Eleonore Brumpt1,2,3, Sebastien Aubry4,5, Fabrice Vuillier6,7, Laurent Tatu6,8. 1. Department of Radiology, Centre Hospitalier Universitaire de Besançon, University of Franche-Comté, 3 Boulevard Fleming, 25000, Besançon, France. ebrumpt@chu-besancon.fr. 2. Department of Anatomy, University of Franche-Comté, 25000, Besançon, France. ebrumpt@chu-besancon.fr. 3. Nanomedecine Laboratory, INSERM EA4662, University of Franche-Comte, 25000, Besançon, France. ebrumpt@chu-besancon.fr. 4. Department of Radiology, Centre Hospitalier Universitaire de Besançon, University of Franche-Comté, 3 Boulevard Fleming, 25000, Besançon, France. 5. Nanomedecine Laboratory, INSERM EA4662, University of Franche-Comte, 25000, Besançon, France. 6. Department of Anatomy, University of Franche-Comté, 25000, Besançon, France. 7. Department of Neurology, Centre Hospitalier Universitaire de Besançon, Boulevard Fleming, 25000, Besançon, France. 8. Department of Neuromuscular Diseases, Centre Hospitalier Universitaire de Besançon, Boulevard Fleming, 25000, Besançon, France.
Abstract
OBJECTIVE: The main objective of this study was to define and verify anatomo-sonographic landmarks for ultrasound-guided injection of botulinum toxin into the longissimus capitis (LC) and splenius cervicis (SC) muscles. METHODS AND RESULTS: After a preliminary work of anatomical description of the LC and SC muscles, we identified these muscles on two cadavers and then on a healthy volunteer using ultrasound and magnetic resonance imaging (MRI) to establish a radio-anatomical correlation. We defined an anatomo-sonographic landmark for the injection of each of these muscles. The correct positioning of vascular glue into the LC muscle and a metal clip into the SC muscle of a fresh cadaver as verified by dissection confirmed the utility of the selected landmarks. DISCUSSION: For the LC muscle, the intramuscular tendon of the cranial part of the muscle appears to be a reliable anatomical landmark. The ultrasound-guided injection can be performed within the cranial portion of the muscle, between the intra-muscular tendon and insertion into the mastoid process at dens of the axis level. For the SC muscle, the surface topographic landmarks of the spinous processes of the C4-C5 vertebrae and the muscle body of the levator scapulae muscle seem to be reliable landmarks. From these, the ultrasound-guided injection can be carried out laterally by transfixing the body of the levator scapulae. CONCLUSION: The study defined two cervical anatomo-sonographic landmarks for injecting the LC and SC muscles.
OBJECTIVE: The main objective of this study was to define and verify anatomo-sonographic landmarks for ultrasound-guided injection of botulinum toxin into the longissimus capitis (LC) and splenius cervicis (SC) muscles. METHODS AND RESULTS: After a preliminary work of anatomical description of the LC and SC muscles, we identified these muscles on two cadavers and then on a healthy volunteer using ultrasound and magnetic resonance imaging (MRI) to establish a radio-anatomical correlation. We defined an anatomo-sonographic landmark for the injection of each of these muscles. The correct positioning of vascular glue into the LC muscle and a metal clip into the SC muscle of a fresh cadaver as verified by dissection confirmed the utility of the selected landmarks. DISCUSSION: For the LC muscle, the intramuscular tendon of the cranial part of the muscle appears to be a reliable anatomical landmark. The ultrasound-guided injection can be performed within the cranial portion of the muscle, between the intra-muscular tendon and insertion into the mastoid process at dens of the axis level. For the SC muscle, the surface topographic landmarks of the spinous processes of the C4-C5 vertebrae and the muscle body of the levator scapulae muscle seem to be reliable landmarks. From these, the ultrasound-guided injection can be carried out laterally by transfixing the body of the levator scapulae. CONCLUSION: The study defined two cervical anatomo-sonographic landmarks for injecting the LC and SC muscles.