The Experts below are selected from a list of 327 Experts worldwide ranked by ideXlab platform
Samer Narouze - One of the best experts on this subject based on the ideXlab platform.
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Ultrasound-Guided Stellate Ganglion Block: Safety and Efficacy
Current Pain and Headache Reports, 2014Co-Authors: Samer NarouzeAbstract:Cervical sympathetic and stellate ganglion blocks (SGB) provide a valuable diagnostic and therapeutic benefit to sympathetically maintained pain syndromes in the head, neck, and upper extremity. With the ongoing efforts to improve the safety of the procedure, the techniques for SGB have evolved over time, from the use of the standard blind technique, to fluoroscopy, and recently to the ultrasound (US)-guided approach. Over the past few years, there has been a growing interest in the ultrasound-guided technique and the many advantages that it might offer. Fluoroscopy is a reliable method for identifying bony surfaces, which facilitates identifying the C6 and C7 transverse processes. However, this is only a surrogate marker for the cervical sympathetic trunk. The ideal placement of the needle tip should be anterolateral to the Longus Colli Muscle, deep to the prevertebral fascia (to avoid spread along the carotid sheath) but superficial to the fascia investing the Longus Colli Muscle (to avoid injecting into the Muscle substance). Identifying the correct fascial plane can be achieved with ultrasound guidance, thus facilitating the caudal spread of the injectate to reach the stellate ganglion at C7-T1 level, even if the needle is placed at C6 level. This allows for a more effective and precise sympathetic block with the use of a small injectate volume. Ultrasound-guided SGB may also improve the safety of the procedure by direct visualization of vascular structures (inferior thyroidal, cervical, vertebral, and carotid arteries) and soft tissue structures (thyroid, esophagus, and nerve roots). Accordingly, the risk of vascular and soft tissue injury may be minimized.
Ibrahim Tekdemir - One of the best experts on this subject based on the ideXlab platform.
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evaluation of the Longus Colli Muscle in relation to stellate ganglion block
Regional Anesthesia and Pain Medicine, 2009Co-Authors: Yesim Ates, Ibrahim Asik, Enver Ozgencil, Halil Ibrahim Acar, Banu Yagmurlu, Ibrahim TekdemirAbstract:Background and Objectives: The Longus Colli (LC) Muscle is an important structure of the anterior cervical spine and has a critical role in stellate ganglion block. This technique involves withdrawing the needle to locate its port for injection above the anterior surface of the LC Muscle; however, its exact thickness at the C5, C6, and C7 levels has not been measured. The aim of this anatomic and magnetic resonance-supported study was to evaluate the thickness of the LC Muscle at these levels from the anterior tubercle of each vertebra toward the vertebral body at 5-, 10-, and 15-mm distances to provide precise anatomic data for stellate ganglion block. Methods: Ten cadavers, 60 vertebral body specimens, and cervical magnetic resonance imaging (MRI) scans of 40 adult patients were used for measurements. Results: The main findings of this study are that the thickness of the LC Muscle varies between 5.0 and 10.0 mm at C6 and C7 in cadavers and between 8.0 and 10.0 mm in MRI scans. Sex has an important role; MRI scans revealed that male patients have a considerably thicker LC Muscle at each vertebral level. Conclusion: We found a highly variable thickness of the LC Muscle in anatomic and imaging studies, which may lead to negative block results.
Scott J. Erickson - One of the best experts on this subject based on the ideXlab platform.
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MR imaging of the stellate ganglion: normal appearance.
AJR. American journal of roentgenology, 1992Co-Authors: Quinn H Hogan, Scott J. EricksonAbstract:The stellate ganglion has not previously been identified by imaging techniques. MR imaging shows the stellate ganglion at the thoracic inlet adjacent to the neck of the first rib, lateral to the Longus Colli Muscle and posterior to the vertebral artery. Although its shape varies somewhat, it can be identified consistently in normal persons.
Richard A. Yeasting - One of the best experts on this subject based on the ideXlab platform.
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Vulnerability of the sympathetic trunk during the anterior approach to the lower cervical spine.
