Risk Analysis of Needle Injury to the Long Thoracic Nerve during Ultrasound-Guided C7 Selective Nerve Root Block

<i<Background and Objectives</i<: Ultrasound (US)-guided cervical selective nerve root block (SNRB) is a widely used treatment for upper limb radicular pain. The long thoracic nerve (LTN) passes through the middle scalene muscle (MSM) at the C7 level. The needle trajectory of US-guided C...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Seok Kang [verfasserIn] Ha-Mok Jeong [verfasserIn] Beom-Suk Kim [verfasserIn] Joon-Shik Yoon [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Schlagwörter:	long thoracic nerve ultrasound cervical nerve root selective nerve root block

Übergeordnetes Werk:	In: Medicina - MDPI AG, 2016, 57(2021), 6, p 635
Übergeordnetes Werk:	volume:57 ; year:2021 ; number:6, p 635

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.3390/medicina57060635

Katalog-ID:	DOAJ035326808

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520			\|a <i<Background and Objectives</i<: Ultrasound (US)-guided cervical selective nerve root block (SNRB) is a widely used treatment for upper limb radicular pain. The long thoracic nerve (LTN) passes through the middle scalene muscle (MSM) at the C7 level. The needle trajectory of US-guided C7 SNRB pierces the MSM, therefore indicating a high probability of injury to the LTN. We aimed to identify the LTN and to investigate the risk of needle injury to the nerve during US-guided C7 SNRB. <i<Materials and Methods:</i< This retrospective observational study included 30 patients who underwent US-guided SNRB at the C7 level in a university hospital. We measured the maximal cross-sectional diameter (MCSD) of the LTN and cross-sectional area (CSA) of the C7 nerve root and assessed the injury risk of LTN during US-guided C7 SNRB by simulating the trajectory of the needle in the ultrasound image. <i<Results:</i< The LTN was detectable in all the cases, located inside and outside the MSM in 19 (63.3%) and 11 (36.7%) of cases, respectively. The LTN’s mean MCSD was 2.10 mm (SD 0.13), and the C7 root’s CSA was 10.78 mm<sup<2</sup< (SD 1.05). The LTN location was within the simulated risk zone in 86.7% (26/30) of cases. <i<Conclusion:</i< Our findings suggest a high potential for LTN injury during US-guided C7 SNRB. The clear visualization of LTNs in the US images implies that US guidance may help avoid nerve damage and make the procedure safer. When performing US-guided C7 SNRB, physicians should take into consideration the location of the LTN.
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allfields	10.3390/medicina57060635 doi (DE-627)DOAJ035326808 (DE-599)DOAJa221a3ab0387451f961ce662caf3970d DE-627 ger DE-627 rakwb eng R5-920 Seok Kang verfasserin aut Risk Analysis of Needle Injury to the Long Thoracic Nerve during Ultrasound-Guided C7 Selective Nerve Root Block 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives</i<: Ultrasound (US)-guided cervical selective nerve root block (SNRB) is a widely used treatment for upper limb radicular pain. The long thoracic nerve (LTN) passes through the middle scalene muscle (MSM) at the C7 level. The needle trajectory of US-guided C7 SNRB pierces the MSM, therefore indicating a high probability of injury to the LTN. We aimed to identify the LTN and to investigate the risk of needle injury to the nerve during US-guided C7 SNRB. <i<Materials and Methods:</i< This retrospective observational study included 30 patients who underwent US-guided SNRB at the C7 level in a university hospital. We measured the maximal cross-sectional diameter (MCSD) of the LTN and cross-sectional area (CSA) of the C7 nerve root and assessed the injury risk of LTN during US-guided C7 SNRB by simulating the trajectory of the needle in the ultrasound image. <i<Results:</i< The LTN was detectable in all the cases, located inside and outside the MSM in 19 (63.3%) and 11 (36.7%) of cases, respectively. The LTN’s mean MCSD was 2.10 mm (SD 0.13), and the C7 root’s CSA was 10.78 mm<sup<2</sup< (SD 1.05). The LTN location was within the simulated risk zone in 86.7% (26/30) of cases. <i<Conclusion:</i< Our findings suggest a high potential for LTN injury during US-guided C7 SNRB. The clear visualization of LTNs in the US images implies that US guidance may help avoid nerve damage and make the procedure safer. When performing US-guided C7 SNRB, physicians should take into consideration the location of the LTN. long thoracic nerve ultrasound cervical nerve root selective nerve root block Medicine (General) Ha-Mok Jeong verfasserin aut Beom-Suk Kim verfasserin aut Joon-Shik Yoon verfasserin aut In Medicina MDPI AG, 2016 57(2021), 6, p 635 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:57 year:2021 number:6, p 635 https://doi.org/10.3390/medicina57060635 kostenfrei https://doaj.org/article/a221a3ab0387451f961ce662caf3970d kostenfrei https://www.mdpi.com/1648-9144/57/6/635 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 57 2021 6, p 635
