Localization of blocking targets based on intramuscular nerve distribution of the iliopsoas and quadratus lumborum muscle spasticity
ZHAO Hong-ming, YANG Xian, YANG Sheng-bo
Chinese Journal of Clinical Anatomy ›› 2019, Vol. 37 ›› Issue (1) : 5-8.
Localization of blocking targets based on intramuscular nerve distribution of the iliopsoas and quadratus lumborum muscle spasticity
Objective To localize the blocking targets for botulinum toxin A injection in iliopsoas and quadratus lumborum muscles by exploring the intramuscular nerve distribution pattern. Methods Iliopsoas and quadratus lumborum muscles of 12 adult cadavers were collected from both sides. Modified Sihler's staining was used to reveal intramuscular nerve distribution. Results The innervation of the iliopsoas and quadratus lumborum originated from the branches of T12 and L1~L4 spinal nerves. There was a nerve branch dense region in the upper 1/2 of psoas major muscle. It was located about (12.1±0.65)%~(43.2±1.17)% of muscle length with a central point at （23.90±0.82）% of muscle length corresponding medially to the middle of L3 vertebral body. There was a broad bean-shaped nerve dense region parallel to the iliac crest in the center of the iliacus muscle. The central point of this region was at （58.0±1.61）% of iliopsoas muscle length corresponding laterally to iliac tubercle. There was an intramuscular nerve dense region in the superomedial 1/3 and inferior 1/3 of the quadratus lumborum muscle respectively, each having a central point medially corresponding to the lower part of the L1 and L3 vertebral bodies. Conclusion The localization study of these intramuscular nerve dense regions and centers of the iliopsoas and quadratus lumborum muscle can allow the clinician to inject BTX-A close to its site of action.
Iliopsoas muscle / Quadratus lumborum muscle / Sihler's staining / Intramuscular nerves； Applied anatomy
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