Posterior Shoulder Pain: A Dynamic Study of the Spinoglenoid Ligament and Treatment With Arthroscopic Release of the Scapular Tunnel

Plancher, Kevin D.; Luke, Timothy; Peterson, Robert K. D.; Yacoubian, Stephen V.

doi:10.1016/j.arthro.2007.03.098

Cited by 72 publications

(40 citation statements)

References 28 publications

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“…Kannan et al (17) Present study 10.0 9.7 has been reported by Plancher et al; (21) the authors concluded that dynamic compression by the spinoglenoid ligament during repetitive shoulder abductions is an important but often overlooked factor in posterior shoulder pain. (21) Thus, an ossified ITSL could be a cause of SSN compression in an osseous spinoglenoid foramen, during overhead and repetitive shoulder movements (hence, SSN compression of this nature may be more prevalent in sportspersons).…”

Section: Indianmentioning

confidence: 60%

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Unusual morphology of scapulae: incidence and dimensions of ossified ligaments and supraspinous bony tunnels for clinical consideration

Kharay

Sharma

Singh

2016

smedj

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INTRODUCTIONKnowledge of anatomical variations and anomalies along the course of the suprascapular nerve (SSN) is important in the treatment of SSN entrapment syndrome, and bony and brachial plexus injuries. This knowledge is also important for surgeons carrying out surgical interventions at the shoulder region.The SSN provides sensory innervation to the posterosuperior aspect of the shoulder and motor innervation to the supraspinatus and infraspinatus muscles. The SSN passes beneath the superior transverse scapular ligament (STSL) and inferior transverse scapular ligament (ITSL) at the fibro-osseous canals of the suprascapular notch and spinoglenoid notch, respectively. Therefore, the STSL and ITSL are potential sites of SSN compression. Complete ossification of the STSL with formation of bony foramina is the most recognised predisposing factor for compression at the suprascapular notch;(1) it is also a risk factor in surgical exploration for SSN decompression. In a recent histological and immunohistochemical study, it was found that all five cadaveric shoulders that had STSL ossification showed signs of neural degeneration in the nerve specimens.(3) However, a high incidence of ossified STSL does not proportionally correlate with the occurrence of SSN entrapment; (4,5) this could be due to the lack of focus on the influence that the body ridge shape (created by the ossified STSL) has on SSN entrapment. With this in mind, the present study was designed to analyse the variable morphological aspects of the ossified STSL, along with other ossified ligaments found in the scapula. We also document any rare findings of ossified ITSL and bony tunnels (i.e. the bony canal found between the suprascapular notch and spinoglenoid notch), as well as their dimensions, as these structures could potentially compress vascular and neural elements by reducing available space in the spinoglenoid notch. (6,7) In short, the present study explored the incidence of ossified ligaments and bony tunnels along the course of the SSN in dry human scapulae from a North Indian population. We also measured and recorded the dimensions of osseous ligaments and any rare bony tunnel and foramina at the suprascapular notch and spinoglenoid notch. As the existing data on ossified ligaments of dry human scapulae is limited, the data obtained in the present study would augment the current anatomical and morphological reference values. This would also aid in defining the anatomical risk factors for SSN entrapment and identifying the surgical hazards present during open and arthroscopic interventions in the suprascapular and spinoglenoid notch regions. METHODSThe present study was conducted on 268 dry human adult scapulae of unknown gender from a North Indian population. Among the 268 scapulae, 126 were right-sided and 142 were

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Section: Indianmentioning

confidence: 60%

“…(21) Thus, an ossified ITSL could be a cause of SSN compression in an osseous spinoglenoid foramen, during overhead and repetitive shoulder movements (hence, SSN compression of this nature may be more prevalent in sportspersons).…”

Section: Indianmentioning

confidence: 99%

Unusual morphology of scapulae: incidence and dimensions of ossified ligaments and supraspinous bony tunnels for clinical consideration

Kharay

Sharma

Singh

2016

smedj

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“…Plancher et al [ 106 ] identifi ed increased traction of the suprascapular nerve over the spinoglenoid ligament during the follow-through phase of the overhand throwing motion. Their study suggests that the spinoglenoid notch may provide a fulcrum against which the nerve stretches, thus producing chronic traction injuries in overhead athletes.…”

Section: Pathogenesismentioning

confidence: 98%

“…Horizontal adduction and internal rotation may exacerbate this pain as a result of the increased tension placed on the suprascapular nerve in this position [ 106 ]. Patients may also complain of weakness with motions that involve abduction and external rotation, especially in those patients with suprascapular nerve entrapment proximal to the supraspinatus muscle (i.e., at the suprascapular notch) [ 110 ].…”

Section: Physical Examinationmentioning

confidence: 98%

Neurovascular Disorders

Warth

Millett

2015

Physical Examination of the Shoulder

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“…It has been proposed that a combination of friction, traction and twist, causes nerve trauma in volleyball players and pitchers [17,21,22], and especially right after the pitch [22]. Another source of neural compression has been proposed to be the infraspinatus impingement on the nerve, when the humerus performs abduction and external rotation in strenuous overhead activities [23].…”

Section: Pathophysiologymentioning

confidence: 99%

Suprascapular Neuropathy: An Overview

Angoules¹,

Boutsikari²

2015

J Nov Physiother

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Objective: To present an overview on suprascapular neuropathy (SSN), a compressive neuropathy which leads to a significant upper extremity impairment. Methods: A narrative review of international medical literature was conducted in order to depict current concepts of diagnosis and treatment.Conlusion: Supracapular neuropathy is a rare albeit painful condition affecting mainly overhead athletes. Although not always observable as initial diagnosis it should be included in the differential diagnosis when assessing a shoulder dysfunction.

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Posterior Shoulder Pain: A Dynamic Study of the Spinoglenoid Ligament and Treatment With Arthroscopic Release of the Scapular Tunnel

Cited by 72 publications

References 28 publications

Unusual morphology of scapulae: incidence and dimensions of ossified ligaments and supraspinous bony tunnels for clinical consideration

Unusual morphology of scapulae: incidence and dimensions of ossified ligaments and supraspinous bony tunnels for clinical consideration

Neurovascular Disorders

Suprascapular Neuropathy: An Overview

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