Scapular morphometrics inform anatomic landmark distances for arthroscopic suprascapular nerve decompression: a...

Area of Science:

• Orthopedic Surgery
• Anatomy
• Surgical Technique

Background:

• Arthroscopic suprascapular nerve (SSN) decompression is a common treatment for SSN entrapment.
• The procedure involves dissection near critical neurovasculature, with limited anatomical guidelines.
• This study addresses the need for patient-specific anatomical guidance.

Purpose of the Study:

• To provide anatomical guidelines for safe, patient-specific arthroscopic SSN decompression.
• To identify critical distances around the suprascapular notch.
• To reduce risks to adjacent neurovasculature during surgery.

Main Methods:

• Dissection of 20 cadaveric shoulders.
• Measurement of distances from the SSN and SSA to the lateral STSL.
• Correlation of these distances with scapular dimensions and landmarks like the acromion and AC joint.

Main Results:

• The SSN and SSA were found as close as 2.6 mm and 1.4 mm to the lateral STSL, respectively.
• Distances from the lateral STSL to the lateral acromion and AC joint correlated significantly with scapular dimensions.
• Established safe dissection limits relative to the AC joint and lateral acromion.

Conclusions:

• A "lateral danger zone" exists at the suprascapular notch, with potential for close proximity of SSN and SSA.
• Blunt dissection can be cautiously performed up to 3.0 cm from the AC joint and 6.0 cm from the lateral acromion.
• Incorporating individual scapular dimensions can refine surgical planning and improve intraoperative safety for SSN decompression.