Spine, 2000Co-Authors: Nabil A. Ebraheim, Hua Yang, Bruce E. Heck, Richard A. YeastingAbstract:STUDY DESIGN Anatomic dissection and measurements of the cervical sympathetic trunk relative to the medial border of the Longus Colli Muscle and lateral angulation of the sympathetic trunk relative to the midline on both sides were performed. OBJECTIVE To determine the course and location of the sympathetic trunk quantitatively and relate this to the vulnerability of the sympathetic trunk during the anterior approach to the lower cervical spine. SUMMARY OF BACKGROUND DATA The sympathetic trunk is sometimes damaged during the anterior approach to lower cervical spine, resulting in Horner's syndrome with its associated ptosis, meiosis, and anhydrosis. No quantitative regional anatomy describing the course and location of the sympathetic trunk and its relation to the Longus Colli Muscle is available in the literature. METHODS In this study, 28 adult cadavers were used for dissection and measurements of the sympathetic trunk. The distance between the sympathetic trunk and the medial borders of the Longus Colli Muscle at C6 and the angle of the sympathetic trunk with respect to the midline were determined bilaterally. The distance between the medial borders of the Longus Colli Muscle from C3 to C6 and the angle between the medial borders of the Longus Colli Muscle also were measured. RESULTS The sympathetic trunk runs in a superior and lateral direction, with an average angle of 10.4 +/- 3.8 degrees relative to the midline. The average distance between the sympathetic trunk and the medial border of the Longus Colli Muscle is 10.6 +/- 2.6 mm. The average diameter of the sympathetic trunk at C6 is 2.7 +/- 0.6 mm. The length and width of the middle cervical ganglion were 9.7 +/- 2.1 mm and 5.2 +/- 1.3 mm, respectively. The distance between the medial borders of the Longus Colli Muscle was 7.9 +/- 2.2 mm at C3, 10.1 +/- 3.1 mm at C4, 12.3 +/- 3.1 mm at C5, and 13.8 +/- 2.2 mm at C6, and the angle between the medial borders of the Longus Colli Muscle was 12.5 +/- 4. 7 degrees. CONCLUSIONS The sympathetic trunk may be more vulnerable to damage during anterior lower cervical spine procedures because it is situated closer to the medial border of the the Longus Colli Muscle at C6 than at C3. The Longus Colli Muscles diverge laterally, whereas the sympathetic trunks converge medially at C6. As the transverse foramen or uncovertebral joint is exposed with dissection or transverse severance of the Longus Colli Muscle at the lower cervical levels, the sympathetic trunk should be identified and protected.
Yesim Ates - One of the best experts on this subject based on the ideXlab platform.
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evaluation of the Longus Colli Muscle in relation to stellate ganglion block
Regional Anesthesia and Pain Medicine, 2009Co-Authors: Yesim Ates, Ibrahim Asik, Enver Ozgencil, Halil Ibrahim Acar, Banu Yagmurlu, Ibrahim TekdemirAbstract:Background and Objectives: The Longus Colli (LC) Muscle is an important structure of the anterior cervical spine and has a critical role in stellate ganglion block. This technique involves withdrawing the needle to locate its port for injection above the anterior surface of the LC Muscle; however, its exact thickness at the C5, C6, and C7 levels has not been measured. The aim of this anatomic and magnetic resonance-supported study was to evaluate the thickness of the LC Muscle at these levels from the anterior tubercle of each vertebra toward the vertebral body at 5-, 10-, and 15-mm distances to provide precise anatomic data for stellate ganglion block. Methods: Ten cadavers, 60 vertebral body specimens, and cervical magnetic resonance imaging (MRI) scans of 40 adult patients were used for measurements. Results: The main findings of this study are that the thickness of the LC Muscle varies between 5.0 and 10.0 mm at C6 and C7 in cadavers and between 8.0 and 10.0 mm in MRI scans. Sex has an important role; MRI scans revealed that male patients have a considerably thicker LC Muscle at each vertebral level. Conclusion: We found a highly variable thickness of the LC Muscle in anatomic and imaging studies, which may lead to negative block results.
