Anatomical Landmarks for Localizing the Suprascapular Notch in Posterior-Approach Accessory-Suprascapular Nerve Transfer: A Cadaveric Study

Abstract Purpose Locating the suprascapular nerve (SNN) via the posterior approach during nerve reconstruction can be challenging, even for experienced surgeons, due to the nerve’s deep position near the superior border of the scapular spine and the limited operative field. This study aims to assess the topographical variations of the suprascapular notch (SN) to provide more precise presurgical guidance on its probable location. Methods In 51 scapulae, distances from the SN (A) to five key bony landmarks were measured: the supraglenoid tubercle (B), lateral border of the acromion (C), superior angle of the scapula (D), inferior angle of the scapula (E), and infraglenoid tubercle (F). The distance between points C and D was recorded, and additional relevant distances were calculated based on these measurements. Results The mean measurements were as follows: AB = 3.55 cm, AC = 6.68 cm, AD = 4.28 cm, AE = 13.38 cm, AF = 4.88 cm, and CD = 9.93 cm. Based on these measurements, the SN was found to be located approximately 63.51% along the line connecting C to D. Conclusion The SN can be identified by palpation at approximately 63.51% along a line extending from the lateral border of the acromion to the superior angle of the scapula, positioning it slightly more medially than commonly suggested in the literature. This anatomical insight can offer a more reliable reference for presurgical planning.