RESUMO
Background: Anatomical knowledge about the suprascapular notch is very important in understanding the risk of suprascapular nerve entrapment syndrome. Suprascapular nerve injuries have become commonly recognized as a cause of shoulder pain and dysfunction. This study aimed to describe the morphometrical influence of the suprascapular notch on the course of the suprascapular nerve. Method: A total of 138 dry human scapulae of both sides of the unknown sex were used. Four measurements were defined and collected for every suprascapular notch: maximum depth (MD), superior transverse diameter (STD), middle transverse diameter (MTD), and total circumferential diameter (TCD). Result: In the present study we found different shapes of suprascapular notches. Out of 138 scapulae, 67 (48.55%) had U-shaped notch, 29 (21.01%) V-shaped notch and 14 (10.14%) J-shaped notch. Nine (6.52%) scapulae had incomplete notch. Two (1.44%) scapulae had large double foramen. Six (4.34%) scapulae had complete suprascapular notch. In seven (5.07%) scapulae, the notch was absent. Interestingly, in two (1.44%) scapulae, we found a W-shaped notch. This observation was unique and not reported anywhere in the literature before. Conclusion: Anatomical knowledge about the morphology of the suprascapular notch is of extreme importance for clinicians, radiologists, neurosurgeons, and orthopedic surgeons in making a proper diagnosis and for planning the surgical procedures of the shoulder region.
RESUMO
Background: The knowledge of sacral hiatus anatomy is crucial in clinical situations requiring caudal epidural block for various diagnostic and therapeutic procedures of the lumbosacral spine to avoid complications and failure rate. This study was undertaken to compare morphometric characteristics of sacral hiatus in human dry sacra and pelvic radiographs for placing the needle more accurately in the sacral hiatus landmarks to permit correct, painless, and uncomplicated caudal epidural accesses. Materials and methods: The present study was done on 138 human adult dry sacra and 110 anteroposterior lumbosacral spine radiographs of the North Karnataka region of India. Sacral hiatus was evaluated in each sacrum based on its shape, level of its apex, and base according to sacral and coccygeal vertebrae, length, anteroposterior diameter at its apex, and transverse width at its base. Results:The mean length of sacral hiatus in men and women was 27.81+1.17 mm and 24.73+2.21 mm, respectively. The mean anteroposterior diameter of the sacral hiatus at the apex was 6.24+2.73 mm in males and 6.63+2.81 mm in females. The transverse width of the sacral hiatus at the base was 17.56+1.81 mm in males and 17.92+2.59 mm in females. The location of the apex of sacral hiatus was the highest in number at the level of the fourth sacral vertebra (23.63%). The location of apex in radiographs of all lumbosacral spine S3 showed 49.09% maximum. The location of the base of the sacral hiatus was observed in the dry sacra at the level of the fifth sacral vertebra (64.54%). In the present study, different shapes of the sacral hiatus were recorded. The most common shape in males and females was inverted U shape (42.02%), followed by inverted V shape (26.08%) and dumbbell shape (12.31%). The least common shape was observed in the bifid sacra (5.07%). In 2.17% of cases, sacral hiatus was absent. Percentage of absence, agenesis, irregular, and bifid shapes were found rather in female than male sacra. An anteroposterior view of spine radiograph showed sacral hiatus agenesis in both females (7.81%) and males (4.34%). The anatomical knowledge of sacral hiatus and its variations are important in caudal epidural anesthesia, and it may improve the success rate of caudal epidural anesthesia.
