Abstract
Local anesthetic injection into the medial head of the semispinalis capitis muscle can anesthetize the greater occipital nerve (GON) and third occipital nerve (TON) simultaneously (greater and third occipital nerve block: GTO block). Alternatively, inter-semispinal plane (ISP) block can anesthetize the dorsal rami of the cervical spinal nerves from C4 to T4. The GON, TON, and the dorsal rami of the inferior level cannot be blocked with a single injection. To elucidate this phenomenon from an anatomical standpoint, we performed an ISP block either alone or with a GTO block using water-based acrylic dye in three thiel-embalmed cadavers. Both dyes were clearly separated by the tendinous septum running obliquely inside the semispinalis capitis muscle (SCA). The tendinous septum of the SCA may have a relatively strong connection with the dorsal edge of the semispinalis cervicis muscle, and this structure may stem the injectate spread. Therefore, the GON and TON, running through the medial head of the SCA, and the dorsal rami of the inferior level are spatially separated by the tendinous septum, and cannot be blocked with a single injection.
| Original language | English |
|---|---|
| Journal | Journal of Anesthesia |
| DOIs | |
| Publication status | Accepted/In press - Jan 1 2018 |
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Keywords
- Greater occipital nerve
- Inter-semispinal plane block
- Semispinalis capitis muscle
- Third occipital nerve
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
The tendinous septum of the semispinalis capitis muscle spatially separates the dorsal ramus between C3 and C4. / Ohgoshi, Yuichi; Usui, Yosuke; Ishikawa, Shinichi; Takeda, Yoshimasa; Ohtsuka, Aiji.
In: Journal of Anesthesia, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The tendinous septum of the semispinalis capitis muscle spatially separates the dorsal ramus between C3 and C4
AU - Ohgoshi, Yuichi
AU - Usui, Yosuke
AU - Ishikawa, Shinichi
AU - Takeda, Yoshimasa
AU - Ohtsuka, Aiji
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Local anesthetic injection into the medial head of the semispinalis capitis muscle can anesthetize the greater occipital nerve (GON) and third occipital nerve (TON) simultaneously (greater and third occipital nerve block: GTO block). Alternatively, inter-semispinal plane (ISP) block can anesthetize the dorsal rami of the cervical spinal nerves from C4 to T4. The GON, TON, and the dorsal rami of the inferior level cannot be blocked with a single injection. To elucidate this phenomenon from an anatomical standpoint, we performed an ISP block either alone or with a GTO block using water-based acrylic dye in three thiel-embalmed cadavers. Both dyes were clearly separated by the tendinous septum running obliquely inside the semispinalis capitis muscle (SCA). The tendinous septum of the SCA may have a relatively strong connection with the dorsal edge of the semispinalis cervicis muscle, and this structure may stem the injectate spread. Therefore, the GON and TON, running through the medial head of the SCA, and the dorsal rami of the inferior level are spatially separated by the tendinous septum, and cannot be blocked with a single injection.
AB - Local anesthetic injection into the medial head of the semispinalis capitis muscle can anesthetize the greater occipital nerve (GON) and third occipital nerve (TON) simultaneously (greater and third occipital nerve block: GTO block). Alternatively, inter-semispinal plane (ISP) block can anesthetize the dorsal rami of the cervical spinal nerves from C4 to T4. The GON, TON, and the dorsal rami of the inferior level cannot be blocked with a single injection. To elucidate this phenomenon from an anatomical standpoint, we performed an ISP block either alone or with a GTO block using water-based acrylic dye in three thiel-embalmed cadavers. Both dyes were clearly separated by the tendinous septum running obliquely inside the semispinalis capitis muscle (SCA). The tendinous septum of the SCA may have a relatively strong connection with the dorsal edge of the semispinalis cervicis muscle, and this structure may stem the injectate spread. Therefore, the GON and TON, running through the medial head of the SCA, and the dorsal rami of the inferior level are spatially separated by the tendinous septum, and cannot be blocked with a single injection.
KW - Greater occipital nerve
KW - Inter-semispinal plane block
KW - Semispinalis capitis muscle
KW - Third occipital nerve
UR - http://www.scopus.com/inward/record.url?scp=85051788639&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85051788639&partnerID=8YFLogxK
U2 - 10.1007/s00540-018-2546-0
DO - 10.1007/s00540-018-2546-0
M3 - Article
C2 - 30128749
AN - SCOPUS:85051788639
JO - Journal of Anesthesia
JF - Journal of Anesthesia
SN - 0913-8668
ER -