Saranteas Theodosios, Paraskeuopoulos Tilemachos, Anagnostopoulou Sofia, Kanellopoulos Ilias, Mastoris Michael, Kostopanagiotou Georgia
2nd Department of Anesthesiology, Attikon Hospital, School of Medicine, University of Athens, Athens, Greece.
Surg Radiol Anat. 2010 Jul;32(6):617-22. doi: 10.1007/s00276-010-0621-9. Epub 2010 Jan 16.
The aim of the study was to examine the ultrasound anatomy of the cervical paravertebral space in order to facilitate the implementation of sonographically guided regional anesthesia techniques for this region.
Twenty volunteers were recruited, and the anatomic components of the cervical paravertebral space were sonographically examined. The transducer was positioned in the axial and coronal plane at the posterior cervical triangle. The cervical transverse processes with their respective nerve roots, the deep cervical fascia and the paravertebral muscles were identified.
There was excellent visualization of the C-3, C-4, C-5, C-6 and C-7 transverse processes in all cases. Excellent visualization of the scalene muscles, vertebral artery and deep cervical fascia was also achieved in all cases. Visualization of the levator of scapula muscle was difficult in 9 and excellent in 11 out of the 20 cases. In all cases, visualization of the C-1, C-2 and C-3 nerve roots was unfeasible. The identification of the C-4 nerve root was excellent in 3, difficult in 6 and unfeasible in 11 out of the 20 cases. The C-5, C-6 and C-7 nerve roots were excellently identified in all cases. The C-8 nerve root was identified only in 8 of the 20 cases. The cervical nerve roots also showed high variation, dividing into more than one branch as they exited the cervical transverse processes.
Cervical paravertebral anatomy can be depicted with ultrasound imaging techniques. This could be highly clinically significant for the implementation of regional anesthesia techniques.
