region is the most common place of suprascapular nerve entrapment formation. The study was performed on 812 specimens: 86 dry scapulae, 104 formalin-fixed cadaveric shoulders, and 622 computer topography scans of scapulae. In the cases with completely ossified superior transverse scapular ligament, the following measurements were performed: proximal and distal width of the bony bridge, middle transverse and vertical diameter of the suprascapular foramen, and area of the suprascapular foramen. An ossified superior transverse scapular ligament was observed more often in men and in the right scapula. The mean age of the subjects with a completely ossified superior transverse scapular ligament was found to be similar than in those without ossification. The ossified band-shaped type of superior transverse scapular ligament was more common than the fan-shaped type and reduced the space below the ligament to a significantly greater degree. The ossified band-shaped type should be taken into consideration as a potential risk factor in the formation of suprascapular nerve entrapment. It could explain the comparable frequency of neuropathy in various populations throughout the world despite the significant differences between them in occurrence of ossified superior transverse scapular ligament.

Morphometric study of suprascapular notch and scapular dimensions in Ugandan dry scapulae with specific reference to the incidence of completely ossified superior transverse scapular ligament

10.21203/rs.3.rs-55406/v2 ◽

2020 ◽

Author(s):

Adesanya Olamide Adewale ◽

Okeniran Olatayo Segun ◽

Ibe Michael Usman ◽

Ann Lemuel Monima ◽

Eric Simidi Kegoye ◽

...

Keyword(s):

Correlation Coefficient ◽

Suprascapular Nerve ◽

Nerve Entrapment ◽

Population Characteristics ◽

Specific Reference ◽

Suprascapular Notch ◽

Entrapment Syndrome ◽

Nerve Entrapment Syndrome

Abstract Background: Understanding of suprascapular notch (SSN) anatomy and relationship with scapular dimensions are vital in diagnosis, prevention, and assessment of suprascapular nerve entrapment syndrome. The study aimed to assess morphometry of suprascapular notch and scapular dimensions in Ugandan dry scapulae with specific reference to scapulae with completely ossified superior transverse scapular ligaments. Methods: This was a cross-sectional analytical study conducted on 50 Ugandan dry scapulae. SSN types and prevalence of completely ossified superior transverse scapular ligament among dry scapulae were quantified and compared with previous data. Scapular dimensions were assessed by measuring scapular length (A), scapular width (B), glenoid length (C), and glenoid width (D). One-way ANOVA was used to compare scapular dimensions of scapulae with different SSN types, and Spearman’s correlation coefficient was used to evaluate the correlation coefficient of scapular dimensions amongst groups. Results: Superior transverse scapular ligament (STSL) was completely ossified in 8% of cases. There was no significant (P > 0.05) difference between scapular dimensions of scapulae with completely ossified STSL compared to scapulae with other SSN types. Scapulae with completely ossified STSL showed strong negative (r = -0.89137, r = -0.877) correlations for its A, B respectively compared against D, this finding was not true to scapulae of other SSN types. Also, there were strong positive or negative (r > 0.7, r > -0.7) correlations: for A, types I and III compared to type VI; for B, types I, III compared to VI; for C, type IV and VI; and for D, type III and VI. Conclusions: The prevalence of completely ossified STSL is moderately high in the Ugandan population. Characteristics of the scapula (scapular dimensions) are not ‘vital’ but rather important or relevant for shoulder pathology with specific reference to suprascapular nerve entrapment syndrome due to completely ossified superior transverse scapular ligaments. Further correlation analyses of scapular dimensions of different SSN types in different populations are important.

Ossification of superior transverse scapular ligament - a case report

National Journal of Clinical Anatomy ◽

10.1055/s-0039-3401562 ◽

2015 ◽

Vol 04 (03) ◽

pp. 155-157

Author(s):

Dibya Prabha Bara ◽

Swagatika Pradhan ◽

Rajashree Biswal ◽

Chinmayi Mohapatra

Keyword(s):

Case Report ◽

Suprascapular Nerve ◽

Nerve Entrapment ◽

Suprascapular Notch ◽

Orthopaedic Surgeons ◽

AbstractSuperior transverse scapular ligament (STSL), a small ligament which bridges over the suprascapular notch bears enormous stress during shoulder movements. This causes the ligament to ossifY thereby compressing the suprascapular nerve which passes beneath it. The ossification can occur partially or cnmpletely. Different shape of ossified STSL also affects the rate of compression of the nerve. Knowledge of ossified STSL may be helpful for radiologists, neurosurgeons and orthopaedic surgeons in dealing with patients of suprascapular nerve entrapment.

Protective and Predisposing Morphological Factors in Suprascapular Nerve Entrapment Syndrome: A Fundamental Review Based on Recent Observations

BioMed Research International ◽

10.1155/2017/4659761 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 10

Author(s):

Piotr Łabętowicz ◽

Marek Synder ◽

Mariusz Wojciechowski ◽

Krzysztof Orczyk ◽

Hubert Jezierski ◽

...

