Ultrasound-Guided Lateral Approach for Needle Insertion into the Subscapularis for Treatment of Spasticity

Abstract

Rha D-w, Han S-H, Kim H-J, Won S-Y, Lee SC. Ultrasound-guided lateral approach for needle insertion into the subscapularis for treatment of spasticity. ObjectiveTo evaluate the safety and accuracy of ultrasound (US)-guided needle insertion into the subscapularis using fresh cadavers. DesignA needle was inserted into the subscapularis of adult human cadavers under US guidance using a lateral approach from the posterior axillary fold. An anatomist dissected the cadavers to evaluate the effectiveness of this injection method. SettingUniversity dissecting room. ParticipantsFresh cadavers (N=5). InterventionsUS-guided dye injections targeting the motor points of the subscapularis. Main Outcome MeasureAccuracy of the injections and prevalence of complications. The presence of dye within 1.0cm of the motor points was defined as reaching the target. The injection procedure was considered a success if two-thirds of the injected dye reached the target. ResultsWe did not identify any neurovascular structures at risk of injury in the injection route. All subscapularis muscles were injected successfully using the US-guided lateral approach. ConclusionsUS-guided needle insertion into the subscapularis using this lateral approach was accurate and had the minimal risk of neurovascular or lung injuries.