The superior transverse scapular ligament and its relation to the suprascapular Neurovascular triad: Anatomical study and clinical significance

Abstract

BackgroundThe anatomical variations at the suprascapular region have great impact on the suprascapular nerve and its entrapment syndrome. AimThis study aimed to describe the morphological types and morphometric parameters of the superior transverse scapular ligament (STSL) and its relation to suprascapular neurovascular triad. Material & methodsThe suprascapular region was dissected in 60 (40 male & 20 female) cadaveric shoulders. The morphological variants, length, widths, thickness of STSL, and its relation to suprascapular triad were evaluated. ResultsFive morphological types of STSL were identified. The common variant was the fan-shaped followed by the band-shaped and the triangular-shaped, while the ossified and bifid forms revealed lower incidence rates with no side or sex significant difference. Morphometrically, the length of STSL measured 16.4 ± 2.4 mm, medial width was 13.3 ± 3 mm and its lateral width measured 5.4 ± 1.3 mm with no side significant difference (p > 0.05). Moreover, its length measured 16.6 ± 2.6 mm in male and 15.8 ± 1.9 mm in female, its medial width was 13.7 ± 2.2 mm in male and 12.2 ± 2 in female, and its lateral width measured 5.6 ± 1.3 in male and 5.1 ± 1.1 mm in female specimens. The relation between the suprascapular triad and STSL showed three main variants: where the blood vessels pass above the STSL (56.7 %), followed by the passage of the artery above and the vein below STSL (23.3 %), and the blood vessels below STSL (11.7 %). ConclusionKnowledge the morphological variants and morphometric measurements of STSL and its relation to the suprascapular triad are important during surgical and arthroscopic procedures of the shoulder region.