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A standardized protocol for needle placement in the infraspinatus muscle: an anatomical perspective

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Abstract

Purpose

This study aimed to evaluate the morphology of the three parts of the infraspinatus muscle based on surface landmarks for precise and effective access, and to propose the most effective fine-wire electrode insertion technique and sites.

Methods

Fifteen Asian fresh cadavers were used. We investigated the probability of the presence of the superior, middle, and inferior parts in each infraspinatus muscle based on surface landmarks. Based on the positional characteristics of the muscle, we determined the needle insertion method and confirmed its effectiveness by dissection.

Results

The superior part was mostly observed near the spine of the scapula. The middle part was broadly observed within the infraspinous fossa. The inferior part showed variable location within the infraspinous fossa. The injection accuracy of the superior, middle, and inferior parts in the infraspinatus muscle was 95.8%, 100%, and 91.7%, respectively. Targeting the superior and middle parts for injection of the infraspinatus muscle is relatively more straightforward than targeting the inferior part. Targeting the inferior part of the infraspinatus muscle in this study was more challenging than targeting the superior and middle parts.

Conclusion

Needling for electromyography should be performed with special care to avoid unintended muscle parts, which could lead to inaccurate data acquisition and affect the conclusions about muscle function.

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Availability of data and materials

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

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Acknowledgements

This study complied with the principles outlined 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

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Author notes

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

Authors and Affiliations

  1. Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam, 13120, Republic of 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 & Hye-Won Hu

  3. Maylin Clinic (Apgujeong), Seoul, Republic of Korea

    Kyu-Ho Yi

  4. Department of Anatomy, School of Medicine, Konkuk University, Chungju, 27478, South Korea

    You-Jin Choi

  5. 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 and HW-H: experiment, validation, and visualization. YJ-C: dissection, experiment, validation, and critical revision of the manuscript for intellectual content. HJ-L: project administration, conceptualization, and supervision. Hyung-Jin Lee is responsible for the overall content as guarantor. All the 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 affect my views on the subject I am presenting significantly.

Ethical approval

The study protocol was approved by the Institutional Review Board of the College of Medicine, The Catholic University of Korea (Approval No. MC22SISI0056) and was conducted in accordance with the Declaration of Helsinki.

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Lee, JH., Lee, KW., Yi, KH. et al. A standardized protocol for needle placement in the infraspinatus muscle: an anatomical perspective. Surg Radiol Anat 45, 1579–1586 (2023). https://doi.org/10.1007/s00276-023-03245-1

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