Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam-Si, Republic of Korea.
Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Republic of Korea.
Pain Physician. 2023 Jul;26(4):E389-E395.
Despite the advantages of ultrasound and previous anatomical data on neuromuscular junction locations, to the best of our knowledge, the feasibility and accuracy of precise ultrasound-guided injection techniques into the proposed injection site of botulinum neurotoxin for the levator scapulae muscle have not been assessed in any publication.
In the present cadaver-based study, the ultrasound-guided injection technique in the middle and distal portions of the levator scapulae muscle was evaluated to determine whether this method distributes injections properly to the target muscle in fresh cadavers.
Cadaveric study.
A cadaver laboratory.
Twenty fresh cadavers were used. Real-time B-mode ultrasound scanning was performed interfaced with a linear array transducer. A mixture of 0.5 mL of dye and yellow filler was injected transverse in-plane with a 6 cm 21-G. needle. Each specimen was dissected to determine whether the dye was correctly targeted to the middle and distal portions of the levator scapulae muscle and to evaluate the accuracy of the injections and any complications.
All 40 injections were successfully injected within the middle and distal portions of the levator scapulae muscle. When dissecting the cadavers, the dye spread was evenly distributed along the muscle fiber.
Despite successful injection into the middle and distal portions of the levator scapulae muscle, the usefulness of this technique was not verified in clinical practice.
The ultrasound-guided injection technique presented in this study might facilitate precise visualization and localization of the levator scapulae muscle, thereby enhancing the effectiveness and safety of botulinum neurotoxin treatment in cervical dystonia.
尽管超声和先前关于神经肌肉接头位置的解剖学数据具有优势，但据我们所知，尚未有文献评估过将肉毒毒素精确超声引导注射技术应用于斜方肌提议注射部位的可行性和准确性。
在本基于尸体的研究中，评估了斜方肌中、远段的超声引导注射技术，以确定这种方法是否能将注射物恰当地分布到目标肌肉中。
尸体研究。
尸体实验室。
使用 20 具新鲜尸体。实时 B 型超声扫描与线性阵列换能器接口进行。将 0.5 毫升染料和黄色填充物的混合物用 6 厘米 21-G 针进行横切平面内注射。每个标本均进行解剖，以确定染料是否正确靶向斜方肌中、远段，并评估注射的准确性和任何并发症。
所有 40 次注射均成功注入斜方肌中、远段。在解剖尸体时，染料的扩散均匀分布于肌肉纤维中。
尽管成功地将注射物注入斜方肌中、远段，但该技术在临床实践中的实用性尚未得到验证。
本研究中提出的超声引导注射技术可能有助于精确可视化和定位斜方肌，从而提高肉毒毒素治疗颈肌张力障碍的效果和安全性。
