Relationship of the long thoracic nerve to the scapular tip: An aid to prevention of proximal nerve injury
Objective: The objective was to determine the course of the long thoracic nerve relative to the scapula as an aid to the prevention of proximal long thoracic nerve injuries. Methods: Eighteen fresh cadavers (7 male, 11 female) were studied. Each was sequentially placed in the transaxillary and poste...
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| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 1998-12, Vol.116 (6), p.960-964 |
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| container_title | The Journal of thoracic and cardiovascular surgery |
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| creator | Salazar, Jorge D. Doty, John R. Tseng, Elaine E. Marin, Philip C. Girotto, John A. Roseborough, Glen S. Yang, Stephen C. Heitmiller, Richard F. |
| description | Objective: The objective was to determine the course of the long thoracic nerve relative to the scapula as an aid to the prevention of proximal long thoracic nerve injuries.
Methods: Eighteen fresh cadavers (7 male, 11 female) were studied. Each was sequentially placed in the transaxillary and posterolateral thoracotomy positions, and the distance of the long thoracic nerve from the scapular tip and anterior scapular border was measured. The measurements were made bilaterally; the mean, standard deviation, and 99% confidence interval were calculated for each position by gender.
Results: Distances from the scapular tip to the long thoracic nerve are listed as mean/outer range: transaxillary thoracotomy, male 4.9/7.0 cm left, 5.2/7.5 cm right; female 4.3/5.0 cm left, 4.7/6.0 cm right; posterolateral thoracotomy, male 3.1/6.0 cm left, 4.5/5.1 cm right; female 3.2/4.5 cm left, 3.8/5.5 cm right. In all instances, the long thoracic nerve was furthest from the scapula at its tip.
Conclusion: For patients positioned for a transaxillary thoracotomy, incision sites should be at least 7.5 and 6.0 cm anterior to the scapular tip for male and female patients, respectively. For patients in posterolateral thoracotomy positioning, incisions should be 6.0 and 5.5 cm anterior to the scapular tip for male and female patients, respectively. By using these anatomic guidelines, we believe that the incidence of iatrogenic proximal long thoracic nerve injury can be minimized. (J Thorac Cardiovasc Surg 1998;116:960-4) |
| doi_str_mv | 10.1016/S0022-5223(98)70047-9 |
| format | Article |
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Methods: Eighteen fresh cadavers (7 male, 11 female) were studied. Each was sequentially placed in the transaxillary and posterolateral thoracotomy positions, and the distance of the long thoracic nerve from the scapular tip and anterior scapular border was measured. The measurements were made bilaterally; the mean, standard deviation, and 99% confidence interval were calculated for each position by gender.
Results: Distances from the scapular tip to the long thoracic nerve are listed as mean/outer range: transaxillary thoracotomy, male 4.9/7.0 cm left, 5.2/7.5 cm right; female 4.3/5.0 cm left, 4.7/6.0 cm right; posterolateral thoracotomy, male 3.1/6.0 cm left, 4.5/5.1 cm right; female 3.2/4.5 cm left, 3.8/5.5 cm right. In all instances, the long thoracic nerve was furthest from the scapula at its tip.
