Case reportThe suprascapular nerve and its articular branch to the acromioclavicular joint: an anatomic study
Section snippets
Materials and methods
Investigational Review Board approval was not required for this study.
Twelve shoulders from six embalmed human cadavers (5 women, 1 man) were bilaterally dissected. The deceased donors had an average age of 83 years (range, 68-91 years). Cadavers were embalmed using a standard preparation of embalming fluid composed of formaldehyde, methanol, and ethanol, which was injected into the carotid artery and also pumped into the organs and abdomen.
In each specimen the surgical exploration was
Results
The suprascapular nerve passed through the scapular notch inferior to the transverse scapular ligament in all 12 specimens. In 6 shoulders (50%), the suprascapular artery accompanied the nerve at the suprascapular notch under the transverse scapular ligament (Fig. 2). From the suprascapular notch, the suprascapular nerve coursed obliquely and laterally in the supraspinous fossa along the inferior surface of the supraspinatus muscle directly to the base of the scapular spine. From the base of
Discussion
The suprascapular nerve is responsible for most of the sensory innervations to the shoulder joint as well as to the supraspinatus and infraspinatus muscles of the rotator cuff.14 This nerve arises from the upper trunk and crosses the posterior triangle of the neck to the scapular notch, passing dorsally to the inferior belly of the omohyoid muscle and anterior to the trapezius. A number of authors have presented research on the path of the suprascapular nerve:
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Shishedo et al12 gave the course of
Conclusion
The sensory branch of suprascapular nerve runs superiorly to the supraspinatus muscle toward the AC joint. The detailed information can be used to help decrease the risk of nerve injury during shoulder surgery and to aid in effectively diagnosing and treating AC joint-related disorders.
Disclaimer
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
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Cited by (46)
Overview of Innervation of Shoulder and Acromioclavicular Joints
2021, Physical Medicine and Rehabilitation Clinics of North AmericaCitation Excerpt :As the SSN courses along the floor of the supraspinous fossa to the spinoglenoid notch, it enters the infraspinous fossa deep to the infraspinatus. The articular branches supplying the posterior region of the capsule have been described as originating from the SSN prior to entry into the infraspinous fossa,1,4,6,7 at the level of the spine of the scapula,3,4 or just inferior to the spinoglenoid notch.4,8 Eckmann and colleagues8 further described these articular branches as supplying the posterior inferior GHJ capsule and head of the humerus.
Sensory innervation of the human shoulder joint: the three bridges to break
2020, Journal of Shoulder and Elbow SurgeryCitation Excerpt :Vorster et al54 provided data to support this medial AB course and described the course of a new branch, splitting off from the parent nerve just proximal to the scapular neck and running on the scapula deep to the supraspinatus before entering the infraspinatus near its tendon. Ebraheim et al13 confirmed that the medial AB turns laterally along the base of the coracoid process and terminated in the acromioclavicular joint and SAB. They also described a second branch running laterally proximal to the infraspinous fossa and entering the posterior aspect of the capsule deep to the infraspinatus.
Motor-Sparing Peripheral Nerve Blocks for Shoulder, Knee, and Hip Surgery
2020, Advances in AnesthesiaCitation Excerpt :The contradictory findings between trials published before and after 2017 could be attributed to a combination of increased technical success with US guidance and to the fact that the anterior approach may provide a more complete block of the shoulder joint. Cadaveric studies have demonstrated that a significant percentage of sensory and articular branches to the glenohumeral joint and SCJ actually split off from the main suprascapular nerve proximal to the transverse scapular ligament, thereby escaping blockade with the posterior approach [44–47]. Thus, from an anatomic standpoint, the anterior approach may provide a more complete block of the suprascapular nerve.
Sensory innervation of the subacromial bursa by the distal suprascapular nerve: a new description of its anatomic distribution
2019, Journal of Shoulder and Elbow SurgeryCitation Excerpt :The authors also described the course of a new branch, splitting off from the parent nerve just proximal to the scapular neck and running on the scapula deep to the supraspinatus before entering the infraspinatus near its tendon. Ebraheim et al5 confirmed that the medial articular branch turns laterally along the base of the coracoid process and terminates in the acromioclavicular joint and SAB. They also described a second branch running laterally before the infraspinous fossa and entering the posterior aspect of the capsule deep to the infraspinatus.
Editorial Commentary: Arthroscopically Assisted Acromioclavicular Joint Reconstruction—Not Seeing Does Not Mean Do Not Worry
2017, Arthroscopy - Journal of Arthroscopic and Related Surgery