Localization of the center of the intramuscular nerve dense region of the medial femoral muscles and the significance for blocking spasticity

Jie Wang; Qing Wang; Deyi Zhu; Yanjun Jiang; Shengbo Yang

doi:10.1016/j.aanat.2020.151529

Localization of the center of the intramuscular nerve dense region of the medial femoral muscles and the significance for blocking spasticity

Ann Anat. 2020 Sep:231:151529. doi: 10.1016/j.aanat.2020.151529. Epub 2020 May 11.

Authors

Jie Wang¹, Qing Wang¹, Deyi Zhu¹, Yanjun Jiang¹, Shengbo Yang²

Affiliations

¹ Department of Anatomy, Zunyi Medical University, Zunyi, 563099, People's Republic of China.
² Department of Anatomy, Zunyi Medical University, Zunyi, 563099, People's Republic of China. Electronic address: yangshengbo8205486@163.com.

PMID: 32437866
DOI: 10.1016/j.aanat.2020.151529

Abstract

Purpose: To identify the body surface position and depth of the center of the intramuscular nerves dense region (CINDR) of the medial femoral muscles.

Methods: Utilizing twelve Chinese adult cadavers (six men and six women), with an age range from 35 to 75 (66.5±5.4) years, the body surface curves between the greater trochanter of the femur and the pubic tubercle and lateral femoral epicondyle were designated as horizontal (H) and longitudinal (L) reference lines, respectively. Sihler's staining was performed on one side of the medial femoral muscles to show the intramuscular nerve dense regions, and the contralateral CINDR was labeled with barium sulfate and scanned by computed tomography, and three-dimensional reconstruction was performed. The body surface projection point of CINDR was designated as P. Projection of P in the opposite direction was identified as P'. The intersection of the longitudinal line from P to line H, and that of the horizontal line from P to line L was designated as P_H and P_L, respectively. The percentage positions of P_H and P_L on the H and L lines and the depth of the CINDRs were determined under the Syngo system.

Results: The pectineus, gracilis, adductor longus, and adductor brevis muscles each possess one intramuscular nerve dense region; the adductor magnus muscle has two. The P_H was located at 80.32%, 95.67%, 85.64%, 94.92%, 84.48%, and 88.83% of line H, respectively. P_L was at 12.76%, 40.68%, 33.26%, 23.39%, 25.57%, and 35.29% of line L, respectively. The depth of CINDRs was at 17.58%, 27.89%, 23.05%, 30.45%, 34.09%, and 29.52% of PP' line, respectively. These percentage values are all means. No statistical difference was observed neither between the left and right sides nor between the male and female cadavers (P>0.05).

Conclusion: These results may help improve the efficiency and efficacy of botulinum toxin A injection in the treatment of medial femoral muscle spasticity.

Keywords: Blocking target localization; Botulinum toxin A; Intramuscular nerve dense region; Medial femoral muscles; Spasticity.

MeSH terms

Adult
Aged
Cadaver
Female
Humans
Male
Middle Aged
Muscle Spasticity / prevention & control*
Muscle, Skeletal / diagnostic imaging
Muscle, Skeletal / innervation*
Staining and Labeling / methods
Thigh
Tomography, Spiral Computed