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经后入路肩部神经移位术中肩胛上横韧带骨化的发生率

The Incidence of Ossified Superior Transverse Scapular Ligament during Nerve Transfer through Posterior Shoulder Approach.

作者信息

Yavari Masoud, Hassanpour Seyed Esmaeil, Alizadeh Otaghvar Hamidreza, Abdolrazaghi Hossein A, Farhoud Amir R

机构信息

Department of Plastic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Iran university of Medical Sciences, & Fellow of plastic and reconstructive surgery, Department of plastic surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Arch Bone Jt Surg. 2019 May;7(3):258-262.

Abstract

BACKGROUND

The purpose of this study was to assess the incidence and importance of bony bridge that covers the supra scapular notch during posterior approach to transfer accessory nerve to suprascapular nerve.

METHODS

Between 2010 and 2015, the frequency and importance of suprascapular bony bridge instead of transverse ligament was assessed among patients with brachial plexus injury candidate to shoulder function restoration by accessory to suprascapular nerve transfer through posterior approach.

RESULTS

Forty three patients, 41 male and 2 female, (mean age: 32.5 years, range 14 to 36) were included in this study. Five male patients (11.6%) had a complete bony rim on the superior scapular notch. Suprascapular nerve release needed osteotomy of the bony bridge and related equipment.

CONCLUSION

Although all previous cadaveric studies among different ethnic groups had reported the prevalence between 0.3 to 30% of suprascapular canal, this in vivo study showed the incidence of 11.6%. Preoperative alertness about this variation could make the exploration and release of the suprascapular nerve easier and reduce the risk of nerve injury or failing to anatomize it.

LEVEL OF EVIDENCE

IV.

摘要

背景

本研究旨在评估在经后路将副神经转移至肩胛上神经时覆盖肩胛上切迹的骨桥的发生率及重要性。

方法

在2010年至2015年期间,对拟通过经后路副神经至肩胛上神经转移来恢复肩部功能的臂丛神经损伤患者,评估肩胛上骨桥而非横韧带的频率及重要性。

结果

本研究纳入了43例患者,其中男性41例,女性2例,(平均年龄:32.5岁,范围14至36岁)。5例男性患者(11.6%)在肩胛上切迹处有完整的骨缘。肩胛上神经松解需要对骨桥进行截骨及相关操作。

结论

尽管之前不同种族的所有尸体研究均报道肩胛上管的发生率在0.3%至30%之间,但本活体研究显示其发生率为11.6%。术前对这种变异保持警惕可使肩胛上神经的探查及松解更容易,并降低神经损伤或解剖失败的风险。

证据级别

IV级。

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Nerve Transfers in the Upper Extremity: A Practical User's Guide.上肢神经移植:实用指南
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