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Anatomical analysis of the intramuscular distribution patterns of the levator scapulae and the clinical implications for pain management

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Abstract

Purpose

The present study aimed to demonstrate the intramuscular nerve distribution of the levator scapulae muscle that is responsible for pain and to use this anatomic data to propose possible injection sites.

Methods

Twenty levator scapulae muscles were dissected from 16 Korean embalmed cadavers. The intramuscular nerve distribution of the levator scapulae muscle was identified by whole-mount nerve staining to preserve and stain the nerve fibers without damage.

Results

The posterior ramus of spinal nerves C3, C4, and C5 innervated the levator scapulae muscles. When the origin and insertion of the muscle were set to 0% and 100%, respectively, most of the intramuscular nerve terminals were located between 30 and 70%. This area may correspond to the cricoid cartilage of the sixth cervical vertebra.

Conclusion

Most intramuscular nerve terminals can be found in the middle and distal portions of the levator scapulae muscle. Our findings improve our understanding of the intramuscular nerve distribution of the levator scapulae muscle and will aid in pain management in clinical practice.

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Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request. All data generated or analyzed during this study are included in this published article.

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Acknowledgements

This study was conducted in compliance with the principles set forth in the Declaration of Helsinki. Consent was received from the families of the deceased patients before beginning the dissections. The authors sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially increase mankind's overall knowledge, which can then improve patient care. Therefore, these donors and their families deserve our highest gratitude.

Funding

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2022R1I1A1A01069499).

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Author notes

  1. Ji-Hyun Lee and Kang-Woo Lee authors are contributed equally to this work.

Authors and Affiliations

  1. Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam, 13120, Korea

    Ji-Hyun Lee

  2. Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, 03722, Republic of Korea

    Kang-Woo Lee & Kyu-Ho Yi

  3. Catholic Institute for Applied Anatomy, Department of Anatomy, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, 06591, Republic of Korea

    Hyung-Jin Lee

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  1. Ji-Hyun Lee
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Contributions

All authors contributed to this study’s conception and design. All authors read and approved the final manuscript. JH-L and KW-L (these authors contributed equally to this work): conceptualization, dissection, experiment, validation, and writing and editing of the original manuscript. KH-Y: experiment, validation, and visualization. HJ-L: project administration, conceptualization, supervision, and critical revision of the manuscript for intellectual content. Hyung-Jin Lee is responsible for the overall content as guarantor. All authors have read and agreed to the publication of this manuscript.

Corresponding author

Correspondence to Hyung-Jin Lee.

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Conflict of interest

I acknowledge that I have considered the conflict of interest statement included in the “Author Guidelines.” I hereby certify that, to the best of my knowledge, no aspect of my current personal or professional situation might reasonably be expected to significantly affect my views on the subject I am presenting.

Ethical approval

This cadaveric study was conducted in compliance with the Act on Dissection and Preservation of Corpses of the Republic of Korea (act number: 14885) and approved by the Institutional Review Board of the College of Medicine, The Catholic University of Korea (Approval No MC22SISI0056).

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Lee, JH., Lee, KW., Yi, KH. et al. Anatomical analysis of the intramuscular distribution patterns of the levator scapulae and the clinical implications for pain management. Surg Radiol Anat 45, 859–864 (2023). https://doi.org/10.1007/s00276-023-03146-3

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  • DOI: https://doi.org/10.1007/s00276-023-03146-3

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