COVID-19 Division, Wonju City Public Health Center, Wonju-si 26417, Korea.
Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, College of Dentistry, Yonsei University, Seoul 03722, Korea.
Toxins (Basel). 2022 Apr 11;14(4):271. doi: 10.3390/toxins14040271.
The serratus anterior muscle is commonly involved in myofascial pain syndrome and is treated with many different injective methods. Currently, there is no definite injection point for the muscle. This study provides a suggestion for injection points for the serratus anterior muscle considering the intramuscular neural distribution using the whole-mount staining method. A modified Sihler method was applied to the serratus anterior muscles (15 specimens). The intramuscular arborization areas were identified in terms of the anterior (100%), middle (50%), and posterior axillary line (0%), and from the first to the ninth ribs. The intramuscular neural distribution for the serratus anterior muscle had the largest arborization patterns in the fifth to the ninth rib portion of between 50% and 70%, and the first to the fourth rib portion had between 20% and 40%. These intramuscular neural distribution-based injection sites are in relation to the external anatomical line for the frequently injected muscles to facilitate the efficiency of botulinum neurotoxin injections. Lastly, the intramuscular neural distribution of serratus anterior muscle should be considered in order to practice more accurately without the harmful side effects of trigger-point injections and botulinum neurotoxin injections.
前锯肌常与肌筋膜疼痛综合征有关，有许多不同的注射方法进行治疗。目前，该肌肉还没有明确的注射点。本研究采用全染色法，根据肌肉内神经分布，对前锯肌的注射点提出建议。改良的 Sihler 法应用于前锯肌（15 个标本）。根据前（100%）、中（50%）和腋后线（0%）和第 1 到第 9 肋，确定肌内分支区域。前锯肌的肌内神经分布在前 5 到 9 肋骨部分的分支模式最大，为 50%到 70%，第 1 到第 4 肋骨部分的分支模式为 20%到 40%。这些基于肌内神经分布的注射部位与常用注射肌肉的外部解剖线有关，有助于提高肉毒毒素注射的效率。最后，为了更准确地实践，而没有触发点注射和肉毒毒素注射的有害副作用，应该考虑前锯肌的肌内神经分布。
