Department of Biomedical and Neuromotor Science, Physical and Rehabilitation Medicine Unit, IRCCS Rizzoli Orthopaedic Institute , Bologna , Italy.
Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School , Ankara , Turkey.
Phys Sportsmed. 2019 Sep;47(3):247-248. doi: 10.1080/00913847.2019.1589105. Epub 2019 Mar 8.
Chronic myofascial pain of the cervical spine and shoulders is commonplace in clinical practice and is often related to adverse posture during work conditions in our lifestyle. The diagnosis is clinical and injections of the neck/shoulder muscles, especially the upper trapezius, are commonly performed in a blinded way. The anatomy of the posterior compartment of the neck is complicated, and several neurovascular structures are located nearby the trapezius and levator scapulae muscles in the inter-fascial planes. In this case of ours, we describe in details the sono-anatomy of the lower neck and propose a posterior ultrasound-guided real-time in-plane approach to inject the muscle belly of the upper trapezius, i.e. avoiding the superficial and deep branches of the transverse cervical artery and the spinal accessory nerve.
颈椎和肩部的慢性肌筋膜疼痛在临床实践中很常见，通常与我们生活方式中的工作条件下的不良姿势有关。诊断是临床的，颈部/肩部肌肉（特别是上斜方肌）的注射通常是盲目进行的。颈部后区的解剖结构很复杂，几个神经血管结构位于斜方肌和肩胛提肌的筋膜间隙附近。在我们的这个病例中，我们详细描述了下颈部的超声解剖结构，并提出了一种后路超声引导实时平面内进针方法来注射上斜方肌的肌腹，即避免了颈横动脉浅支和深支以及副神经。
