Abstract
ObjectivesOur study aimed to explore the clinical therapeutic effects of ultrasound-guided five-point injection of botulinum toxin type A for patients with trapezius hypertrophy.MethodsTwenty female patients diagnosed with trapezius hypertrophy were enrolled in this study. The thicknesses of the trapezius muscle were measured by using the ultrasound scanner to locate the thickest point of trapezius, followed by labelling the other four points around the first point. Botulinum toxin type A was injected bilaterally (50 IU/side, 5 points/side) in the trapezius muscle of these patients. The surgery effects were evaluated by thicknesses of the trapezius muscle, intramuscular needle electromyographic and electroneurographic examinations, appearance changes and patients’ satisfactions.ResultsStatistically significant differences in thicknesses of the trapezius muscle were observed at 4 weeks (p < 0.001), 12 weeks (p < 0.001), 20 weeks (p < 0.001), 28 weeks (p = 0.011), 36 weeks (p = 0.022), and 44 weeks (p = 0.032) after surgery. The latencies of trapezius muscle became longer at 12 weeks after surgery (left: 2.40 ms, right: 2.53 ms vs. left: 1.75 ms, right: 2.00 ms). Electroneurographic results showed amplitude reduction of compound muscle action potentials (CMAPs) at 12 weeks after surgery (left: 1.91 uV, right: 3.10 uV vs. left: 15.00 uV, right: 15.40 uV). Obvious appearance changes were revealed at 12 weeks after surgery. All of 80% patients were very satisfied, 15% patients were relatively satisfied, and 5% patients were not satisfied with the surgery.ConclusionUltrasound-guided five-point injection of botulinum toxin type A might be effective for patients with trapezius hypertrophy.
Highlights
Human trapezius is a triangular muscle with the superior muscle fibers attached to the posterior aspect of the neck and the inferior fibers attached to the base of the spine of the scapula [1]
The botulinum toxin type A treatment often reduces the pain associated with headache, cervical dystonia and achalasia
Inclusion and exclusion criteria were as follows: female patients diagnosed with bilateral trapezius hypertrophy feeling muscle tension and soreness; age between 20 and 50 years; healthy liver and kidney function; no shoulder lesion; no sign of coagulation dysfunction, myasthenia gravis, neurological disorders or other major diseases; not taking blood-activating drugs one week before surgery; no history of receiving specific training and other treatments within one year; no plan of pregnancy in the year; had willingness and ability to comply with study procedures
Summary
Human trapezius is a triangular muscle with the superior muscle fibers attached to the posterior aspect of the neck and the inferior fibers attached to the base of the spine of the scapula [1]. It is really important to find effective treatments for patients with trapezius hypertrophy. The botulinum toxin type A treatment often reduces the pain associated with headache, cervical dystonia and achalasia. Few studies have reported about the botulinum toxin type A injection treatment methods for trapezius hypertrophy. The effects of botulinum neurotoxin are dependent on the location, concentration, and volume of the solution injected [11, 12]. It is necessary to standardize the injection procedures to improve the therapeutic effects, especially the locating method for injection sites. In the study of Zhou et al [13], 30 women with bilateral trapezius hypertrophy were treated with botulinum toxin type A injection. It is still necessary to develop more effective ways for injection of botulinum toxin for treating patients with trapezius hypertrophy
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