Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain; Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Máster Oficial en Dolor Orofacial y Disfunción Cráneo-Mandibular, Universidad San-Pablo CEU, Madrid, Spain.
Máster Oficial en Dolor Orofacial y Disfunción Cráneo-Mandibular, Universidad San-Pablo CEU, Madrid, Spain; Department of Physical Therapy, Universidad San-Pablo CEU, Madrid, Spain.
Musculoskelet Sci Pract. 2020 Feb;45:102075. doi: 10.1016/j.msksp.2019.102075. Epub 2019 Oct 25.
Evidence suggests that suboccipital musculature plays an important role in headache. Proper therapeutic approaches targeting this muscle are needed.
Our aim was to determine with fresh cadavers and ultrasound imaging if a solid needle is able to properly penetrate the obliquus capitis inferior muscle during the application of dry needling.
A cadaveric and human descriptive study.
Needling insertion and ultrasound imaging of the obliquus capitis inferior muscle was conducted on 10 pain-free healthy subjects and 5 fresh cadavers. Needling insertion was performed using a 40 mm needle inserted midway between the spinous process of C2 and transverse process of C1. The needle was advanced from a posterior to anterior direction into the obliquus capitis inferior muscle with an inferior-lateral angle to reach the lamina of C2. For the cadaveric study, the obliquus capitis inferior placement was verified by resecting the superficial upper trapezius, splenius capitis, and semispinalis capitis muscles. For ultrasographic study, a linear transducer was aligned with the long axis of the obliquus capitis inferior muscle after needle insertion.
Both the cadaveric and ultrasonic studies showed that the needle penetrated the obliquus capitis inferior muscle during its insertion and that the tip of the needle rested against C2 laminae, thereby reaching the targeted muscle.
This anatomical and ultrasound imaging study supports the assertion that needling insertion of the obliquus capitis inferior muscle can be properly conducted by an experienced clinician.
有证据表明，枕下肌在头痛中起着重要作用。需要针对该肌肉的适当治疗方法。
我们的目的是通过新鲜尸体和超声成像来确定在进行干针治疗时，实心针是否能够正确穿透斜角肌下肌。
尸体和人体描述性研究。
在 10 名无痛健康受试者和 5 具新鲜尸体上进行斜角肌下肌的针刺插入和超声成像。使用插入 C2 棘突和 C1 横突之间中点的 40mm 针进行针刺插入。针从前向后以向下方和外侧的角度插入斜角肌下肌，直至达到 C2 椎板。对于尸体研究，通过切除浅层上斜方肌、头半棘肌和头半棘肌来验证斜角肌下肌的位置。对于超声研究，在插入针后，将线性换能器与斜角肌下肌的长轴对齐。
尸体和超声研究均显示，在插入过程中，针穿透了斜角肌下肌，并且针的尖端抵靠 C2 椎板，从而到达了目标肌肉。
这项解剖学和超声成像研究支持这样一种观点，即有经验的临床医生可以正确地进行斜角肌下肌的针刺插入。
