The superior transverse scapular ligament bridges the suprascapular notch, converting it into a foramen through which the suprascapular nerve passes, while the suprascapular artery travels above it. It is a flat fibrous band running between the medial and lateral margins of the scapular notch at the superior border of the scapula.
Converts the suprascapular notch into a fibro-osseous tunnel protecting the suprascapular nerve during overhead motion. The key anatomical relationship: the nerve passes below the ligament while the suprascapular artery passes above it.
Ossification of this ligament is a well-recognised cause of suprascapular nerve entrapment at the suprascapular notch, producing supraspinatus and infraspinatus atrophy with posterior shoulder pain and weakness of abduction and external rotation. The absence of the ligament in some individuals allows the nerve to run freely. Surgical release of the ligament is performed endoscopically or open in refractory entrapment.
Ossification or hypertrophy of the ligament compresses the suprascapular nerve, producing insidious posterior shoulder pain and progressive wasting of both supraspinatus and infraspinatus, distinguishing notch entrapment from spinoglenoid entrapment where only infraspinatus is affected.
