肩部痉挛中肉毒杆菌神经毒素治疗大圆肌的实用指南：尸体模型中大圆肌的肌内神经分布
A practical guide to botulinum neurotoxin treatment of teres major muscle in shoulder spasticity: Intramuscular neural distribution of teres major muscle in cadaver model.
作者信息
Yi Kyu-Ho, Lee Kang-Woo, Hu Hye-Won, Lee Ji-Hyun, Lee Hyung-Jin
机构信息
Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea.
Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam-si, South Korea.
出版信息
PM R. 2024 Feb;16(2):160-164. doi: 10.1002/pmrj.13048. Epub 2023 Sep 5.
BACKGROUND
Botulinum neurotoxin treatment typically focuses on the teres major muscle as a primary target for addressing shoulder spasticity. The muscle is located deep within a large muscle group and optimal injection locations have not been identified.
OBJECTIVE
To identify the preferred location for administering botulinum toxin injections in the teres major muscle.
METHODS
Teres major specimens were removed from 18 cadaveric models and stained with Sihler's method to reveal the neural distribution within the muscle. The muscles were systematically divided into equal lengths from origin to insertion. The neural density in each section was evaluated to determine the location that would be likely to increase effectiveness of the injection.
RESULTS
The greatest density of intramuscular nerve endings was located in the middle 20% of the muscle. The tendinous portion was observed at the ends of the muscle.
CONCLUSIONS
The results suggest that botulinum neurotoxin should be delivered in the middle 20% of the teres major muscle.
背景
肉毒杆菌神经毒素治疗通常将大圆肌作为治疗肩部痉挛的主要靶点。该肌肉位于一个大肌群的深处，尚未确定最佳注射部位。
目的
确定在大圆肌中注射肉毒杆菌毒素的首选部位。
方法
从18个尸体模型中取出大圆肌标本，用西勒氏法染色以显示肌肉内的神经分布。将肌肉从起点到止点系统地分成相等的长度。评估每个节段的神经密度，以确定可能提高注射效果的部位。
结果
肌内神经末梢密度最大的部位位于肌肉中间20%处。在肌肉两端观察到腱性部分。
结论
结果表明，肉毒杆菌神经毒素应注射在大圆肌中间20%处。
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