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T_The levator scapular muscle: Ultrasound scan and US-guided block technique

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Practical Pain Management with Dr. Lee

It is the partial volume of the full video of the levator scapular muscle_ultrasound scan and ultrasound guided dorsal scapular nerve block technique.

Today, I will talk about the ultrasound scanning technique of the levator scapular muscle and share an ultrasoundguided block of the dorsal scapular nerve.
The medial scapular area is a commonplace of pain complaints. Many physiotherapists blame the muscles as a cause of pain. Otherwise, the spinal pain interventionists pick the spinal problem as a leading cause. However, I have been working as a pain physician for two decades and have more elderly patients than youth.
I found that cervical pathology causes more frequent chronic pain than muscle in my clinic.
Dorsal scapular nerve neuropathy is not common, and we don't know the exact pain mechanism yet. However, I want to include the dorsal scapular nerve neuropathy in the list of differential diagnoses.
I usually consider the muscle first for young adults, and the levator scapular muscle is one of them
As an ultrasound pain physician, it is worth knowing about the levator scapular muscle, dorsal scapular nerve for comprehensive pain management.
When we do an ultrasound scan of the posterior neck and interscapular region, we must study each muscle group in advance and know the orientation of the multiple layers before scanning.
Even though we believe we know the muscle, it is not easy to differentiate each layer on the ultrasound scan because it shows the crosssectional anatomy.
Furthermore, the dorsal scapular nerve is too tiny and deeply located in the posterior neck region. So, it is impossible to detect the nerve on a sonogram.
However, it is possible to block the nerve under ultrasound guidance because the dorsal scapular nerve constantly passes in the interfascial layer under the levator scapular muscle and rhomboid muscle group.
I will show you an easy way to identify each muscle and fascial layer.
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posted by lel1neki