Myofascial Pain, Thoracic Diseases
Conditions
Keywords
Ultrasound guided intervention, Rhomboid muscle, Thoracic spine
Brief summary
Typically, the rhomboid minor muscles rise from the C7-T1 spinous process and run downward to touch the upper inner corner of the scapula, and the rhomboid major muscles rise from the T2-T5 spinous process and run downward to reach the lower middle inner corner of the scapula. In anatomical research articles, it has been reported that the rhomboid muscle's anatomical variations are rare. Considering the characteristics of these rhomboid muscles, the investigators planned a study on the utility of rhomboid muscles as a landmark for identifying thoracic spine levels.
Interventions
PROCEDUREUltrasound imaging & fluoroscopic confirmation
The researchers use ultrasound to scan the left and right sides of the paravertebral sagittal imaging to identify trapezius, semispinalis, erector spinae muscle, transverse process and rhomboid muscle. The radiopaque marker is attached respectively to the skin of the inferior margin of the rhomboid muscle on the left and right thoracic spinal spines. Then, as the first step for the scheduled nerve block to the patient, thoracic vertebra level verification using C-arm is performed. At this time, left and right level of the transverse process of thoracic spine marked with the radiopaque marker are confirmed and recorded.
Sponsors
Seoul National University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
19 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Patients undergoing thoracic nerve root block due to herpes zoster, postherpetic neuralgia, complex regional pain syndrome, post traumatic pain syndrome, or compression fracture of vertebra.
Exclusion criteria
1. Previous T-spine surgery 2. Patient refusal 3. Coagulopathy 4. Generalized infection or localized infection at injection site 5. Anatomical abnormality of T-spine 6. Allergic reaction to local anesthetics
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ultrasound-guided Thoracic Spinal Level | during the procedure | Thoracic vertebra level of radiopaque marker labeled on the rhomboid muscle inferior margin on C-arm |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 1. Changes in marker position when raised the arm above the head and in a relaxed position | during the procedure | — |
| 2. Rhomboid muscle variation | during the procedure | The presence of rhomboid muscle fusion |
| 3. Visibility grade of muscle fascia using Ultrasound (I - IV) | during the procedure | A. Grade I: Definitely visible B. Grade II: Somewhat visible C. Grade III: Barely visible D. Grade IV: Not visible |
| 4. Depth: The distance from the skin where the marker is attached to the transverse process of thoracic spine | during the procedure | — |
| 5. Difference between left and right sides | during the procedure | The distance between left and right inferior thoracic spine attachment site of rhomboid muscle |
Outcome results
None listed