{"title":"Anatomical validation of needle placement for cervical paraspinal mapping of the multifidus.","authors":"Brian Malave, Steven Johnson, Andrew J Haig","doi":"10.1002/mus.28268","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction/aims: </strong>The paraspinal muscles are an important component of electrodiagnostic testing for radiculopathy. In the cervical region, a protocol for cervical paraspinal mapping assumes accurate placement of the electromyography (EMG) needle into the cervical multifidus. However, there is scant information regarding the accuracy of needle placement in that muscle. This study examines the accuracy of this protocol in sampling the intended multifidus muscle of cadavers.</p><p><strong>Methods: </strong>An experienced electromyographer directed needles to multifidus at C5, C7, and T2 spinous processes of 19 embalmed cadavers, and injected color dyes. Separately another examiner dissected the cadavers, noting whether the dye was in the correct location and whether its trajectory approached any \"danger zones\" of nerve, artery, or joint.</p><p><strong>Results: </strong>The dye was in the multifidus muscle 100% of the time and hit the intended bony target in 79%, 73%, and 79% of C5, C7, and T2 insertions. No insertion was found in a danger zone.</p><p><strong>Discussion: </strong>The results indicate modest accuracy for EMG needle placement as proposed in the clinical protocol. Clinical utility of this method requires more work including the establishment of norms, sensitivities, specificities, and clinical impact.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Muscle & Nerve","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/mus.28268","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/28 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction/aims: The paraspinal muscles are an important component of electrodiagnostic testing for radiculopathy. In the cervical region, a protocol for cervical paraspinal mapping assumes accurate placement of the electromyography (EMG) needle into the cervical multifidus. However, there is scant information regarding the accuracy of needle placement in that muscle. This study examines the accuracy of this protocol in sampling the intended multifidus muscle of cadavers.
Methods: An experienced electromyographer directed needles to multifidus at C5, C7, and T2 spinous processes of 19 embalmed cadavers, and injected color dyes. Separately another examiner dissected the cadavers, noting whether the dye was in the correct location and whether its trajectory approached any "danger zones" of nerve, artery, or joint.
Results: The dye was in the multifidus muscle 100% of the time and hit the intended bony target in 79%, 73%, and 79% of C5, C7, and T2 insertions. No insertion was found in a danger zone.
Discussion: The results indicate modest accuracy for EMG needle placement as proposed in the clinical protocol. Clinical utility of this method requires more work including the establishment of norms, sensitivities, specificities, and clinical impact.
期刊介绍:
Muscle & Nerve is an international and interdisciplinary publication of original contributions, in both health and disease, concerning studies of the muscle, the neuromuscular junction, the peripheral motor, sensory and autonomic neurons, and the central nervous system where the behavior of the peripheral nervous system is clarified. Appearing monthly, Muscle & Nerve publishes clinical studies and clinically relevant research reports in the fields of anatomy, biochemistry, cell biology, electrophysiology and electrodiagnosis, epidemiology, genetics, immunology, pathology, pharmacology, physiology, toxicology, and virology. The Journal welcomes articles and reports on basic clinical electrophysiology and electrodiagnosis. We expedite some papers dealing with timely topics to keep up with the fast-moving pace of science, based on the referees'' recommendation.