Ultrasound-guided Thoracic Spinal Level Identification

Seoul National University100 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

Purpose

DIAGNOSTIC

Masking

NONE

Enrollment

100

Conditions

Thoracic Diseases Myofascial Pain

Interventions

Ultrasound imaging & fluoroscopic confirmationPROCEDURE

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.

Eligibility

Sex: ALLMin age: 19 YearsMax age: 85 Years

Medical Language ↔ Plain English

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

Outcomes

Primary Outcomes

Ultrasound-guided Thoracic Spinal Level

Thoracic vertebra level of radiopaque marker labeled on the rhomboid muscle inferior margin on C-arm