Correlation of suprascapular notch morphology with suprascapular neuropathy and rotator cuff tear patterns: MRI data
- Authors: Dokolin S.Y.1, Ushkova O.G.2, Shershnev A.M.1, Kuzmina V.I.1
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Affiliations:
- Vreden National Medical Research Center of Traumatology and Orthopedics
- Eucalyptus Clinical Medicine Center
- Issue: Vol 31, No 4 (2025)
- Pages: 120-129
- Section: СLINICAL STUDIES
- URL: https://journal-vniispk.ru/2311-2905/article/view/357900
- DOI: https://doi.org/10.17816/2311-2905-17748
- ID: 357900
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Abstract
Background. Suprascapular nerve neuropathy combined with massive rotator cuff tears presents significant challenges in both diagnosis and treatment. Modern diagnostic methods allow for sufficiently accurate detection of neurological impairments. This condition involves several pathophysiological mechanisms. Routine MRI enables the assessment of the morphology of the scapular notch and allows clinicians to suspect suprascapular nerve neuropathy.
The aim of the study — to identify the anatomical features of the scapular notch on MRI in patients with suprascapular nerve neuropathy combined with massive rotator cuff tears, and to assess their impact on the extent of rotator damage, the severity of pain, and functional impairment.
Methods. The study included 19 patients with traumatic injuries of the rotator cuff tendons and muscles combined with the clinical signs of suprascapular nerve neuropathy, including 15 men and 4 women. The mean patient age was 58.7 years. During the clinical examination, patients completed standardized questionnaires: VAS, the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), and ASES. All patients underwent pre- and postoperative shoulder MRI to assess the morphological features of the suprascapular notch, as well as electromyography (EMG) to diagnose conduction impairments within the suprascapular nerve innervation zone.
Results. Suprascapular nerve neuropathy in patients with rotator cuff injuries is more commonly observed in those with a deep and relatively narrow U-shaped scapular notch, particularly in the presence of posterosuperior tears of the supraspinatus and infraspinatus tendons (Collin type D), combined with pronounced tendon retraction (Patte grade 3). EMG revealed impaired impulse conduction within the suprascapular nerve innervation zone in all patients, demonstrated by altered M-responses from the supraspinatus and infraspinatus muscles. The analysis showed that both the morphology type of the notch and the extent of the tear were statistically significant predictors of functional status as assessed by the ASES score. Notably, the morphology of the notch showed a slightly greater contribution to predicting functional limitations.
Conclusion. The strong correlation identified between the morphology of the scapular notch and the severity of rotator cuff tears supports the hypothesis that a narrow notch creates neurological preconditions for the development of chronic pain and impaired innervation of the rotator cuff muscles. This should be taken into account when developing diagnostic and treatment algorithms for patients with this pathology.
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##article.viewOnOriginalSite##About the authors
Sergei Yu. Dokolin
Vreden National Medical Research Center of Traumatology and Orthopedics
Email: sdokolin@gmail.com
ORCID iD: 0000-0003-1890-4342
SPIN-code: 1993-2304
Dr. Sci. (Med.)
Russian Federation, St. PetersburgOksana G. Ushkova
Eucalyptus Clinical Medicine Center
Author for correspondence.
Email: ushkovaoksana@yandex.ru
ORCID iD: 0009-0003-0641-4351
SPIN-code: 4078-3170
Russian Federation, Voronezh
Andrey M. Shershnev
Vreden National Medical Research Center of Traumatology and Orthopedics
Email: andreyshersh@gmail.com
ORCID iD: 0000-0001-6623-2144
SPIN-code: 7684-4262
Cand. Sci. (Med.)
Russian Federation, St. PetersburgVladislava I. Kuzmina
Vreden National Medical Research Center of Traumatology and Orthopedics
Email: tasha_777@bk.ru
ORCID iD: 0000-0001-7866-5545
SPIN-code: 9849-0036
Cand. Sci. (Med.)
Russian Federation, St. PetersburgReferences
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