Ossification of the suprascapular ligament: A risk factor for suprascapular nerve compression?

R. Shane Tubbs, Carl Nechtman, Anthony V. D'Antoni, Mohammadali Mohajel Shoja, Martin M. Mortazavi, Marios Loukas, Curtis J. Rozzelle, Robert J. Spinner

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Introduction: Entrapment of the suprascapular nerve at the suprascapular notch may be due to an ossified suprascapular ligament. The present study was conducted in order to investigate the incidence of this anomaly and to analyze the resultant bony foramen (foramen scapula) for gross nerve compression. Materials and Methods: We evaluated 104 human scapulae from 52 adult skeletons for the presence of complete ossification of the suprascapular ligament. When an ossified suprascapular ligament was identified, the diameter of the resultant foramen was measured. Also, the suprascapular regions of 50 adult cadavers (100 sides) were dissected. When an ossified suprascapular ligament was identified, the spinati musculature was evaluated for gross atrophy and the diameters of the resultant foramen scapulae and the suprascapular nerve were measured. Immunohistochemical analysis of the nerve was also performed. Results: For dry scapular specimens, 5.7% were found to have an ossified suprascapular ligament. The mean diameter of these resultant foramina was 2.6 mm. For cadavers, an ossified suprascapular ligament was identified in 5% of sides. Sections of the suprascapular nerve at the foramen scapulae ranged from 2 to 2.8 mm in diameter. In all cadaveric samples, the suprascapular nerve was grossly compressed (~10-20%) at this site. All nerves demonstrated histologic signs of neural degeneration distal to the site of compression. The presence of these foramina in male cadavers and on right sides was statistically significant. Conclusions: Based on our study, even in the absence of symptoms, gross compression of the suprascapular nerve exists in cases of an ossified suprascapular ligament. Asymptomatic patients with an ossified suprascapular ligament may warrant additional testing such as electromyography.

Original languageEnglish (US)
Pages (from-to)19-22
Number of pages4
JournalInternational Journal of Shoulder Surgery
Volume7
Issue number1
DOIs
StatePublished - Jan 1 2013
Externally publishedYes

Fingerprint

Ligaments
Osteogenesis
Scapula
Cadaver
Nerve Compression Syndromes
Electromyography
Skeleton
Atrophy
Incidence

Keywords

  • Anatomy
  • entrapment
  • neurosurgery
  • ossification
  • peripheral nerve
  • suprascapular ligament
  • suprascapular nerve

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Tubbs, R. S., Nechtman, C., D'Antoni, A. V., Mohajel Shoja, M., Mortazavi, M. M., Loukas, M., ... Spinner, R. J. (2013). Ossification of the suprascapular ligament: A risk factor for suprascapular nerve compression? International Journal of Shoulder Surgery, 7(1), 19-22. https://doi.org/10.4103/0973-6042.109882

Ossification of the suprascapular ligament : A risk factor for suprascapular nerve compression? / Tubbs, R. Shane; Nechtman, Carl; D'Antoni, Anthony V.; Mohajel Shoja, Mohammadali; Mortazavi, Martin M.; Loukas, Marios; Rozzelle, Curtis J.; Spinner, Robert J.

In: International Journal of Shoulder Surgery, Vol. 7, No. 1, 01.01.2013, p. 19-22.

Research output: Contribution to journalArticle

Tubbs, RS, Nechtman, C, D'Antoni, AV, Mohajel Shoja, M, Mortazavi, MM, Loukas, M, Rozzelle, CJ & Spinner, RJ 2013, 'Ossification of the suprascapular ligament: A risk factor for suprascapular nerve compression?', International Journal of Shoulder Surgery, vol. 7, no. 1, pp. 19-22. https://doi.org/10.4103/0973-6042.109882
Tubbs, R. Shane ; Nechtman, Carl ; D'Antoni, Anthony V. ; Mohajel Shoja, Mohammadali ; Mortazavi, Martin M. ; Loukas, Marios ; Rozzelle, Curtis J. ; Spinner, Robert J. / Ossification of the suprascapular ligament : A risk factor for suprascapular nerve compression?. In: International Journal of Shoulder Surgery. 2013 ; Vol. 7, No. 1. pp. 19-22.
@article{e6290aa3104e46258ad6d3a74705e1cd,
title = "Ossification of the suprascapular ligament: A risk factor for suprascapular nerve compression?",
abstract = "Introduction: Entrapment of the suprascapular nerve at the suprascapular notch may be due to an ossified suprascapular ligament. The present study was conducted in order to investigate the incidence of this anomaly and to analyze the resultant bony foramen (foramen scapula) for gross nerve compression. Materials and Methods: We evaluated 104 human scapulae from 52 adult skeletons for the presence of complete ossification of the suprascapular ligament. When an ossified suprascapular ligament was identified, the diameter of the resultant foramen was measured. Also, the suprascapular regions of 50 adult cadavers (100 sides) were dissected. When an ossified suprascapular ligament was identified, the spinati musculature was evaluated for gross atrophy and the diameters of the resultant foramen scapulae and the suprascapular nerve were measured. Immunohistochemical analysis of the nerve was also performed. Results: For dry scapular specimens, 5.7{\%} were found to have an ossified suprascapular ligament. The mean diameter of these resultant foramina was 2.6 mm. For cadavers, an ossified suprascapular ligament was identified in 5{\%} of sides. Sections of the suprascapular nerve at the foramen scapulae ranged from 2 to 2.8 mm in diameter. In all cadaveric samples, the suprascapular nerve was grossly compressed (~10-20{\%}) at this site. All nerves demonstrated histologic signs of neural degeneration distal to the site of compression. The presence of these foramina in male cadavers and on right sides was statistically significant. Conclusions: Based on our study, even in the absence of symptoms, gross compression of the suprascapular nerve exists in cases of an ossified suprascapular ligament. Asymptomatic patients with an ossified suprascapular ligament may warrant additional testing such as electromyography.",
keywords = "Anatomy, entrapment, neurosurgery, ossification, peripheral nerve, suprascapular ligament, suprascapular nerve",
author = "Tubbs, {R. Shane} and Carl Nechtman and D'Antoni, {Anthony V.} and {Mohajel Shoja}, Mohammadali and Mortazavi, {Martin M.} and Marios Loukas and Rozzelle, {Curtis J.} and Spinner, {Robert J.}",
year = "2013",
month = "1",
day = "1",
doi = "10.4103/0973-6042.109882",
language = "English (US)",
volume = "7",
pages = "19--22",
journal = "International Journal of Shoulder Surgery",
issn = "0973-6042",
publisher = "Cape Shoulder Institute",
number = "1",

