title: What is the function of the anterior coracoscapular ligament? - a morphological study on the newest potential risk factor for suprascapular nerve entrapment.
abstract: BACKGROUND
  The suprascapular notch (SSN) is the most common site of suprascapular nerve neuropathy, which may be brought on by the presence of a deep, narrow SSN and structures restricting the space for the nerve. The anterior coracoscapular ligament (ACSL) is a fibrous band extending on the anterior side of the suprascapular notch. As it may tighten the osteo-fibrous tunnel for the nerve, it has been proposed as a new anatomical risk factor in its entrapment. However, this structure occurs in up to 60% of patients, many of whom do not demonstrate any nerve injury. The aim of this work is to evaluate the association between the occurrence of the ACSL and SSN morphology.
  
  
  METHODS
  The suprascapular notch region was dissected in 100 formalin-fixed, cadaveric shoulders. The ACSL (if present) and the SSN were assigned to a classification based on their morphology and diameters. Statistical analysis was performed.
  
  
  RESULTS
  The ACSL was present in 52 scapulae (52%) and in all cases, the suprascapular nerve travelled superior to the ACSL. Mechanically relevant types of ACSL were found to occur significantly more often when deeper notches were present (p=0.0018).
  
  
  CONCLUSIONS
  The mechanically efficient ACSL is more common in deep and narrow SSNs, which are associated with suprascapular nerve neuropathy. Thus, by supporting the nerve, the ACSL can protect against its injury.
authors.affiliation: Department of Normal and Clinical Anatomy, Interfaculty Chair of Anatomy and Histology, Medical University of Łódź, Poland. Electronic address: michal.podgorski@umed.lodz.pl.
authors.forename: Michał
authors.initials: M
authors.lastname: Podgórski
authors.affiliation: Department of Normal and Clinical Anatomy, Interfaculty Chair of Anatomy and Histology, Medical University of Łódź, Poland.
authors.forename: Mirosław
authors.initials: M
authors.lastname: Topol
authors.affiliation: Clinic of Orthopedic and Pediatric Orthopedics, Medical University of Łódź, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Sibiński
authors.affiliation: Clinic of Orthopedic and Traumatology, Medical University of Łódź, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Domżalski
authors.affiliation: Department of Radiology, Medical University of Łódź, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Grzelak
authors.affiliation: Department of Angiology, Interfaculty Chair of Anatomy and Histology, Medical University of Łódź, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Polguj
mesh_terms: D002102:Cadaver; D006801:Humans; D008023:Ligaments, Articular / Q000033:anatomy & histology* / Q000294:innervation* / Q000473:pathology; D009408:Nerve Compression Syndromes / Q000473:pathology*; D012307:Risk Factors; D012540:Scapula / Q000294:innervation / Q000473:pathology; D012782:Shoulder / Q000033:anatomy & histology / Q000294:innervation / Q000473:pathology; D016707:Tissue Fixation
keywords: Anterior coracoscapular ligament; Suprascapular nerve entrapment; Suprascapular notch