Bilateral Suprascapular Notches Are Asymmetrically Shaped in a Third of the Asian Population

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2021 Aug 21

PMID 34417834

Citations 2

Authors

Jumpei Inoue

Kaneaki Tawada

Katsumasa Sugimoto

Hideyuki Goto

Atsushi Tsuchiya

Tetsuya Takenaga

Satoshi Takeuchi

Keishi Takaba

Hideki Murakami

Masahito Yoshida

Affiliations

Soon will be listed here.

Abstract

Purpose: The side-to-side differences within an individual's suprascapular notch (SSN) and the clinical characteristics of an ossified superior transverse scapular ligament are unclear. Therefore, the morphological asymmetry of the SSN was investigated, and the factors associated with the ossification of the superior transverse scapular ligament were analyzed.

Methods: Two hundred and seventy-six computed tomography images were retrospectively analyzed, which included those of both scapulae of Asian patients (mean age, 62.1 ± 19.1 years; males, 197) with high-energy injuries or respiratory diseases. Variations in the SSN were classified into six types based on Rengachary's classification using reconstructed three-dimensional computed tomography. The group with a type VI SSN (completely ossified superior transverse scapular ligament) in at least one scapula was compared with the other group for age, sex, and chronic comorbidities.

Results: Among 276 patients, 95 (34.4%) had asymmetric SSNs and 15 (5.4%) had type VI SSNs. There were no significant differences in age, sex, or comorbidities between both the groups. However, on comparing age groups, the prevalence of type VI SSN was higher in patients aged > 70 years than in those aged < 70 years. Fifteen patients had type VI SSNs, which were unilateral in 10 patients.

Conclusion: Asymmetric SSNs were observed in a third of the Asian patients. There were variations in SSNs between individuals and also within an individual. In the cases with suprascapular nerve paralysis, the difference in SSN morphology compared to a healthy side should be considered.

Level Of Evidence: III.

Citing Articles

Morphometry of the Scapular Notch and Its Clinical Implication in Suprascapular Nerve Entrapment.

Duque-Colorado J, Alzate-Mejia O, Del Sol M Diagnostics (Basel). 2025; 15(3).

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Systematic Review and Meta-analysis of Suprascapular Notch Morphological Variability: Do We Know Everything?.

Tsakotos G, Tudose R, Triantafyllou G, Koutserimpas C, Rusu M, Flevas D Cureus. 2024; 16(3):e55852.

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Correlation of suprascapular notch morphology with suprascapular nerve palsy: a 3D-computed tomography study.

Honoki K, Suenaga N, Oizumi N, Yamane S, Yoshioka C, Hisada Y JSES Int. 2023; 7(2):316-323.

PMID: 36911777 PMC: 9998890. DOI: 10.1016/j.jseint.2022.12.016.

References

Adewale A, Segun O, Usman I, Monima A, Kegoye E, Kasozi K . 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 Musculoskelet Disord. 2020; 21(1):733. PMC: 7656716. DOI: 10.1186/s12891-020-03769-2. View

Akune T, Ogata N, Seichi A, Ohnishi I, Nakamura K, Kawaguchi H . Insulin secretory response is positively associated with the extent of ossification of the posterior longitudinal ligament of the spine. J Bone Joint Surg Am. 2001; 83(10):1537-44. DOI: 10.2106/00004623-200110000-00013. View

Albino P, Carbone S, Candela V, Arceri V, Vestri A, Gumina S . Morphometry of the suprascapular notch: correlation with scapular dimensions and clinical relevance. BMC Musculoskelet Disord. 2013; 14:172. PMC: 3674975. DOI: 10.1186/1471-2474-14-172. View

Albritton M, Graham R, Richards 2nd R, Basamania C . An anatomic study of the effects on the suprascapular nerve due to retraction of the supraspinatus muscle after a rotator cuff tear. J Shoulder Elbow Surg. 2003; 12(5):497-500. DOI: 10.1016/s1058-2746(03)00182-4. View

Al-Redouan A, Hudak R, Nanka O, Kachlik D . The morphological stenosis pattern of the suprascapular notch is revealed yielding higher incidence in the discrete type and elucidating the inevitability of osteoplasty in horizontally oriented stenosis. Knee Surg Sports Traumatol Arthrosc. 2020; 29(7):2272-2280. DOI: 10.1007/s00167-020-06168-1. View

