Serratus Posterior Superior Research Articles

Ultrasound-Guided Serratus Posterior Superior Intercostal Plane Block in Modified Radical Mastectomy Surgeries: A Case Series.

Effective pain management is crucial for modified radical mastectomy (MRM) surgeries. The Serratus Posterior Superior Intercostal Plane Block (SPSIPB), introduced in 2023, shows promise for postoperative analgesia. This study was designed to demonstrate the analgesic efficacy of the SPSIPB in MRM surgeries. SPSIPB was administered to 7 patients who underwent MRM for postoperative analgesia. NRS scores of patients were ≤4 and total tramadol consumption was 0 mg in 3 of 7 patients. In conclusion, SPSIPB appears to be an effective, safe, and easily applicable option for analgesia.

Efficacy of Serratus Posterior Superior Intercostal Plane Block on Postoperative Pain and Total Analgesic Consumption in Patients Undergoing Reduction Mammoplasty Surgery: An Evidence Based Report.

Serratus posterior superior intercostal plane block (SPSIPB) is a novel technique that provides analgesia in shoulder, hemithorax and in the back of the neck. In this study, the efficacy of this block on postoperative pain and quality of recovery is reported in ten consecutive patients who had undergone reduction mammoplasty. Blocks were performed bilaterally with 30 ml 0.25 % bupivacaine for each side, at the end of surgery. Cumulative tramadol consumption and numerical rating scale (NRS) scores during rest (static) and coughing (dynamic) were assessed within the first postoperative 24 hours. Mean total tramadol consumption was 39 ±9.94 mg. NRS scores above 4 were observed in 5 patients in the dynamic NRS assessment at the postoperative 1st hour, while static and dynamic NRS scores were ≤4 at other durations. SPSIPB may play a part in postoperative multimodal analgesia following mammoplasty in the future and may reduce total analgesic consumption. Key Words: Serratus posterior superior intercostal plane block, Reduction mammoplasty, Breast surgery, Postoperative analgesia.

Novel Serratus Posterior Superior Intercostal Plane Block Provided Satisfactory Analgesia after Breast Cancer Surgery: Two Case Reports.

The serratus posterior superior intercostal plane (SPSIP) block is a novel technique recently described for thoracic analgesia. This study presents two cases using this technique for postoperative pain after mastectomy with axillary lymph node dissection. The SPSIP block was administered to the patients in the preoperative period as part of multimodal analgesia, and postoperative pain was monitored using the numeric rating scale (NRS). In both patients, the NRS pain scores were below 3/10. SPSIP provided adequate postoperative analgesia in these cases without the need for any opioid agents. Thus, an SPSIP block can be a valuable treatment option for postoperative pain after breast surgery.

Enhancing Minimally Invasive Thoracic Surgery: Efficacy of Serratus Posterior Superior Intercostal Plane Block in VATS Procedures

Enhancing Minimally Invasive Thoracic Surgery: Efficacy of Serratus Posterior Superior Intercostal Plane Block in VATS Procedures

A Possible Accessory Muscle of the Serratus Posterior Superior Muscle

Anatomical variation is defined as the normal range of possibilities in the topography and morphology of body structures. In contrast, an anomaly is any structural or functional anatomical finding beyond the normal range of possibilities. This case study describes a muscular anomaly found in a 73-year-old preserved Caucasian male. We observed a left-sided anomalous muscle originating from the transverse process of the C1 (Atlas) vertebra and inserting onto the proximal attachment of the serratus posterior superior (SPS) muscle at the C7 level. We suggest that this anomaly is a result of early embryological development and hypothesize that the atypical neck muscle may reinforce the action of the SPS. This finding is rare and no reference of it can be found in the literature. Reporting anatomical anomalies is important for the medical literature and education.

Case Study: A Possible Accessory Muscle of the Serratus Posterior Superior Muscle

Anatomical variation is defined as the normal range of possibilities in the topography and morphology of body structures. In contrast, congenital anomaly is any structural or functional anatomical finding beyond the normal range of possibilities. This case study describes a congenital anomaly found in a 73‐year old preserved Caucasian male.This individual presents an atypical left accessory neck muscle originating from the transverse process of the C1 (Atlas) vertebrae. It inserts at more than 90 degrees onto the serratus posterior superior (SPS) proximal attachment at the C7 level.Head and neck anatomical variations are also present in this individual, which include 4‐headed levator scapulae and 3‐headed splenius muscles bilaterally.It is thought that this anomaly is a result of embryologic development and it is hypothesize that the atypical neck muscle may reinforce the action of the SPS. Due to the rarity of this finding, a description of such a case is very infrequent in the literature. Identifying anatomical head and neck anomalies are important in understanding pathological and evolutionary implications in our species.Support or Funding InformationThe opinions or assertions contained herein are the private ones of the author/speaker and are not to be construed as official or reflecting the views of the Department of Defense, the Uniformed Services University of the Health Sciences or any other agency of the U.S. Government.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Efficacy of dry needling on latent myofascial trigger points in male subjects with neck/shoulders musculoskeletal pain. A case series

