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Review
. 2016:2016:4134280.
doi: 10.1155/2016/4134280. Epub 2016 Dec 25.

Anterior Coracoscapular Ligament as a Factor Predisposing to or Protective for Suprascapular Neuropathy

Michał Polguj  1 , Marek Synder  2 , Andrzej Borowski  2 , Mariusz Wojciechowski  3 , Grzegorz Wysiadecki  4 , Mirosław Topol  4
Affiliations
Review

Anterior Coracoscapular Ligament as a Factor Predisposing to or Protective for Suprascapular Neuropathy

Michał Polguj et al. Biomed Res Int. 2016.

Abstract

Suprascapular neuropathy is a pathology caused by injury or compression of the suprascapular nerve. As the nerve runs from the anterior to posterior side of the scapula, the hot point where it is most susceptible to both injury and compression is the suprascapular notch. A literature search reveals several potential predisposing morphological factors in this area. However the most recent reports indicate that the structures at the suprascapular notch region may also prevent nerve injury and compression. The role of the anterior coracoscapular ligament (ACSL) remains unclear. While some studies indicate that it may predispose to suprascapular neuropathy, the newest study proposes a protective function. The aim of the article was to review the function of the anterior coracoscapular ligament in the light of the most recent studies. An understanding of the role of the ligament is essential for arthroscopic and other surgical procedures of this area in order to avoid iatrogenic injury of the suprascapular nerve.

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Conflict of interest statement

The authors declare that they have no conflict of interests.

Figures

Figure 1
Figure 1
Formalin-fixed cadaveric shoulder focused on suprascapular region (band-shape ACSL); ACSL, anterior coracoscapular ligament; arrowhead, superior border of the scapula; CP, coracoid process; SN, suprascapular nerve; SM, supraspinatus muscle; STSL, superior transverse scapular ligament.
Figure 2
Figure 2
Schema presenting the predisposing (red arrows) or protective (green arrow) roles of the ACSL. In “deep and narrow” suprascapular notch (a), the nerve might be irritated by bony borders (red zigzag), but when the ACSL is present (b) the nerve might be protected by this ligament. When the nerve passes between the ACSL and the bottom of the suprascapular notch (c) it might be compressed (red zigzag). ACSL, anterior coracoscapular ligament; SN, suprascapular nerve; STSL, superior transverse scapular ligament.
Figure 3
Figure 3
Formalin-fixed cadaveric shoulder focused on suprascapular region (fan-shape ACSL); ACSL, anterior coracoscapular ligament; arrowhead, superior border of the scapula; STSL, superior transverse scapular ligament.
Figure 4
Figure 4
Formalin-fixed cadaveric shoulder focused on suprascapular region (bifid ACSL); ACSL, anterior coracoscapular ligament; arrowhead, superior border of the scapula; SM, supraspinatus muscle; STSL, superior transverse scapular ligament.
Figure 5
Figure 5
Formalin-fixed cadaveric shoulder focused on suprascapular region (vestigial ACSL); ACSL, anterior coracoscapular ligament; arrowhead, superior border of the scapula; STSL, superior transverse scapular ligament.
See this image and copyright information in PMC

References

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