Systematic cadaveric dissection of four specimens (eight extremities) mapping the three-dimensional layered anatomy of the scapulothoracic articulation — including muscle attachments, bursae dimensions, and spinal accessory nerve course — to clarify the structural basis for periscapular pain and guide surgical approaches.
When approaching the superomedial scapular angle — open or endoscopic — remember that the spinal accessory nerve runs predictably 2.7 cm lateral to the angle along the scapulotrapezial bursa wall; also consider injecting or resecting the scapulotrapezial bursa (not just the deeper scapulothoracic bursa) in patients with persistent superomedial angle pain after standard bursectomy.
Systematic cadaveric dissection of four specimens (eight extremities) mapping the three-dimensional layered anatomy of the scapulothoracic articulation — including muscle attachments, bursae dimensions, and spinal accessory nerve course — to clarify the structural basis for periscapular pain and guide surgical approaches.
When approaching the superomedial scapular angle — open or endoscopic — remember that the spinal accessory nerve runs predictably 2.7 cm lateral to the angle along the scapulotrapezial bursa wall; also consider injecting or resecting the scapulotrapezial bursa (not just the deeper scapulothoracic bursa) in patients with persistent superomedial angle pain after standard bursectomy.