Abstract Aims To assess the impact of dry needling on neural mechanosensitivity and grip strength in male subjects with a history of persistent pain in the neck/shoulder area. Methods Case series study. Eight male subjects (mean age 25±6.24 years) with a recurrent history of bilateral neck/shoulder pain for at least 6 months, and with symptoms provoked by neck/shoulder postures or movement were recruited from a University-based clinical research center. Measurements were taken at baseline, immediately after intervention, and fifteen days later, of the pressure pain threshold (PPT) over the median, ulnar, and radial nerves, and the tibialis anterior (TA) muscle. Secondary measures included free-pain grip strength with a hydraulic dynamometer. A therapist assessed the presence of latent (not spontaneously painful, but painful upon palpation) myofascial trigger points (MTrP) over the scalene, subclavius, pectoralis minor, infraspinatus and serratus posterior superior muscles, on the most painful side. Deep dry needling was then performed on the latent MtrP by quickly inserting and partially removing the needle from the MTrP until 2 local twitch responses were provoked. Results PPT over the nerve trunks significantly increased after intervention (p < 0.05 for all locations). These changes remained constant in the second assessment, both in the treated (p < 0.001 for median and ulnar nerves, and p = 0.004 for radial nerve), and the non-treated upper limb (median nerve p < 0.001, ulnar nerve p = 0.003, and radial nerve p = 0.006). No statistical significance was found for PPT over the TA muscle (p > 0.05) or for grip strength (p = 0.153 on the treated side, and p = 0.564 on the non-treated upper limb). Conclusions Dry needling on the cervicothoracic and shoulder areas may help to improve peripheral neural features over the brachial plexus nerve trunks in subjects with recurrent neck/shoulder pain. No effect was observed for grip strength.

An anatomic investigation of the serratus posterior superior and serratus posterior inferior muscles

In classical anatomy textbooks the serratus posterior superior muscle was said to elevate the superior four ribs, thus increasing the AP diameter of the thorax and raising the sternum. However, electromyographic and other studies do not support its role in respiration. In order to help resolve this controversy and provide some insight into their possible functionality, the present study aimed at examining the morphology, topography and morphometry of serratus posterior superior and inferior muscles in both normal specimens and those derived from patients with a history of chronic obstructive pulmonary disorder (COPD). These muscles were examined in 50 human cadavers with an age range of 58-82 years. In 18 of the cadavers their histories revealed that they were suffering from COPD. There was no significant difference between right and left sides, race, gender and age and positive COPD history in regard to dimensions and nerves supply of serratus posterior superior and inferior muscles (P > 0.05). Based upon our findings that no morphometric differences exist between the of serratus posterior superior and inferior muscles of COPD patients versus controls, we are suggesting that no respiratory function be attributed to either of the serratus posterior superior and inferior muscles.

Differential Diagnosis and Treatment of Upper Thoracic Pain: A Case Study

An estimated 80% of Americans will suffer from back pain in their lifetime. Differential diagnosis of upper thoracic pain can be difficult secondary to complicated anatomy, biomechanics, function, proximity to vital organs, and articulation with ribs. The purpose of this study is to describe a complete clinical exam of a patient presenting with upper thoracic pain, using the hypothetico-deductive clinical reasoning process and evidenced-based clinical test and measures. The subject was a 32-year-old male with a chief complaint of tightness/discomfort under the right shoulder blade, of insidious onset approximately one month in duration. An extensive examination including a complete history, systems review and administration of tests and measures combined with the hypothetico-deductive clinical reasoning process was used. The patient's lung infection (with excessive coughing) within the previous months (determined by a history and systems review), along with the systematic clinical reasoning process, revealed two possible origins of thoracic pain: visceral referral or serratus posterior superior (SPS) muscle trigger point. The final diagnosis was SPS trigger point (mechanically reproduced with palpation). At the two-week follow-up, the patient reported complete resolution of symptoms. An assessment that the SPS trigger point was the origin of pain was achieved using the hypothetico-deductive clinical reasoning process. This case study demonstrates an accurate diagnosis followed by an efficient treatment plan.

The fine connective tissue architecture of the human ligamentum nuchae.

An anatomic study of the posterior midline structures of the cervical spine was performed using a new sheet-plastination (E12) technique in conjunction with gross anatomic dissection. To clarify the structural status of the human ligamentum nuchae. Little is known about the arrangement of connective tissue attachments of the neighboring neck muscles to the ligamentum nuchae. In addition, it is not clear whether the cervical supraspinous ligaments form part of the ligamentum nuchae. This study used a combined approach of a detailed gross anatomic study on eight cadavers and a macroscopic and microscopic study of the connective tissue organization of the posterior midline structures on serial horizontal thin (2.5 mm) plastinated slices of the cervical spine (occiput-T1) from an adult female cadaver. The dorsal and ventral portions of the ligamentum nuchae are a single entity formed by the aponeurotic fibers of the trapezius, splenius capitis, rhomboideus minor, and serratus posterior superior muscles. The regional differences in the connective tissue organization of the ligamentum nuchae and its well-defined attachments to the C6 and C7 vertebrae suggest that it is designed to function in the lower cervical spine.