Anatomical classification and clinical significance of scapular notch based on CT 3D reconstruction

ZHANG Lei LIU Yang ZENG Yan YU Fei REN Lin  FU Shi-jie*

doi:10.16098/j.issn.0529-1356.2019.05.013

PDF(325 KB)

Acta Anatomica Sinica ›› 2019, Vol. 50 ›› Issue (5) : 620-626. DOI: 10.16098/j.issn.0529-1356.2019.05.013

Anatomy

Anatomical classification and clinical significance of scapular notch based on CT 3D reconstruction

ZHANG Lei ^1,2 LIU Yang ^1,2 ZENG Yan^1,2 YU Fei³ REN Lin³ FU Shi-jie ^1,2*

Author information +

History +

Abstract

Objective To research the anatomical classification of suprascapular notch based on CT 3D reconstruction and its clinical significance. Methods A total of 300 suprascapular (left 142, right 158) data were collected from Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University were measured based on CT 3D reconstruction. The suprascapular images were reconstructed by CT 3D technique, and the scapular morphological classification was made and geometric data were measured. Results Five types of suprascapular notch were found. Type Ⅰ(√, a total of 138 cases, 46%) was the most common, followed by type Ⅱ (U, a total of 125 cases, 41.7%), type Ⅲ(Ⅴ, a total of 20 cases, 6.7%), type Ⅳ(O, atotol of 10 cases, 3.3%) and type Ⅴ (Ω, a total of 7 cases, 2.3%), in addition, found W-shaped, double O-shaped each 1, because of the number was rare, it was not included in the classification. The average depth and width of the left suprascapular notch were (5.58±1.42) mm and (10.22±3.24) mm, and the right scapula were (6.02±1.87)mm and (10.81±3.35) mm, respectively(P<0.05). The width of the incision of type Ⅰ and type Ⅱ was wider than that of the other three types, which were (12.46±3.20)mm and (9.95±2.68)mm, and P<0.05. In addition, the length of the vertical point from the lowest point of the suprascapular notch to the base of the scapula was different. Type Ⅰ (the shortest) was about (12.52±2.56) mm, and type Ⅲ(the longest) was about (14.48±4.29) mm. There was a statistical difference between type Ⅰ and type Ⅲ (P<0.05). Conclusion Based on the result of CT three-dimensional reconstruction, the suprascapular notch is divided into five types, which are √-shaped, U-shaped, Ⅴ-shaped, O-shaped, and Ω-shaped. The probability of suprascapular nerve compression in Ⅴ-shaped and O-shaped is more, on the contrary, the shape of the √-shaped and U-shaped compression is small.

Key words

Suprascapular notch / Variable morphology / Classification / CT 3D reconstruction / Human

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

ZHANG Lei LIU Yang ZENG Yan YU Fei REN Lin FU Shi-jie. Anatomical classification and clinical significance of scapular notch based on CT 3D reconstruction[J]. Acta Anatomica Sinica. 2019, 50(5): 620-626 https://doi.org/10.16098/j.issn.0529-1356.2019.05.013

References

[1］ Kopell HP, Thompson WAL. Pain and the frozen shoulder ［J］. Surg Gynecol Obstet, 1959, 109（1）：92-96.

［2］ Zhu ShX. Anatomical basis of suprapapular notch and suprapapular nerve entrapment ［J］. Chinese Journal of Clinical Anatomy, 1992, 10(3): 199. (in Chinese)

朱盛修. 肩胛上切迹与肩胛上神经嵌压症的解剖学基础［J］. 中国临床解剖学杂志, 1992, 10(3):199.

［3］ Duparc F, Coquerel D, Michot C, et al. Anatomical basis of the suprascapular nerve entrapment and clinical relevance of the supraspinatus fascia ［J］. Surg Radiol Anat, 2010, 32(3): 277-284.

［4］ Holzgraefe M, Kukowski B, Eggert S, et al. Prevalence of latent and manifest suprascapular neuropathy in high-performance volleyball players ［J］. Br J Sports Med, 1994, 28(3): 177-179.

［5］ Zehetgruber H, Noske H, Lang T, et al. Suprascapular nerve entrapment A meta-analysis ［J］. Int Orthop, 2002, 26(6): 339-343.

［6］ Zhang ZhH, Wang LB, Xu GL, et al. Anatomy of the scapulae safety prediction ［J］. Acta Anatomica Sinica, 2017, 48(1): 65-69. (in Chinese)

张振华, 王立博, 徐高磊, 等. 肩胛骨安全区的解剖［J］. 解剖学报, 2017, 48(1): 65-69.

［7］ Ozer Y, Grossman J, Gilbert A. Anatomic observations on the suprascapular nerve ［J］. Hand Clin, 1995, 11(4): 539-544.