spelling	10.3390/medicina57060635 doi (DE-627)DOAJ035326808 (DE-599)DOAJa221a3ab0387451f961ce662caf3970d DE-627 ger DE-627 rakwb eng R5-920 Seok Kang verfasserin aut Risk Analysis of Needle Injury to the Long Thoracic Nerve during Ultrasound-Guided C7 Selective Nerve Root Block 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives</i<: Ultrasound (US)-guided cervical selective nerve root block (SNRB) is a widely used treatment for upper limb radicular pain. The long thoracic nerve (LTN) passes through the middle scalene muscle (MSM) at the C7 level. The needle trajectory of US-guided C7 SNRB pierces the MSM, therefore indicating a high probability of injury to the LTN. We aimed to identify the LTN and to investigate the risk of needle injury to the nerve during US-guided C7 SNRB. <i<Materials and Methods:</i< This retrospective observational study included 30 patients who underwent US-guided SNRB at the C7 level in a university hospital. We measured the maximal cross-sectional diameter (MCSD) of the LTN and cross-sectional area (CSA) of the C7 nerve root and assessed the injury risk of LTN during US-guided C7 SNRB by simulating the trajectory of the needle in the ultrasound image. <i<Results:</i< The LTN was detectable in all the cases, located inside and outside the MSM in 19 (63.3%) and 11 (36.7%) of cases, respectively. The LTN’s mean MCSD was 2.10 mm (SD 0.13), and the C7 root’s CSA was 10.78 mm<sup<2</sup< (SD 1.05). The LTN location was within the simulated risk zone in 86.7% (26/30) of cases. <i<Conclusion:</i< Our findings suggest a high potential for LTN injury during US-guided C7 SNRB. The clear visualization of LTNs in the US images implies that US guidance may help avoid nerve damage and make the procedure safer. When performing US-guided C7 SNRB, physicians should take into consideration the location of the LTN. long thoracic nerve ultrasound cervical nerve root selective nerve root block Medicine (General) Ha-Mok Jeong verfasserin aut Beom-Suk Kim verfasserin aut Joon-Shik Yoon verfasserin aut In Medicina MDPI AG, 2016 57(2021), 6, p 635 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:57 year:2021 number:6, p 635 https://doi.org/10.3390/medicina57060635 kostenfrei https://doaj.org/article/a221a3ab0387451f961ce662caf3970d kostenfrei https://www.mdpi.com/1648-9144/57/6/635 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 57 2021 6, p 635
allfields_unstemmed	10.3390/medicina57060635 doi (DE-627)DOAJ035326808 (DE-599)DOAJa221a3ab0387451f961ce662caf3970d DE-627 ger DE-627 rakwb eng R5-920 Seok Kang verfasserin aut Risk Analysis of Needle Injury to the Long Thoracic Nerve during Ultrasound-Guided C7 Selective Nerve Root Block 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives</i<: Ultrasound (US)-guided cervical selective nerve root block (SNRB) is a widely used treatment for upper limb radicular pain. The long thoracic nerve (LTN) passes through the middle scalene muscle (MSM) at the C7 level. The needle trajectory of US-guided C7 SNRB pierces the MSM, therefore indicating a high probability of injury to the LTN. We aimed to identify the LTN and to investigate the risk of needle injury to the nerve during US-guided C7 SNRB. <i<Materials and Methods:</i< This retrospective observational study included 30 patients who underwent US-guided SNRB at the C7 level in a university hospital. We measured the maximal cross-sectional diameter (MCSD) of the LTN and cross-sectional area (CSA) of the C7 nerve root and assessed the injury risk of LTN during US-guided C7 SNRB by simulating the trajectory of the needle in the ultrasound image. <i<Results:</i< The LTN was detectable in all the cases, located inside and outside the MSM in 19 (63.3%) and 11 (36.7%) of cases, respectively. The LTN’s mean MCSD was 2.10 mm (SD 0.13), and the C7 root’s CSA was 10.78 mm<sup<2</sup< (SD 1.05). The LTN location was within the simulated risk zone in 86.7% (26/30) of cases. <i<Conclusion:</i< Our findings suggest a high potential for LTN injury during US-guided C7 SNRB. The