Cadaveric and ultrasonographic validation of needling placement in the cervical multifidus muscle
Author: Fernández de las Peñas, César; Mesa Jiménez, Juan A.; Paredes Mancilla, Jose A.; Shane L., Koppenhaver; Fernández Carnero, Samuel
Abstract: Objective: The aim of this study was to determine if a needle is able to reach the cervical multifidus during the
application of dry needling or acupuncture.
Methods: Dry needling and ultrasound imaging of cervical multifidi was conducted on 5 patients (age: 32 ± 5 years)
with mechanical neck pain and on 2 fresh cadavers (age: 64 ± 1 years). Dry needling was done using a needle of 40 mm in
length inserted perpendicular to the skin about 1 cmlateral to the spinous process at C3-C4. The needlewas advanced from
a posterior to anterior direction into the cervical multifidus with a slight inferior-medial angle (approximately 10°) to reach
the vertebra lamina. For the cadaveric study, the multifidus was isolated by carefully resecting the superficial posterior
cervical muscles: trapezius, splenius, and semispinalis. For the ultrasonographic study, a convex transducer was placed
transversely over C3-C4 after the insertion of the needle into the muscle.
Results: The results of both the cadaveric and ultrasonic studies found that the needle does pierce the cervical
multifidus muscle during insertion and that the tip of the needle rests properly against the vertebral laminae, thereby
guarding the sensitive underlying spinal structures from damage.
Conclusion: This anatomical and ultrasound imaging study supports that dry needling of the cervical multifidus
could be conducted clinically. (J Manipulative Physiol Ther 2017;xx:0-6)
Universal identifier: http://hdl.handle.net/10641/1293
Date: 2017
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