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Purpose <p>The suprascapular (SSN) and axillary (AXN) nerves are vital for shoulder mobility and are at notable risk for injury during glenohumeral surgeries due to their proximity to key anatomical landmarks. This systematic review evaluates their anatomical positioning relative to the glenohumeral joint and highlights the clinical significance of these relationships in shoulder procedures.</p> Methods <p>A thorough literature search across PubMed, MEDLINE, and Google Scholar (2018–2025) yielded 424 studies. After applying inclusion criteria, 21 articles—including clinical, cadaveric, and systematic reviews—were selected to assess nerve pathways, anatomical variations, injury rates, and surgical relevance.</p> Results <p>The pooled incidence of SSN injury was 0.03 (95% CI: 0.00–0.08), indicating an extremely low occurrence across studies. In contrast, the pooled incidence of AXN injury was 0.07 (4%) [95% CI: 0.01–0.18], reflecting a higher but still uncommon risk. Meta-regression showed a significant association between longer follow-up duration and increased reporting of AXN injuries (<i>p</i> = 0.0005), whereas this relationship was not significant for SSN injuries (<i>p</i> = 0.3612). Significant publication bias was detected for both nerves (AXN: <i>p</i> = 0.0016; SSN: <i>p</i> &lt; 0.0001). Overall, AXN injuries occurred in approximately 1% of cases—more frequent than SSN injuries, which were nearly absent in pooled analysis.</p> Conclusion <p>Anatomical variability in the SSN and AXN significantly influences the likelihood of nerve injury during shoulder surgery. Utilizing preoperative imaging, tailoring surgical approaches to individual anatomy, and employing intraoperative nerve monitoring are essential strategies for minimising nerve damage. Enhanced anatomical education—through cadaveric dissection and surgical simulation—should be emphasised to reinforce knowledge. These findings support adopting nerve-sparing, patient-specific surgical techniques to improve safety and outcomes in shoulder procedures.</p>

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Anatomical relationship of the suprascapular and axillary nerves to the glenohumeral joint and its surgical significance: a systematic review

  • 期刊论文

  • 发表日期：

    2026年2月16日

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  • Mohd Maqbool,
  • Kamil Khan,
  • Anjali Aggarwal,
  • Khushbu Sharma

摘要

Purpose

The suprascapular (SSN) and axillary (AXN) nerves are vital for shoulder mobility and are at notable risk for injury during glenohumeral surgeries due to their proximity to key anatomical landmarks. This systematic review evaluates their anatomical positioning relative to the glenohumeral joint and highlights the clinical significance of these relationships in shoulder procedures.

Methods

A thorough literature search across PubMed, MEDLINE, and Google Scholar (2018–2025) yielded 424 studies. After applying inclusion criteria, 21 articles—including clinical, cadaveric, and systematic reviews—were selected to assess nerve pathways, anatomical variations, injury rates, and surgical relevance.

Results

The pooled incidence of SSN injury was 0.03 (95% CI: 0.00–0.08), indicating an extremely low occurrence across studies. In contrast, the pooled incidence of AXN injury was 0.07 (4%) [95% CI: 0.01–0.18], reflecting a higher but still uncommon risk. Meta-regression showed a significant association between longer follow-up duration and increased reporting of AXN injuries (p = 0.0005), whereas this relationship was not significant for SSN injuries (p = 0.3612). Significant publication bias was detected for both nerves (AXN: p = 0.0016; SSN: p < 0.0001). Overall, AXN injuries occurred in approximately 1% of cases—more frequent than SSN injuries, which were nearly absent in pooled analysis.

Conclusion

Anatomical variability in the SSN and AXN significantly influences the likelihood of nerve injury during shoulder surgery. Utilizing preoperative imaging, tailoring surgical approaches to individual anatomy, and employing intraoperative nerve monitoring are essential strategies for minimising nerve damage. Enhanced anatomical education—through cadaveric dissection and surgical simulation—should be emphasised to reinforce knowledge. These findings support adopting nerve-sparing, patient-specific surgical techniques to improve safety and outcomes in shoulder procedures.