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The Inferior Angle of the Scapula As A Spinal Landmark
The Study: The location of the inferior angle of the scapula in relation to the spine in the upright position: a systematic review of the literature and meta-analysis.
a. Anatomical landmarks are sometimes used by clinicians in order to identify spinal levels.
b. Some sources indicate that the inferior scapular angle is at the same level as the spinous (SP) of T7 when the patient is in the upright position.
c. However, other sources place the inferior scapular angle at the level of the T7-T8 interspace and still others place it at the level of T8.
d. The authors performed an extensive reviewed of the literature to better determine which spinal level most closely correlated with the level of the inferior scapular angle (IAS).
e. “… the upright IAS on average aligns closely with the T8 SP, range T4-T11.”
f. “…using the IAS may be less preferred than using the location of vertebral prominens to identify thoracic spine locations.”
g. The authors felt that this should be of interest to the medical profession as well as the providers of manual therapy.
Let me repeat, “… the upright IAS on average aligns closely with the T8 SP, range T4-T11.”
I think this one speaks for itself. How an individual provider practices is likely to determine how important this information is to them.
Reviewer: Roger Coleman DC
Editor’s Comments: The very wide range (T4 to T11) shows just how difficult it can be to accurately identify spinal levels using the IAS alone. One of the studies cited “reported accuracy rates of 18%, 62%, and 41% respectively in using the IAS for identifying T-7” This can be an important issue for chiropractors because errors in accurately numbering spinal levels in the patient’s charts, could easily lead to non intended consequences during treatment…especially if/when communicating with other practitioners. The authors mentioned using both the vertebral prominens (C7 SP) and/or the iliac crests as possibly better options for locating specific spinal levels.
Editor: Mark R. Payne DC
Reference: Cooperstein R, Hanelline M, Young M. The location of the inferior angle of the scapula in relation to the spine in the upright position: a systematic review of the literature and meta-analysis. Chiropr Man Therap 2015;23:7.
Link to Abstract:http://www.ncbi.nlm.nih.gov/pubmed/25729566
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