［8］ Lee J, Yoo Y, Hwang J, et al. Efficacy of direct arthroscopy-guided suprascapular nerve block after arthroscopic rotator cuff repair: a prospective randomized study ［J］. Knee Surg Sports Traumatol Arthrosc, 2015, 23(2): 562-566.

［9］ Hrdicka A. The scapul: visual observations ［J］. Am J Phys Antropol, 1942, 29: 73-94.

［10］Agrawal D, Singh B, Dixit SG, et al. Morphometry and variations of the human suprascapular notch ［J］. Morphologie, 2015, 99(327): 132-140.

［11］Bayramolu A, Demiryürek D, Tetik O, et al. Variations in anatomy at the suprascapular notch possibly causing suprascapular nerve entrapment: an anatomical study ［J］. Knee Surg Sports Traumatol Arthrosc, 2003, 11(6): 393-398.

［12］Rengachary SS, Burr D, Lucas S, et al. Suprascapular entrapment neuropathy: a clinical, anatomical, and comparative study Part 2: anatomical study ［J］. Neurosurgery, 1979, 5(4): 447-451.

［13］Tao YS, Zhong ShZh, Xu DCh, et al. Anatomical study of volleyball players' lower muscular dystrophy ［J］. Acta Anatomica Sinica, 1984, 15(1): 1-8. (in Chinese)

陶永松, 钟世镇, 徐达传, 等. 排球运动员冈下肌萎缩症的解剖学研究［J］. 解剖学报, 1984,15(1):1-8.

［14］Singh R. Variations in the origin and course of the suprascapular artery: case report and literature review ［J］. J Vasc Bras, 2018, 17(1):61-65.

［15］ab?towicz P, Synder M, Wojciechowski M, et al. Protective and predisposing morphological factors in suprascapular nerve entrapment syndrome: a fundamental review based on recent observations ［J］. Biomed Res Int, 2017, 2017: 4659761.

［16］Wang BW, Luo JW, Yu B. Treatment progress of acromioclavicular joint dislocation ［J］. Chinese Journal of Shoulder and Elbow, 2018, 6(1): 1-5. (in Chinese)

王博炜, 罗吉伟, 余斌. 肩锁关节脱位的治疗进展［J］. 中华肩肘外科电子杂志, 2018, 6(1): 1-5.

［17］Clavert P, Thomazeau H. Peri-articular suprascapular neuropathy ［J］. Orthop Traumatol Surg Res, 2014, 100(8): 409-411.

［18］Jiang HJ, Qu W. A case of proximal humeral cyst combined with posterior dislocation of shoulder joint ［J］. Chinese Journal of Shoulder and Elbow, 2017, 5(4): 305-307. (in Chinese)

蒋华军, 曲巍. 肱骨近端骨囊肿合并肩关节锁定后脱位一例［J］. 中华肩肘外科电子杂志, 2017, 5(4): 305-307.

［19］Rizzello G, Longo U, Trovato U, et al. Bilateral suprascapular nerve entrapment by ganglion cyst associated with superior labral lesion ［J］. Open Orthop J, 2013, 7(1):129-132.

［20］Sangam MR, Krupadanam K, Anasuya K, et al. A study on the morphology of the Suprascapular notch and its distance from the glenoid cavity ［J］. J Clin Diagn Res, 2013, 7(2): 189-192.

［21］Natsis K, Totlis T, Tsikaras P, et al. Proposal for classification of the suprascapular notch: a study on 423 dried scapulac ［J］. Clin Anat, 2007, 20(2): 135-139.

［22］Polguj M, J?drzejewski K, Podgórski M, et al, Morphometric study of the suprascapular notch: proposal of classification ［J］. Surg Radiol Anat, 2011, 33(9): 781-787.

［23］Polguj M, Ro K?niecki J, Sibiński M, et al. The variable morphology of suprascapular nerve and vessels at suprascapular notch: a proposal for classification and its potential clinical implications ［J］. Knee Surg Sports Traumatol Arthrosc, 2015, 23(5): 1542-1548.

［24］Song YJ, Wang YW, Xiao ChSh, et al. Amechanism study of clinical anatomy on suprascapular nerve entrapment ［J］. Chinese Journal of Clinical Anatomy, 2015, 3(6): 623-626. (in Chinese)

宋云骏, 王永为, 肖春山, 等. 肩胛上神经卡压机制的临床解剖学研究［J］. 中国临床解剖学杂志, 2015, 3(6): 623-626.

［25］Wang HJ, Chen C, Wu LP, et al. Variable morphology of the suprascapular notch: an investigation and quantitative measurements in Chinese population ［J］. Clin Anat, 2011, 24(1): 47-55.

［26］Dunkelgrun M, Iesaka K, Park SS, et al. Interobserver reliability and intraobserver reproducibility yinyongcankaowenxian14in suprascapular notch typing ［J］. Bull Hosp Jt Dis, 2003, 61(3-4): 118-122.