clear visualization of LTNs in the US images implies that US guidance may help avoid nerve damage and make the procedure safer. When performing US-guided C7 SNRB, physicians should take into consideration the location of the LTN. long thoracic nerve ultrasound cervical nerve root selective nerve root block Medicine (General) Ha-Mok Jeong verfasserin aut Beom-Suk Kim verfasserin aut Joon-Shik Yoon verfasserin aut In Medicina MDPI AG, 2016 57(2021), 6, p 635 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:57 year:2021 number:6, p 635 https://doi.org/10.3390/medicina57060635 kostenfrei https://doaj.org/article/a221a3ab0387451f961ce662caf3970d kostenfrei https://www.mdpi.com/1648-9144/57/6/635 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 57 2021 6, p 635
allfieldsGer	10.3390/medicina57060635 doi (DE-627)DOAJ035326808 (DE-599)DOAJa221a3ab0387451f961ce662caf3970d DE-627 ger DE-627 rakwb eng R5-920 Seok Kang verfasserin aut Risk Analysis of Needle Injury to the Long Thoracic Nerve during Ultrasound-Guided C7 Selective Nerve Root Block 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives</i<: Ultrasound (US)-guided cervical selective nerve root block (SNRB) is a widely used treatment for upper limb radicular pain. The long thoracic nerve (LTN) passes through the middle scalene muscle (MSM) at the C7 level. The needle trajectory of US-guided C7 SNRB pierces the MSM, therefore indicating a high probability of injury to the LTN. We aimed to identify the LTN and to investigate the risk of needle injury to the nerve during US-guided C7 SNRB. <i<Materials and Methods:</i< This retrospective observational study included 30 patients who underwent US-guided SNRB at the C7 level in a university hospital. We measured the maximal cross-sectional diameter (MCSD) of the LTN and cross-sectional area (CSA) of the C7 nerve root and assessed the injury risk of LTN during US-guided C7 SNRB by simulating the trajectory of the needle in the ultrasound image. <i<Results:</i< The LTN was detectable in all the cases, located inside and outside the MSM in 19 (63.3%) and 11 (36.7%) of cases, respectively. The LTN’s mean MCSD was 2.10 mm (SD 0.13), and the C7 root’s CSA was 10.78 mm<sup<2</sup< (SD 1.05). The LTN location was within the simulated risk zone in 86.7% (26/30) of cases. <i<Conclusion:</i< Our findings suggest a high potential for LTN injury during US-guided C7 SNRB. The clear visualization of LTNs in the US images implies that US guidance may help avoid nerve damage and make the procedure safer. When performing US-guided C7 SNRB, physicians should take into consideration the location of the LTN. long thoracic nerve ultrasound cervical nerve root selective nerve root block Medicine (General) Ha-Mok Jeong verfasserin aut Beom-Suk Kim verfasserin aut Joon-Shik Yoon verfasserin aut In Medicina MDPI AG, 2016 57(2021), 6, p 635 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:57 year:2021 number:6, p 635 https://doi.org/10.3390/medicina57060635 kostenfrei https://doaj.org/article/a221a3ab0387451f961ce662caf3970d kostenfrei https://www.mdpi.com/1648-9144/57/6/635 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 57 2021 6, p 635
allfieldsSound	10.3390/medicina57060635 doi (DE-627)DOAJ035326808 (DE-599)DOAJa221a3ab0387451f961ce662caf3970d DE-627 ger DE-627 rakwb eng R5-920 Seok Kang verfasserin aut Risk Analysis of Needle Injury to the Long Thoracic Nerve during Ultrasound-Guided C7 Selective Nerve Root Block 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives</i<: Ultrasound (US)-guided cervical selective nerve root block (SNRB) is a widely used treatment for upper limb radicular pain. The long thoracic nerve (LTN) passes through the middle scalene muscle (MSM) at the C7 level. The needle trajectory of US-guided C7 SNRB pierces the MSM, therefore indicating a high probability of injury to the LTN. We aimed to identify the LTN and to investigate the risk of needle injury to the nerve during US-guided C7 SNRB. <i<Materials and Methods:</i< This retrospective observational study included 30 patients who underwent US-guided SNRB at the C7 level in a university hospital. We measured the maximal cross-sectional diameter (MCSD) of the LTN and cross-sectional area (CSA) of the C7 nerve root and assessed the injury risk of LTN during US-guided C7 SNRB by simulating the trajectory of the needle in the ultrasound image. <i<Results:</i< The LTN was detectable in all the cases, located inside and outside the MSM in 19 (63.3%) and 11 (36.7%) of cases, respectively. The