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Al-Redouan A, Benes M, Theodorakioglou A, Sadat SM, Modrak M, Kunc V, Kachlik D. Muscles variations with topographical relationship to the suprascapular notch and its potential arthroscopic feasibility. Surg Radiol Anat 2025; 47:84. [PMID: 40000494 DOI: 10.1007/s00276-025-03595-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 02/10/2025] [Indexed: 02/27/2025]
Abstract
PURPOSE This study provides an insight on the extent of muscular variability at the suprascapular notch and elaborates on its anatomical interference in suprascapular nerve arthroscopic decompression procedures. METHODS The suprascapular notch was dissected and its muscular topography was observed in 115 cadaveric specimens. High resolution imaging of the suprascapular notch was captured by a handheld digital microscope (Q-scope). The supraspinatus and subscapularis muscles were traced as they course at the suprascapular notch vicinity. The omohyoid muscle attachment onto the suprascapular ligament was measured. A scoping review and meta-analysis were done to investigate the observed rare muscular variants. RESULTS In 3.48%, the suprascapular notch anterior surface was fully covered by the subscapularis muscle. The omohyoid muscle inserted onto the suprascapular ligament in 31.25% and extended up to 3/4th of the suprascapular ligament length in 2.61%. Two rare variant muscles were encountered: subclavius posticus muscle and a newly reported "coracoscapularis muscle". CONCLUSIONS Four categories of muscles with topographical relationship to the suprascapular notch and its arthroscopic feasibility have been classified: (1) constant muscles not intervening with the suprascapular notch space - supraspinatus muscle; (2) constant muscles with variable positions that can intervene with the suprascapular notch space - subscapularis muscle; (3) constant muscles with variable positions that can intervene with the surgical approach - omohyoid muscle; (4) variable muscles intervening with the suprascapular notch space and surgical approach - subclavius posticus and coracoscapularis muscles. This study elucidates the necessity to assess/secure the omohyoid muscle attachment onto the suprascapular ligament in suprascapular nerve decompression ligamentectomy. LEVEL OF EVIDENCE V Basic Science Research.
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Affiliation(s)
- Azzat Al-Redouan
- Department of Anatomy, Second Faculty of Medicine, Charles University, V Uvalu 84, Prague, 150 06, Czech Republic.
- Centre for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Michal Benes
- Department of Anatomy, Second Faculty of Medicine, Charles University, V Uvalu 84, Prague, 150 06, Czech Republic
- Centre for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Aimilia Theodorakioglou
- Department of Anatomy, Second Faculty of Medicine, Charles University, V Uvalu 84, Prague, 150 06, Czech Republic
- Centre for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Seyed Mehdi Sadat
- Department of Anatomy, Second Faculty of Medicine, Charles University, V Uvalu 84, Prague, 150 06, Czech Republic
- Centre for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Martin Modrak
- Department of Bioinformatics, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vojtech Kunc
- Department of Anatomy, Second Faculty of Medicine, Charles University, V Uvalu 84, Prague, 150 06, Czech Republic
- Centre for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - David Kachlik
- Department of Anatomy, Second Faculty of Medicine, Charles University, V Uvalu 84, Prague, 150 06, Czech Republic
- Centre for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic
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Rossi MJ, Brand JC, Provencher MT, Lubowitz JH. A cavalcade of shoulder controversies: deadman angle revisited… divergent anchor angles and depths, and rotator cuff vectors confuse comparison… and more. Arthroscopy 2014; 30:1529-32. [PMID: 25464868 DOI: 10.1016/j.arthro.2014.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 10/07/2014] [Indexed: 02/02/2023]
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Poehling GG. Change: a constant in orthopaedics. Arthroscopy 2014; 30:415-7. [PMID: 24680296 DOI: 10.1016/j.arthro.2014.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 01/09/2014] [Indexed: 02/02/2023]
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