Arriaza R, Ballesteros J, Lopez-Vidriero E . Suprascapular neuropathy as a cause of swimmer's shoulder: results after arthroscopic treatment in 4 patients. Am J Sports Med. 2013; 41(4):887-93. DOI: 10.1177/0363546513477383. View

Chan C, Chung C, Lan H . Scapular fracture complicating suprascapular neuropathy: the role of computed tomography with 3D reconstruction. J Chin Med Assoc. 2009; 72(6):340-2. DOI: 10.1016/S1726-4901(09)70383-1. View

Coory J, Parr A, Wilkinson M, Gupta A . Efficacy of suprascapular nerve block compared with subacromial injection: a randomized controlled trial in patients with rotator cuff tears. J Shoulder Elbow Surg. 2019; 28(3):430-436. DOI: 10.1016/j.jse.2018.11.051. View

Fehrman D, Orwin J, Jennings R . Suprascapular nerve entrapment by ganglion cysts: a report of six cases with arthroscopic findings and review of the literature. Arthroscopy. 1995; 11(6):727-34. DOI: 10.1016/0749-8063(95)90118-3. View

10.

Ferretti A, Cerullo G, Russo G . Suprascapular neuropathy in volleyball players. J Bone Joint Surg Am. 1987; 69(2):260-3. View

11.

Gereli A, Uslu S, Okur B, Ulku T, Kocaoglu B, Yoo Y . Effect of suprascapular nerve injury on rotator cuff enthesis. J Shoulder Elbow Surg. 2020; 29(8):1584-1589. DOI: 10.1016/j.jse.2019.12.028. View

12.

Getz J, Recht M, Piraino D, Schils J, Latimer B, Jellema L . Acromial morphology: relation to sex, age, symmetry, and subacromial enthesophytes. Radiology. 1996; 199(3):737-42. DOI: 10.1148/radiology.199.3.8637998. View

13.

Inoue K, Suenaga N, Oizumi N, Sakamoto Y, Sakurai G, Miyoshi N . Suprascapular notch variations: a 3DCT study. J Orthop Sci. 2014; 19(6):920-4. DOI: 10.1007/s00776-014-0636-x. View

14.

Jung T, Lee S, Min S, Lee S, Yoo J . Does Combining a Suprascapular Nerve Block With an Intra-articular Corticosteroid Injection Have an Additive Effect in the Treatment of Adhesive Capsulitis? A Comparison of Functional Outcomes After Short-term and Minimum 1-Year Follow-up. Orthop J Sports Med. 2019; 7(7):2325967119859277. PMC: 6651672. DOI: 10.1177/2325967119859277. View

15.

Lajtai G, Pfirrmann C, Aitzetmuller G, Pirkl C, Gerber C, Jost B . The shoulders of professional beach volleyball players: high prevalence of infraspinatus muscle atrophy. Am J Sports Med. 2009; 37(7):1375-83. DOI: 10.1177/0363546509333850. View

16.

McIntosh J, Akhbari P, Malhas A, Funk L . Scapula Fractures in Elite Soccer and Rugby Players. Orthop J Sports Med. 2019; 7(12):2325967119887388. PMC: 6887832. DOI: 10.1177/2325967119887388. View

17.

Podgorski M, Polguj M, Topol M, Kusak A, Lukaszewski M, Grzelak P . Suprascapular notch morphology in the pediatric population: a computed tomography study. Anat Sci Int. 2016; 93(1):42-47. PMC: 5741778. DOI: 10.1007/s12565-016-0364-8. View

18.

Polguj M, Jedrzejewski K, Podgorski M, Majos A, Topol M . A proposal for classification of the superior transverse scapular ligament: variable morphology and its potential influence on suprascapular nerve entrapment. J Shoulder Elbow Surg. 2013; 22(9):1265-73. DOI: 10.1016/j.jse.2012.11.017. View

19.

Rengachary S, Neff J, Singer P, BRACKETT C . Suprascapular entrapment neuropathy: a clinical, anatomical, and comparative study. Part 1: clinical study. Neurosurgery. 1979; 5(4):441-6. DOI: 10.1227/00006123-197910000-00006. View

20.

Sandow M, Ilic J . Suprascapular nerve rotator cuff compression syndrome in volleyball players. J Shoulder Elbow Surg. 1998; 7(5):516-21. DOI: 10.1016/s1058-2746(98)90205-1. View