LTN’s mean MCSD was 2.10 mm (SD 0.13), and the C7 root’s CSA was 10.78 mm<sup<2</sup< (SD 1.05). The LTN location was within the simulated risk zone in 86.7% (26/30) of cases. <i<Conclusion:</i< Our findings suggest a high potential for LTN injury during US-guided C7 SNRB. The clear visualization of LTNs in the US images implies that US guidance may help avoid nerve damage and make the procedure safer. When performing US-guided C7 SNRB, physicians should take into consideration the location of the LTN. long thoracic nerve ultrasound cervical nerve root selective nerve root block Medicine (General) Ha-Mok Jeong verfasserin aut Beom-Suk Kim verfasserin aut Joon-Shik Yoon verfasserin aut In Medicina MDPI AG, 2016 57(2021), 6, p 635 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:57 year:2021 number:6, p 635 https://doi.org/10.3390/medicina57060635 kostenfrei https://doaj.org/article/a221a3ab0387451f961ce662caf3970d kostenfrei https://www.mdpi.com/1648-9144/57/6/635 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 57 2021 6, p 635
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callnumber-first	R - Medicine
author	Seok Kang
spellingShingle	Seok Kang misc R5-920 misc long thoracic nerve misc ultrasound misc cervical nerve root misc selective nerve root block misc Medicine (General) Risk Analysis of Needle Injury to the Long Thoracic Nerve during Ultrasound-Guided C7 Selective Nerve Root Block
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topic_title	R5-920 Risk Analysis of Needle Injury to the Long Thoracic Nerve during Ultrasound-Guided C7 Selective Nerve Root Block long thoracic nerve ultrasound cervical nerve root selective nerve root block
topic	misc R5-920 misc long thoracic nerve misc ultrasound misc cervical nerve root misc selective nerve root block misc Medicine (General)
topic_unstemmed	misc R5-920 misc long thoracic nerve misc ultrasound misc cervical nerve root misc selective nerve root block misc Medicine (General)
topic_browse	misc R5-920 misc long thoracic nerve misc ultrasound misc cervical nerve root misc selective nerve root block misc Medicine (General)
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title	Risk Analysis of Needle Injury to the Long Thoracic Nerve during Ultrasound-Guided C7 Selective Nerve Root Block
ctrlnum	(DE-627)DOAJ035326808 (DE-599)DOAJa221a3ab0387451f961ce662caf3970d
title_full	Risk Analysis of Needle Injury to the Long Thoracic Nerve during Ultrasound-Guided C7 Selective Nerve Root Block
author_sort	Seok Kang
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author_browse	Seok Kang Ha-Mok Jeong Beom-Suk Kim Joon-Shik Yoon
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title_sort	risk analysis of needle injury to the long thoracic nerve during ultrasound-guided c7 selective nerve root block
callnumber	R5-920
title_auth	Risk Analysis of Needle Injury to the Long Thoracic Nerve during Ultrasound-Guided C7 Selective Nerve Root Block
abstract	<i<Background and Objectives</i<: Ultrasound (US)-guided cervical selective nerve root block (SNRB) is a widely used treatment for upper limb radicular pain. The long thoracic nerve (LTN) passes through the middle scalene muscle (MSM) at the C7 level. The needle trajectory of US-guided C7 SNRB pierces the MSM, therefore indicating a high probability of injury to the LTN. We aimed to identify the LTN and to investigate the risk of needle injury to the nerve during US-guided C7 SNRB. <i<Materials and Methods:</i< This retrospective observational study included 30 patients who underwent US-guided SNRB at the C7 level in a university hospital. We measured the maximal cross-sectional diameter (MCSD) of the LTN and cross-sectional area (CSA) of the C7 nerve root and assessed the injury risk of LTN during US-guided C7 SNRB by simulating the trajectory of the needle in the ultrasound image. <i<Results:</i< The LTN was detectable in all the cases, located inside and outside the MSM in 19 (63.3%) and 11 (36.7%) of cases, respectively. The LTN’s mean MCSD was 2.10 mm (SD 0.13), and the C7 root’s CSA was 10.78 mm<sup<2</sup< (SD 1.05). The LTN location was within the simulated risk zone in 86.7% (26/30) of cases. <i<Conclusion:</i< Our findings suggest a high potential for LTN injury during US-guided C7 SNRB. The clear visualization of LTNs in the US images implies that US guidance may help avoid nerve damage and make the procedure safer. When performing US-guided C7 SNRB, physicians should take into consideration the location of the LTN.
