New insights into pathways of the accessory nerve and transverse cervical artery for distal selective accessory nerve blockade.
Accessory Nerve
Diagnosis
Injections
Scapula
Scapular Region
Selective Nerve Blockade
Transverse Cervical Artery
Ultrasound
Journal
The Korean journal of pain
ISSN: 2005-9159
Titre abrégé: Korean J Pain
Pays: Korea (South)
ID NLM: 101528125
Informations de publication
Date de publication:
01 Jan 2020
01 Jan 2020
Historique:
received:
31
05
2019
revised:
06
09
2019
accepted:
10
09
2019
entrez:
1
1
2020
pubmed:
1
1
2020
medline:
1
1
2020
Statut:
ppublish
Résumé
The aim of this study was to clarify the topographical relationship between the accessory nerve (AN) and transverse cervical artery (TCA) to provide safe and convenient injection points for AN blockade. This study included 21 and 30 shoulders of 14 embalmed Korean adult cadavers and 15 patients, respectively, for dissection and ultrasound (US) examination. The courses of the TCA and AN in the scapular region were classified into four types based on their positional relationships. Type A indicated the nerve that was medial to the artery and ran parallel without changing its location (38%). In type B (38%), the nerve was lateral to the artery and ran parallel without changing its location. In type C (19%), the nerve or artery traversed each other only once during the whole course. In type D (5%), the nerve or artery traversed each other more than twice forming a twist. At the levels of lines I-IV, the nerve was relatively close to the artery (approximately 10 mm). TCAs were observed in all specimens around the superior angle of the scapula at the level of line II, whereas they were not found below line VI. In US images of the patients, the TCA was commonly observed at the level of line II (93.3%) where all ANs and TCAs were observed in cadaveric dissection. The results expand the current knowledge of the relation between the AN and TCA, and provide helpful information for selective diagnostic nerve blocks in the scapular region.
Sections du résumé
BACKGROUND
BACKGROUND
The aim of this study was to clarify the topographical relationship between the accessory nerve (AN) and transverse cervical artery (TCA) to provide safe and convenient injection points for AN blockade.
METHODS
METHODS
This study included 21 and 30 shoulders of 14 embalmed Korean adult cadavers and 15 patients, respectively, for dissection and ultrasound (US) examination.
RESULTS
RESULTS
The courses of the TCA and AN in the scapular region were classified into four types based on their positional relationships. Type A indicated the nerve that was medial to the artery and ran parallel without changing its location (38%). In type B (38%), the nerve was lateral to the artery and ran parallel without changing its location. In type C (19%), the nerve or artery traversed each other only once during the whole course. In type D (5%), the nerve or artery traversed each other more than twice forming a twist. At the levels of lines I-IV, the nerve was relatively close to the artery (approximately 10 mm). TCAs were observed in all specimens around the superior angle of the scapula at the level of line II, whereas they were not found below line VI. In US images of the patients, the TCA was commonly observed at the level of line II (93.3%) where all ANs and TCAs were observed in cadaveric dissection.
CONCLUSIONS
CONCLUSIONS
The results expand the current knowledge of the relation between the AN and TCA, and provide helpful information for selective diagnostic nerve blocks in the scapular region.
Identifiants
pubmed: 31888317
pii: kjp.2020.33.1.48
doi: 10.3344/kjp.2020.33.1.48
pmc: PMC6944375
doi:
Types de publication
Journal Article
Langues
eng
Pagination
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