Ultrasound-Guided Dorsal Scapular Nerve Blockade in the Diagnosis and Management of Neck Pain

Neck pain is common and has multiple sources, but correct diagnosis and matched treatment provide the best outcomes. The first description of ultrasound-guided dorsal scapular nerve blockade using a single-shot local anesthetic technique for the diagnosis and treatment of neck pain is reported. A 38-year-old female patient presented with neck pain, and the history and clinical examination strongly suggested myofascial pain affecting the middle scalene muscle. The pain had been unresponsive to pharmacological therapy or physiotherapy. After identifying the dorsal scapular nerve (DSN) in the body of the middle scalene muscle, an ultrasound-guided nerve block was performed using a single injection of local anesthetic to alleviate the patient’s pain. It has been demonstrated that the dorsal scapular nerve can be identified in the neck and effectively blocked using ultrasound guidance. This technique has the potential to assist in the diagnosis and treatment of neck pain originating from the middle scalene muscle.

肩胛背神经的解剖学研究及其临床意义

目的 :研究肩胛背神经的解剖学特点及其临床意义。方法 :在 49侧成人整尸标本上观测肩胛神经的起源 ,走行 ,在中斜角肌内的长度 ,与中斜角肌的关系 ,中斜角肌的形态 ,肩胛背神经的分支等。结果 :肩胛背神经来源于C5的有 3 4侧 (占 69.4% ) ,肩胛背神经的走行分 2种类型 :第一种类型是发出后跨中斜角肌的表面向下、外、后走行 ,约40 %者中斜角肌的表面大部分为腱性者 ;第二种是穿过中斜角肌向下、外、后走行 ,在中斜角肌内走行的长度为 2 0 .9±6.1mm ,途中结构大部分为腱性者占 17.9%。结论 :肩胛背神经起始部走行方式及其与中斜角肌比邻中的致密的纤维组织 。

肩胛背神经卡压的应用解剖学研究

观察并分析腱性纤维束是否为造成肩胛背神经卡压的主要因素。方法：在３２侧成人尸体标本上，观测肩肿背神经的起源、走行、分支、分布及其与中斜角肌的解剖关系。结果：肩胛背神经７５％（２４／３２）从Ｃ５神经根发出；由前内侧向后外侧从中斜角肌穿过，其长度为１．２±０．３ｃｍ，在其内侧缘有大部分键性纤维组织存在。该神经除发出２～５支肌支外，另有２５％（８／３２）还发出细小分支走向肩背部。结论：中斜角肌内侧缘的限性结构特点是造成肩胛背神经卡压的形态学基础。