A Novel Variant of Suprascapular Neurovascular Morphology: Clinical and Surgical Implications

The suprascapular neurovascular structures traverse the suprascapular notch in a variety of morphologies. However, the suprascapular nerve has always been described as coursing under the superior transverse scapular ligament (STSL) at the level of the notch. This report aims to describe a novel variant of suprascapular neurovascular structures found in a cadaver.

During the dissection of a cadaveric upper extremity in an 85-year-old Caucasian male, the suprascapular nerve, artery, and vein were found to course above the STSL, with no structures passing through the foramen of the notch itself. A total of 94 upper extremities from 52 different cadavers were subsequently examined for the morphology of the suprascapular nerve, artery, and vein at the level of the suprascapular notch. No other cadavers were found to have this morphology, thereby resulting in an estimated prevalence of 1.1%.

This case study describes this unique unilateral shoulder anomaly, reviews the relevant literature, and discusses the potential clinical significance of this variant, which should be considered during various posterior shoulder surgeries or peripheral nerve blocks wherein aberrant morphology can increase the risk of neurovascular complications.