Variation in morphology of suprascapular notch as a factor of suprascapular nerve entrapment

• Published in: International orthopaedics 2013-11, Vol.37 (11), p.2185-2192
• Main Authors: Polguj, Michał, Sibiński, Marcin, Grzegorzewski, Andrzej, Grzelak, Piotr, Majos, Agata, Topol, Mirosław
• Format: Article
• Language: English
• Subjects: Aged; Decompression, Surgical; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Nerve Compression Syndromes - epidemiology; Nerve Compression Syndromes - surgery; Original Paper; Orthopedics; Peripheral Nerves; Retrospective Studies; Risk Factors; Scapula - anatomy & histology; Scapula - diagnostic imaging; Sex Characteristics; Shoulder Joint - anatomy & histology; Shoulder Joint - diagnostic imaging; Tomography, Spiral Computed
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-013-2005-3

Purpose The shape and size of the suprascapular notch (SSN) is one of the most important risk factors in suprascapular nerve entrapment. The aim of the study was to perform a morphological study of SSN variations. Methods A total of 616 computer tomography scans of scapulae were retrospectively analysed in 308 patients. The examination focused on the suprascapular region. The type of suprascapular notch was determined by using a classification based on three geometrical measurements: maximal depth (MD), superior (STD) and middle (MTD) transverse diameters. Results In the scans, five types of SSN were noted. In type I (24.18 %) maximal depth was greater than superior transverse diameter. Type II (1.95 %) has equal MD, STD and MTD. In type III (56.16 %) the superior transverse diameter was greater than the maximal depth. Scapulae with bony foramen were classified as type IV (4.72 %). In type V a discrete notch (12.99 %) was found. Additionally, types I and III were divided into three subtypes: A, B and C. The frequency of type I and IV was lower in females than in males, but type III was more common in females than males. Distribution of other types of SSN in both groups was similar. Conclusion Knowledge of the anatomical variations of the suprascapular notch described in this study should be helpful in endoscopic and open procedures of the suprascapular region and also may increase the safety of operative decompression of the suprascapular nerve.