Suprascapular nerve anatomy during shoulder motion: a cadaveric proof of concept study with implications for neurogenic shoulder pain.
The suprascapular nerve (SSN) has its origin in the C5 and C6 nerve roots and runs through suprascapular notch and the supraspinatus fossa and has motor branches that extend to the infraspinatus fossa via the spinoglenoid notch. The anatomy of the SSN makes it particularly prone to lesions due to excessive compression or traction.
This study employed a 3-D fluoroscopic imaging technique to investigate the course of the SSN: 1) with and without a simulated rotator cuff tendon tear and its repair, and; 2) the torn and repaired condition with and without the effect of release of the transverse scapular ligament in a cadaver model.
Medial traction to the nerve around the spinoglenoid notch was present in the case of a simulated massive rotator cuff tendon tear; noteworthy, this effect could be reversed with repair of the transosseous footprint. Moreover, the SSN had more room for superior-posterior movement out of the suprascapular notch when the transverse scapular ligament was released.
These results confirm the concept that a retracted posterosuperior rotator cuff causes more tension of the SSN at both the suprascapular as well as the spinoglenoid notch and that release of the transverse scapular ligament effectively reduces traction on the SSN. > From: Massimini et al., J Shoulder Elbow Surg 22 (2013) 463-470. All rights reserved to the Journal of Shoulder and Elbow Surgery Board of Trustees.
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