New insights into pathways of the dorsal scapular nerve and artery for selective dorsal scapular nerve blockade

Abstract

BackgroundThe aim of this study was to clarify the topographical relationships between the dorsal scapular nerve (DSN) and the dorsal scapular artery (DSA) in the interscapular region to identify safe and convenient injection points related to DSN blockade.MethodsThirty shoulders of embalmed Korean cadavers and 50 live subjects were used for dissection and ultrasound (US) analysis.ResultsThe running patterns of the DSA and DSN in the interscapular region were classified into 3 types. Type I was defined as nerves that were medial to the artery and parallel without changing location (80.0% of specimens). In type II (13.3%), the nerve and artery traversed one another only one time over their entire length. In type III (6.7%), the nerve and artery traversed one another, resembling a twist. Above the level of the scapular spine, the nerve was always medial to the artery. Below the scapular spine, the number of arteries was obviously decreased. Most of the arteries were lateral to the medial border of the scapula, except at the level of the superior angle of the scapula artery (SA). The positional tendency of the DSN toward the medial or lateral sides from the medial border of the scapula was similar. In US imaging of live subjects, the DSA was most observed at the level of the SA (94.0%).ConclusionsResults of this study enhance the current knowledge regarding the pathway of the DSN and DSA and provide helpful information for selective diagnostic nerve blocks in the interscapular region.

Changes in blood flow in the dorsal scapular artery and relationship to shoulder joint function in rotator cuff tears

“… 28 The DSA, which is located medial to the superior angle of the scapula and on the first rib, was delineated in the short axis with the ultrasound probe; the beating was confirmed on the Doppler image; and then the probe was rotated to delineate the vessel in the long axis. In a prior study, the DSA was observed in 94% at this specific site, 5 and our study observed the DSA in all cases. The angle of incidence was set at 60°.…”

Diagnosis of suprascapular nerve entrapment syndrome based on the infraspinatus muscle cross-sectional area on shoulder MRI

“…First, SNE syndrome has a variety of causes, including trauma, rotator cuff damages, repetitive overhead activities, and the supraspinatus and/or infraspinatus muscles. [20][21][22][23][24][25][26][27][28][29][30] However, we only focused on the infraspinatus muscle. Second, there may be incorrect measurements of IMCSA and SMT in MRS.…”

Accuracy of suprascapular notch cross-sectional area by MRI in the diagnosis of suprascapular nerve entrapment syndrome – a retrospective pilot study

“…Imaging studies can also be used for diagnosis [ 14 , 15 ]. Ultrasound, X-ray, computed tomography, and MRI provide information on the suprascapular nerve and surrounding structures, helping diagnose SNES [ 15 , 25 , 26 ]. Nerve conduction velocity and EMG are the gold standards for SNES diagnosis [ 14 ].…”