Department of Neurology and Movement Disorders, CHU Lille, F-59037 Lille, France.
Centre d'Etude et de Recherche en Informatique Médicale, EA 2694, Université de Lille, CHU Lille, F-59045 Lille, France.
Toxins (Basel). 2024 Oct 11;16(10):439. doi: 10.3390/toxins16100439.
Cervical dystonia is widely understood to benefit from botulinum toxin injections. The injection practices may be influenced by specific factors, including the method of injection. Three main guidance methods can be used: palpation of anatomical landmarks, ultrasound, and electromyography. We investigated how target muscles and doses of botulinum toxin were modified after the transition from surface anatomy (non-guided) to ultrasound (US-guided), in patients with cervical dystonia. We also determined the long-term dose trend.
We studied a group of 82 patients, who received non-guided injections (median: 16.5 cycles/5.1 years) followed by US-guided injections (median: 12.0 cycles/3.8 years).
More muscles, and especially deep muscles, were injected during the US-guided period. The total dose and number of injected muscles were higher when US guidance was used, but the mean dose per muscle was lower. Over the long term, the total dose stabilized, and the mean dose per muscle decreased during the US-guided period.
According to our results, the guidance method has a strong impact on the botulinum toxin injection strategy in cervical dystonia (target muscles and dose). Also, the treatment appeared more stable when using US guidance; this could be explained by the good precision of such injections.
广泛认为颈部肌张力障碍受益于肉毒毒素注射。注射实践可能受到特定因素的影响，包括注射方法。可以使用三种主要的指导方法：解剖标志触诊、超声和肌电图。我们研究了从体表解剖（非引导）到超声（US 引导）后，颈部肌张力障碍患者的目标肌肉和肉毒毒素剂量如何改变。我们还确定了长期剂量趋势。
我们研究了一组 82 名患者，他们接受了非引导注射（中位数：16.5 个周期/5.1 年），随后接受了 US 引导注射（中位数：12.0 个周期/3.8 年）。
在 US 引导期间，更多的肌肉，特别是深部肌肉被注射。使用 US 引导时，总剂量和注射肌肉数量较高，但每块肌肉的平均剂量较低。从长期来看，总剂量稳定，而在 US 引导期间，每块肌肉的平均剂量下降。
根据我们的结果，引导方法对颈部肌张力障碍的肉毒毒素注射策略（目标肌肉和剂量）有很大影响。此外，使用 US 引导时，治疗似乎更稳定；这可以通过这种注射的良好精度来解释。
