Albert Anju Mary, Magimairaj Henry Prakash, Lakshmanan Jeyaseelan, Holla Sunil Jonathan, Prithishkumar Ivan James
Centre for Anatomical and Human Sciences, Hull York Medical School, York, United Kingdom.
Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, India.
Anat Cell Biol. 2024 Dec 31;57(4):503-510. doi: 10.5115/acb.24.065. Epub 2024 Aug 28.
Spasticity which is focal or segmental such as affecting a single muscle group or limb can be treated by chemical neurolysis or surgical denervation at the neurovascular hilus. This study determines the motor entry points (MEPs) of adductor muscles of the thigh in the adult Indian population and identifies precise anatomical landmarks for the successful performance motor point procedures for the relief of muscle spasticity. A total of 10 adult lower limbs were dissected, and nerve branches to adductor muscles were carefully exposed up to their MEP. The morphometry of adductor muscles, precise locations of proximal and distal MEPs, and ideal sites for motor point procedures were identified. The median number of MEPs in adductor longus was two. Most of them were located between 40% and 50% of the muscle length , in the third-fifth of the total muscle length. Adductor magnus and gracilis had a median number of one and six MEPs respectively. The ideal site of motor point procedures is in the second-fifth of the muscle length for both. This preliminary study describes the location of MEPs and ideal sites of motor point procedures in the adductor muscle of the thigh. However, further cadaveric and electromyographic studies with larger samples are necessary to investigate precise locations of MEPs aiding in the treatment of spasticity.
局灶性或节段性痉挛，如影响单个肌肉群或肢体的痉挛，可通过化学神经溶解或在神经血管蒂处进行手术去神经支配来治疗。本研究确定了成年印度人群中大腿内收肌的运动点（MEP），并确定了成功进行运动点手术以缓解肌肉痉挛的精确解剖标志。共解剖了10条成年下肢，仔细暴露内收肌的神经分支直至其运动点。确定了内收肌的形态学、近端和远端运动点的精确位置以及运动点手术的理想部位。长收肌运动点的中位数为2个。其中大多数位于肌肉长度的40%至50%之间，在总肌肉长度的三分之一至五分之三之间。大收肌和股薄肌的运动点中位数分别为1个和6个。两者运动点手术的理想部位均在肌肉长度的五分之二处。这项初步研究描述了大腿内收肌运动点的位置和运动点手术的理想部位。然而，需要进一步进行更大样本量的尸体研究和肌电图研究，以探究有助于治疗痉挛的运动点的精确位置。
