Abstract
Background: Sonographic evaluation of the suprascapular notch (SSN) region is clinically important, because it is the most common location for performing suprascapular nerve block. The aim of the study was to describe the morphology of the SSN region based on ultrasound examination and in accordance with the patients’ body mass index (BMI). Material and Methods: The SSN region was sonographically examined in 120 healthy volunteers according to our new four-step protocol. The morphometry of the SSN and the neurovascular bundle was assessed, and patients’ BMI were calculated. The shape of the suprascapular notch was classified based on its superior transverse diameter (STD) and maximal depth (MD). Result: The type III scapular notch was the most prevalent (64%). The BMI was higher in type IV/V (27.38 ± 3.76) than in type I (24.77 ± 3.49). However, no significant differences were observed in the distribution of SSN notch types with regard to BMI (p = 0.0536). The suprascapular artery was visualised in all of the recognised SSNs, while the suprascapular vein and nerve were visualised only in 74.9% and 48.1% of the SSNs, respectively. The suprascapular nerve was significantly thicker on the right side (3.5 ± 1.1 mm) than on the left (1.3 ± 0.4 mm) (p = 0.001). In contrast, the suprascapular vein (1.5 ± 0.9 mm) was found to be a significantly wider on the left side than the right (1.2 ± 0.7 mm) (p = 0.001). Conclusion: Our original four-step sonographic protocol enabled characterising the morphology of the SSN region, despite the SSN notch types. The suprascapular artery is the best sonographic landmark for the suprascapular notch region. No significant differences were found between sides regarding the thickness of the soft tissue above the suprascapular nerve and vessels. Recognition of the SSN morphology is not affected by the BMI.
Highlights
The suprascapular notch (SSN) is a depression located on the superior border of the scapula, medially to the coracoid process
No significant differences were observed in the distribution of SSN notch types with regard to body mass index (BMI) (p = 0.0536) (Table 1)
Our present findings indicate the thickness of the soft tissue over the suprascapular nerve, suprascapular vein, and suprascapular artery to be 36.0 ± 5.7 mm, 35.8 ± 6.0 mm, and 34.2 ± 5.7 mm, respectively
Summary
The suprascapular notch (SSN) is a depression located on the superior border of the scapula, medially to the coracoid process. A great deal of variation exists in the SSN region regarding the morphology of the SSN itself [1,2], the morphology of the superior transverse scapular ligament [3,4] and anterior coracoscapular ligament [5,6], and the arrangement of the suprascapular triad (a nerve, a vein, and an artery) [7,8]. The morphology of the SSN region is important from a clinical point of view, because it is the most common site of suprascapular nerve compression and injury [9,10]. Sonographic evaluation of the suprascapular notch (SSN) region is clinically important, because it is the most common location for performing suprascapular nerve block. Conclusion: Our original four-step sonographic protocol enabled characterising the morphology of the SSN region, despite the SSN notch types. Recognition of the SSN morphology is not affected by the BMI
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