A practical guide to botulinum neurotoxin treatment of teres major muscle in shoulder spasticity: Intramuscular neural distribution of teres major muscle in cadaver model
Kyu-Ho Yi
Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
Search for more papers by this authorKang-Woo Lee
Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
Search for more papers by this authorHye-Won Hu
Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
Search for more papers by this authorCorresponding Author
Ji-Hyun Lee
Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam-si, South Korea
Correspondence
Ji-Hyun Lee, Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
Email: [email protected]
Hyung-Jin Lee, Research Assistance Professor, Address: Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of South Korea, Seoul 06591, South Korea.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Hyung-Jin Lee
Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of Korea, Seoul, South Korea
Correspondence
Ji-Hyun Lee, Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
Email: [email protected]
Hyung-Jin Lee, Research Assistance Professor, Address: Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of South Korea, Seoul 06591, South Korea.
Email: [email protected]
Search for more papers by this authorKyu-Ho Yi
Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
Search for more papers by this authorKang-Woo Lee
Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
Search for more papers by this authorHye-Won Hu
Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
Search for more papers by this authorCorresponding Author
Ji-Hyun Lee
Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam-si, South Korea
Correspondence
Ji-Hyun Lee, Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
Email: [email protected]
Hyung-Jin Lee, Research Assistance Professor, Address: Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of South Korea, Seoul 06591, South Korea.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Hyung-Jin Lee
Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of Korea, Seoul, South Korea
Correspondence
Ji-Hyun Lee, Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
Email: [email protected]
Hyung-Jin Lee, Research Assistance Professor, Address: Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of South Korea, Seoul 06591, South Korea.
Email: [email protected]
Search for more papers by this authorKyu-Ho Yi and Kang-Woo Lee contributed equally.
Abstract
Background
Botulinum neurotoxin treatment typically focuses on the teres major muscle as a primary target for addressing shoulder spasticity. The muscle is located deep within a large muscle group and optimal injection locations have not been identified.
Objective
To identify the preferred location for administering botulinum toxin injections in the teres major muscle.
Methods
Teres major specimens were removed from 18 cadaveric models and stained with Sihler's method to reveal the neural distribution within the muscle. The muscles were systematically divided into equal lengths from origin to insertion. The neural density in each section was evaluated to determine the location that would be likely to increase effectiveness of the injection.
Results
The greatest density of intramuscular nerve endings was located in the middle 20% of the muscle. The tendinous portion was observed at the ends of the muscle.
Conclusions
The results suggest that botulinum neurotoxin should be delivered in the middle 20% of the teres major muscle.
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