Keyword(s):

Suprascapular Nerve ◽

Nerve Entrapment ◽

Protective Function ◽

Suprascapular Notch ◽

Entrapment Syndrome ◽

Nerve Entrapment Syndrome ◽

Spinoglenoid Notch

Suprascapular nerve entrapment syndrome (SNES) is a neuropathy caused by compression of the nerve along its course. The most common compression sites include the suprascapular notch and the spinoglenoid notch. The aim of this article was to review the anatomical factors influencing the occurrence of SNES in the light of the newest reports. Potential predisposing morphological factors include a V-shaped, narrow, or “deep” suprascapular notch; a band-shaped, bifurcated, or completely ossified superior transverse scapular ligament (STSL); particular arrangements of the suprascapular nerve and vessels at the suprascapular notch. A very recent report indicates structures at the suprascapular notch region that may protect from SNES, such as the suprascapular notch veins (SNV). The role of the anterior coracoscapular ligament (ACSL) is still not clear. While some studies indicate that it may predispose for SNES, the newest study proposes a protective function. Knowledge of these variations is essential for arthroscopic and other surgical procedures of this area in order to avoid iatrogenic injury of the suprascapular nerve or unexpected bleeding from the suprascapular vessels running alongside the STSL.

Morphometric study of suprascapular notch and scapular dimensions in Ugandan dry scapulae with specific reference to the incidence of completely ossified superior transverse scapular ligament

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03769-2 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Adesanya Olamide Adewale ◽

Okeniran Olatayo Segun ◽

Ibe Michael Usman ◽

Ann Lemuel Monima ◽

Eric Simidi Kegoye ◽

...

Keyword(s):

Correlation Coefficient ◽

Suprascapular Nerve ◽

Nerve Entrapment ◽

Population Characteristics ◽

Specific Reference ◽

Suprascapular Notch ◽

Entrapment Syndrome ◽

Nerve Entrapment Syndrome

Abstract Background Understanding of suprascapular notch (SSN) anatomy and relationship with scapular dimensions are vital in diagnosis, prevention, and assessment of suprascapular nerve entrapment syndrome. The study aimed to assess morphometry of suprascapular notch and scapular dimensions in Ugandan dry scapulae with specific reference to scapulae with completely ossified superior transverse scapular ligaments. Methods This was a cross-sectional analytical study conducted on 50 Ugandan dry scapulae. SSN types and prevalence of completely ossified superior transverse scapular ligament among dry scapulae were quantified and compared with previous data. Scapular dimensions were assessed by measuring scapular length (A), scapular width (B), glenoid length (C), and glenoid width (D). One-way ANOVA was used to compare scapular dimensions of scapulae with different SSN types, and Spearman’s correlation coefficient was used to evaluate the correlation coefficient of scapular dimensions amongst groups. Results Superior transverse scapular ligament (STSL) was completely ossified in 8% of cases. There was no significant (P > 0.05) difference between scapular dimensions of scapulae with completely ossified STSL compared to scapulae with other SSN types. Scapulae with completely ossified STSL showed strong negative (r = − 0.89137, r = − 0.877) correlations for its A, B respectively compared against D, this finding was not true to scapulae of other SSN types. Also, there were strong positive or negative (r > 0.7, r > − 0.7) correlations: for A, types I and III compared to type VI; for B, types I, III compared to VI; for C, type IV and VI; and for D, type III and VI. Conclusions The prevalence of completely ossified STSL is moderately high in the Ugandan population. Characteristics of the scapula (scapular dimensions) are not ‘vital’ but rather important or relevant for shoulder pathology with specific reference to suprascapular nerve entrapment syndrome due to completely ossified superior transverse scapular ligaments. Further correlation analyses of scapular dimensions of different SSN types in different populations are important.

A Study on Morphology of Suprascapular Notch with Specific Emphasis on Completely Ossified Superior Transverse Scapular Ligament

National Journal of Clinical Anatomy ◽

10.1055/s-0040-1705291 ◽

2020 ◽

Author(s):

Tushar V. Nayak ◽

Subhash M. Gujar

Keyword(s):

Digital Camera ◽

Suprascapular Nerve ◽

Nerve Entrapment ◽

Suprascapular Notch ◽

Medical College ◽

Risk Patients ◽

Type V ◽

Superior Border

Abstract Background and Aim The superior border of scapula is marked by suprascapular notch which is bridged by suprascapular ligament. Beneath this ligament, passes the suprascapular nerve. Narrow notch and completely ossified superior transverse scapular ligament is one of the risk factors for suprascapular nerve entrapment. This study is done to study morphological variation of suprascapular notch. Knowledge of various types of suprascapular notch will help the clinician in early diagnosis and surgical treatment. Materials and Methods A total of 525 human scapulae of unknown age and sex were studied for morphology of suprascapular notch at the Department of Anatomy, GMERS medical college, Vadnagar and at B. J. Medical College, Ahmedabad. Photographs of various types of suprascapular notch were taken using digital camera and classified as per the Rengachary classification. Result In the present study, as per Rengachary classification, out of 525 scapulae, the most common is Type III (47.1%), least common is Type V (1.9%), and completely ossified superior transverse scapular ligament is Type VI (8.9%). Conclusion Knowledge of various types of suprascapular notch will help the physician in screening high-risk patients as well as diagnosis and treatment of suprascapular nerve entrapment disorder.