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肩胛切迹的形态测量及其在肩胛上神经卡压中的临床意义

Morphometry of the Scapular Notch and Its Clinical Implication in Suprascapular Nerve Entrapment.

作者信息

Duque-Colorado Jhonatan, Alzate-Mejia Oscar Andrés, Del Sol Mariano

机构信息

Programa de Doctorado en Ciencias Morfológicas, Facultad de Medicina, Universidad de La Frontera, Temuco 4780000, Chile.

Centro de Excelencia en Estudios Morfológicos y Quirúrgicos (CEMyQ), Facultad de Medicina, Universidad de La Frontera, Temuco 4780000, Chile.

出版信息

Diagnostics (Basel). 2025 Feb 2;15(3):346. doi: 10.3390/diagnostics15030346.

Abstract

: The aim of the present study was to evaluate the relationship between the type of scapular notch (SN), the morphometry of the SN, and the area of the suprascapular nerve (SSN). In addition to determining whether scapular notches other than Type VI, according to the classification of Rengachary, can generate a predisposition to SSN entrapment neuropathy. : One hundred and sixty-nine dry scapulae were examined, the scapular notches were classified, according to the classification of Rengachary, and for each SN, the superior transverse diameter (STD), longitudinal diameter (LD), and area of the SN were determined. The SSN was dissected in five shoulders and its area was calculated. The data were analyzed in the statistical software SPSS. : The values for the STD, LD, and area of the SN showed significant differences between the types of scapular notches ( < 0.0001). Along the same lines, a considerable positive correlation (r = 0.79; < 0.0001) was established between the area of the SN and the STD. Similarly, a very strong positive correlation (r = 0.87; < 0.0001) was established between the area of the SN and the LD. This indicated that, as the STD and the LD increase, the area of the SN increases. : Although different studies have reported an association between SN Type VI and the compression of the SSN by the formation of a bony hole that reduces the area of the notch, we have found that SN Type IV presented a smaller area among the types of notches and a smaller area than the SSN, which exposes the SSN to be closer to or in contact with the superior transverse ligament of the scapula, potentially subjecting the nerve to greater pressure and potentially resulting in SSN entrapment. This is evidence that should be considered in the clinical diagnosis of patients with entrapment neuropathy, since the type of SN and the area of the SSN can be determined by ultrasound, which contributes to a more accurate preoperative evaluation and diagnosis.

摘要

本研究的目的是评估肩胛切迹(SN)的类型、SN的形态测量以及肩胛上神经(SSN)的面积之间的关系。此外,根据Rengachary分类法,确定除VI型以外的肩胛切迹是否会导致SSN压迫性神经病变。:检查了169块干燥肩胛骨,根据Rengachary分类法对肩胛切迹进行分类,并确定每个SN的上横径(STD)、纵径(LD)和SN的面积。在五个肩部解剖了SSN并计算其面积。数据在统计软件SPSS中进行分析。:SN的STD、LD和面积值在肩胛切迹类型之间显示出显著差异(<0.0001)。同样,SN的面积与STD之间建立了相当强的正相关(r = 0.79;<0.0001)。类似地,SN的面积与LD之间建立了非常强的正相关(r = 0.87;<0.0001)。这表明,随着STD和LD的增加,SN的面积也增加。:尽管不同的研究报告了VI型SN与由于形成SSN受压之间的关联,即形成骨孔会减小切迹面积,但我们发现IV型SN在切迹类型中面积较小,且小于SSN的面积,这使得SSN更靠近或接触肩胛上横韧带,可能使神经承受更大压力,从而可能导致SSN受压。这是在压迫性神经病变患者的临床诊断中应考虑的证据,因为SN的类型和SSN的面积可以通过超声确定,这有助于进行更准确的术前评估和诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d524/11817711/33d5e38dce68/diagnostics-15-00346-g001.jpg

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