abstractGer	<i<Background and Objectives</i<: Ultrasound (US)-guided cervical selective nerve root block (SNRB) is a widely used treatment for upper limb radicular pain. The long thoracic nerve (LTN) passes through the middle scalene muscle (MSM) at the C7 level. The needle trajectory of US-guided C7 SNRB pierces the MSM, therefore indicating a high probability of injury to the LTN. We aimed to identify the LTN and to investigate the risk of needle injury to the nerve during US-guided C7 SNRB. <i<Materials and Methods:</i< This retrospective observational study included 30 patients who underwent US-guided SNRB at the C7 level in a university hospital. We measured the maximal cross-sectional diameter (MCSD) of the LTN and cross-sectional area (CSA) of the C7 nerve root and assessed the injury risk of LTN during US-guided C7 SNRB by simulating the trajectory of the needle in the ultrasound image. <i<Results:</i< The LTN was detectable in all the cases, located inside and outside the MSM in 19 (63.3%) and 11 (36.7%) of cases, respectively. The LTN’s mean MCSD was 2.10 mm (SD 0.13), and the C7 root’s CSA was 10.78 mm<sup<2</sup< (SD 1.05). The LTN location was within the simulated risk zone in 86.7% (26/30) of cases. <i<Conclusion:</i< Our findings suggest a high potential for LTN injury during US-guided C7 SNRB. The clear visualization of LTNs in the US images implies that US guidance may help avoid nerve damage and make the procedure safer. When performing US-guided C7 SNRB, physicians should take into consideration the location of the LTN.
abstract_unstemmed	<i<Background and Objectives</i<: Ultrasound (US)-guided cervical selective nerve root block (SNRB) is a widely used treatment for upper limb radicular pain. The long thoracic nerve (LTN) passes through the middle scalene muscle (MSM) at the C7 level. The needle trajectory of US-guided C7 SNRB pierces the MSM, therefore indicating a high probability of injury to the LTN. We aimed to identify the LTN and to investigate the risk of needle injury to the nerve during US-guided C7 SNRB. <i<Materials and Methods:</i< This retrospective observational study included 30 patients who underwent US-guided SNRB at the C7 level in a university hospital. We measured the maximal cross-sectional diameter (MCSD) of the LTN and cross-sectional area (CSA) of the C7 nerve root and assessed the injury risk of LTN during US-guided C7 SNRB by simulating the trajectory of the needle in the ultrasound image. <i<Results:</i< The LTN was detectable in all the cases, located inside and outside the MSM in 19 (63.3%) and 11 (36.7%) of cases, respectively. The LTN’s mean MCSD was 2.10 mm (SD 0.13), and the C7 root’s CSA was 10.78 mm<sup<2</sup< (SD 1.05). The LTN location was within the simulated risk zone in 86.7% (26/30) of cases. <i<Conclusion:</i< Our findings suggest a high potential for LTN injury during US-guided C7 SNRB. The clear visualization of LTNs in the US images implies that US guidance may help avoid nerve damage and make the procedure safer. When performing US-guided C7 SNRB, physicians should take into consideration the location of the LTN.
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title_short	Risk Analysis of Needle Injury to the Long Thoracic Nerve during Ultrasound-Guided C7 Selective Nerve Root Block
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The LTN location was within the simulated risk zone in 86.7% (26/30) of cases. <i<Conclusion:</i< Our findings suggest a high potential for LTN injury during US-guided C7 SNRB. The clear visualization of LTNs in the US images implies that US guidance may help avoid nerve damage and make the procedure safer. 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Risk Analysis of Needle Injury to the Long Thoracic Nerve during Ultrasound-Guided C7 Selective Nerve Root Block

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