Polguj Michał, Jędrzejewski Kazimierz, Majos Agata, Topol Mirosław
Department of Angiology, Medical University of Łódź, Narutowicza 60, 90-136 Łódź, Poland.
Anat Sci Int. 2013 Jun;88(3):156-62. doi: 10.1007/s12565-012-0165-7. Epub 2012 Dec 4.
The suprascapular notch is the most common site of suprascapular nerve entrapment, which can manifest in disability and pain of the upper limb. Here, we present three cases of a very rare anatomical variation in the suprascapular region: the coexistence of the suprascapular notch and the suprascapular foramen. The variation was found during radiological and anatomical investigations. The suprascapular foramen was situated inferior to the suprascapular notch. A bony bridge lay between them, likely created by an ossified anterior coracoscapular ligament (ACSL). This anatomical variation probably increased the risk of suprascapular nerve entrapment by nerve irritation of the bony margins during passsage through the foramen and by a lack of the elasticity that the ACSL normally demonstrates. Also, a bony bridge passing through the middle part of the suprascapular notch reduces the space available for nerve passage (bony bridge decreases the space by about 36.5-38.6 %). One patient who underwent the radiological study had typical symptoms of suprascapular nerve entrapment. Based on his medical history and the presence of this rare variation of the suprascapular notch at the suprascapular region we suspect this neuropathy.
肩胛上切迹是肩胛上神经卡压最常见的部位，可表现为上肢功能障碍和疼痛。在此，我们报告3例肩胛上区域非常罕见的解剖变异病例：肩胛上切迹与肩胛上孔并存。这种变异是在影像学和解剖学检查中发现的。肩胛上孔位于肩胛上切迹下方。它们之间有一个骨桥，可能是由喙肩韧带（ACSL）骨化形成的。这种解剖变异可能会增加肩胛上神经卡压的风险，原因是神经在通过肩胛上孔时受到骨边缘的刺激，以及缺乏ACSL通常所具有的弹性。此外，穿过肩胛上切迹中部的骨桥会减少神经通过的空间（骨桥使空间减少约36.5-38.6%）。1例接受影像学检查的患者有肩胛上神经卡压的典型症状。根据他的病史以及肩胛上区域存在这种罕见的肩胛上切迹变异情况，我们怀疑存在这种神经病变。
