Suprascapular Nerve Position and Distances to Bony and Arthroscopic Landmarks: An Anatomic Study of Sex Variations and Surgical Implications

肩胛上神经的位置及其与骨性标志和关节镜标志的距离:性别差异和手术意义的解剖学研究

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Abstract

BACKGROUND: Arthroscopic suprascapular nerve release treats suprascapular neuropathy, but surgical challenges require precise anatomic landmarks and optimal instrument positioning. PURPOSES: To examine the anatomic relationships of the suprascapular nerve to bony and arthroscopic landmarks, evaluate sex- and height-related variations, and provide insights to improve arthroscopic surgical accuracy and reduce complications. STUDY DESIGN: Descriptive laboratory study. METHODS: A total of 22 shoulders from 11 Thiel-embalmed cadavers (6 male, 5 female) were dissected to measure distances from the suprascapular nerve to bony landmarks (acromion, coracoid process, glenoid) and arthroscopic landmarks (coracoacromial ligament and conoid ligament). Notch dimensions and angles relevant to arthroscopic portal placement were also evaluated. Measurements were analyzed for correlations with sex and height. RESULTS: The mean distance from the suprascapular nerve to the posterolateral acromion (D1) was 58.34 ± 6.58 mm, and to the anterolateral acromion (D2) was 59.50 ± 5.22 mm, both statistically significantly greater in male patients (D1, 63.38 ± 3.90 mm vs 52.29 ± 2.79 mm; D2, 63.09 ± 3.49 mm vs 55.20 ± 3.30 mm; P < .001). Arthroscopic landmarks showed no statistically significant correlation with height. The suprascapular notch was predominantly type 3 (90.9%) with a mean width of 9.93 ± 1.34 mm and nerve-to-lateral border distance of 4.67 ± 1.27 mm, consistent across sex. Moderate, statistically significant correlations with height were noted for distances D1 (r = 0.51). CONCLUSION: This study demonstrated that the suprascapular nerve's distance to bony landmarks varies by sex, while arthroscopic and notch dimensions remain consistent. Height moderately influences certain bony landmark distances. CLINICAL RELEVANCE: These results provide essential anatomic references to enhance the precision of arthroscopic decompression.

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