}

TY - JOUR

T1 - Ossification of the suprascapular ligament

T2 - A risk factor for suprascapular nerve compression?

AU - Tubbs, R. Shane

AU - Nechtman, Carl

AU - D'Antoni, Anthony V.

AU - Mohajel Shoja, Mohammadali

AU - Mortazavi, Martin M.

AU - Loukas, Marios

AU - Rozzelle, Curtis J.

AU - Spinner, Robert J.

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Introduction: Entrapment of the suprascapular nerve at the suprascapular notch may be due to an ossified suprascapular ligament. The present study was conducted in order to investigate the incidence of this anomaly and to analyze the resultant bony foramen (foramen scapula) for gross nerve compression. Materials and Methods: We evaluated 104 human scapulae from 52 adult skeletons for the presence of complete ossification of the suprascapular ligament. When an ossified suprascapular ligament was identified, the diameter of the resultant foramen was measured. Also, the suprascapular regions of 50 adult cadavers (100 sides) were dissected. When an ossified suprascapular ligament was identified, the spinati musculature was evaluated for gross atrophy and the diameters of the resultant foramen scapulae and the suprascapular nerve were measured. Immunohistochemical analysis of the nerve was also performed. Results: For dry scapular specimens, 5.7% were found to have an ossified suprascapular ligament. The mean diameter of these resultant foramina was 2.6 mm. For cadavers, an ossified suprascapular ligament was identified in 5% of sides. Sections of the suprascapular nerve at the foramen scapulae ranged from 2 to 2.8 mm in diameter. In all cadaveric samples, the suprascapular nerve was grossly compressed (~10-20%) at this site. All nerves demonstrated histologic signs of neural degeneration distal to the site of compression. The presence of these foramina in male cadavers and on right sides was statistically significant. Conclusions: Based on our study, even in the absence of symptoms, gross compression of the suprascapular nerve exists in cases of an ossified suprascapular ligament. Asymptomatic patients with an ossified suprascapular ligament may warrant additional testing such as electromyography.

AB - Introduction: Entrapment of the suprascapular nerve at the suprascapular notch may be due to an ossified suprascapular ligament. The present study was conducted in order to investigate the incidence of this anomaly and to analyze the resultant bony foramen (foramen scapula) for gross nerve compression. Materials and Methods: We evaluated 104 human scapulae from 52 adult skeletons for the presence of complete ossification of the suprascapular ligament. When an ossified suprascapular ligament was identified, the diameter of the resultant foramen was measured. Also, the suprascapular regions of 50 adult cadavers (100 sides) were dissected. When an ossified suprascapular ligament was identified, the spinati musculature was evaluated for gross atrophy and the diameters of the resultant foramen scapulae and the suprascapular nerve were measured. Immunohistochemical analysis of the nerve was also performed. Results: For dry scapular specimens, 5.7% were found to have an ossified suprascapular ligament. The mean diameter of these resultant foramina was 2.6 mm. For cadavers, an ossified suprascapular ligament was identified in 5% of sides. Sections of the suprascapular nerve at the foramen scapulae ranged from 2 to 2.8 mm in diameter. In all cadaveric samples, the suprascapular nerve was grossly compressed (~10-20%) at this site. All nerves demonstrated histologic signs of neural degeneration distal to the site of compression. The presence of these foramina in male cadavers and on right sides was statistically significant. Conclusions: Based on our study, even in the absence of symptoms, gross compression of the suprascapular nerve exists in cases of an ossified suprascapular ligament. Asymptomatic patients with an ossified suprascapular ligament may warrant additional testing such as electromyography.

KW - Anatomy

KW - entrapment

KW - neurosurgery

KW - ossification

KW - peripheral nerve

KW - suprascapular ligament

KW - suprascapular nerve

UR - http://www.scopus.com/inward/record.url?scp=84883231901&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84883231901&partnerID=8YFLogxK

U2 - 10.4103/0973-6042.109882

DO - 10.4103/0973-6042.109882

M3 - Article

C2 - 23858291

AN - SCOPUS:84883231901

VL - 7

SP - 19

EP - 22

JO - International Journal of Shoulder Surgery

JF - International Journal of Shoulder Surgery

SN - 0973-6042

IS - 1

ER -