Preoperative ultrasound mapping of the suprascapular and spinal accessory nerves: A surgeon's guide to precision

Background: The aim of the study was to evaluate the accessibility and localization of spinal accessory and suprascapular nerves in the suprascapular region in healthy volunteers using ultrasonography.

Methods: One hundred healthy volunteers were included and the location of the spinal accessory nerve (SAN) and suprascapular nerve (SSN) was assessed in the right suprascapular region.

Findings: Seventy men and 30 women, (mean age 40.37 years; mean BMI 23.44 kg/m²) participated in the study. Mean distance of SAN from the vertebral spinous process and medial border of the scapula was 3.80 and 0.7 cm, respectively. Mean depth of SAN from the skin was 2.67 cm. The mean distance of SSN from the spine was 7 cm and mean depth of SSN from the skin was 3.28 cm. In overweight and obese individuals, the distance of SAN from the skin and vertebral spinous process and distance of SSN from the vertebral spine increased significantly. According to gender, there was no statistically significant difference in the location of SSN and SAN; however, the distance of SSN from the vertebral spine was significantly increased with increasing age.

Interpretation: The SSN and SAN in the suprascapular region can be consistently and reliably mapped using ultrasound. These data can also help in surface markings of both the nerves, which reduces the operating time and risk of iatrogenic injury.