Conclusion: For patients positioned for a transaxillary thoracotomy, incision sites should be at least 7.5 and 6.0 cm anterior to the scapular tip for male and female patients, respectively. For patients in posterolateral thoracotomy positioning, incisions should be 6.0 and 5.5 cm anterior to the scapular tip for male and female patients, respectively. By using these anatomic guidelines, we believe that the incidence of iatrogenic proximal long thoracic nerve injury can be minimized. (J Thorac Cardiovasc Surg 1998;116:960-4)</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/S0022-5223(98)70047-9</identifier><identifier>PMID: 9832687</identifier><identifier>CODEN: JTCSAQ</identifier><language>eng</language><publisher>Philadelphia, PA: Mosby, Inc</publisher><subject>Adult ; Biological and medical sciences ; Cadaver ; Female ; Fundamental and applied biological sciences. Psychology ; Humans ; Intercostal Muscles - innervation ; Intercostal Muscles - surgery ; Intraoperative Complications - prevention & control ; Male ; Peripheral nervous system. Autonomic nervous system. Neuromuscular transmission. Ganglionic transmission. Electric organ ; Posture ; Scapula - innervation ; Sex Characteristics ; Thoracic Nerves - anatomy & histology ; Thoracic Nerves - injuries ; Thoracotomy - adverse effects ; Vertebrates: nervous system and sense organs</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 1998-12, Vol.116 (6), p.960-964</ispartof><rights>1998 Mosby, Inc.</rights><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c563t-818e9c79ae2fd45907fa090b8dfc405dd5128bdec9940658a92826bdf44d2c753</citedby><cites>FETCH-LOGICAL-c563t-818e9c79ae2fd45907fa090b8dfc405dd5128bdec9940658a92826bdf44d2c753</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0022-5223(98)70047-9$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1625321$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9832687$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Salazar, Jorge D.</creatorcontrib><creatorcontrib>Doty, John R.</creatorcontrib><creatorcontrib>Tseng, Elaine E.</creatorcontrib><creatorcontrib>Marin, Philip C.</creatorcontrib><creatorcontrib>Girotto, John A.</creatorcontrib><creatorcontrib>Roseborough, Glen S.</creatorcontrib><creatorcontrib>Yang, Stephen C.</creatorcontrib><creatorcontrib>Heitmiller, Richard F.</creatorcontrib><title>Relationship of the long thoracic nerve to the scapular tip: An aid to prevention of proximal nerve injury</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Objective: The objective was to determine the course of the long thoracic nerve relative to the scapula as an aid to the prevention of proximal long thoracic nerve injuries.
Methods: Eighteen fresh cadavers (7 male, 11 female) were studied. Each was sequentially placed in the transaxillary and posterolateral thoracotomy positions, and the distance of the long thoracic nerve from the scapular tip and anterior scapular border was measured. The measurements were made bilaterally; the mean, standard deviation, and 99% confidence interval were calculated for each position by gender.
Results: Distances from the scapular tip to the long thoracic nerve are listed as mean/outer range: transaxillary thoracotomy, male 4.9/7.0 cm left, 5.2/7.5 cm right; female 4.3/5.0 cm left, 4.7/6.0 cm right; posterolateral thoracotomy, male 3.1/6.0 cm left, 4.5/5.1 cm right; female 3.2/4.5 cm left, 3.8/5.5 cm right. In all instances, the long thoracic nerve was furthest from the scapula at its tip.
Conclusion: For patients positioned for a transaxillary thoracotomy, incision sites should be at least 7.5 and 6.0 cm anterior to the scapular tip for male and female patients, respectively. For patients in posterolateral thoracotomy positioning, incisions should be 6.0 and 5.5 cm anterior to the scapular tip for male and female patients, respectively. By using these anatomic guidelines, we believe that the incidence of iatrogenic proximal long thoracic nerve injury can be minimized. (J Thorac Cardiovasc Surg 1998;116:960-4)</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Cadaver</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Humans</subject><subject>Intercostal Muscles - innervation</subject><subject>Intercostal Muscles - surgery</subject><subject>Intraoperative Complications - prevention & control</subject><subject>Male</subject><subject>Peripheral nervous system. Autonomic nervous system. Neuromuscular transmission. Ganglionic transmission. Electric organ</subject><subject>Posture</subject><subject>Scapula - innervation</subject><subject>Sex Characteristics</subject><subject>Thoracic Nerves - anatomy & histology</subject><subject>Thoracic Nerves - injuries</subject><subject>Thoracotomy - adverse effects</subject><subject>Vertebrates: nervous system and sense organs</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkFtrFDEYhoNY6lr9CYW5EA8Xo0lmcvJGStG2UBA8gHchm3zTzTKbTJOZ1f57M7tDvfQqH7yHvDwInRP8nmDCP3zHmNKaUdq8VfKdwLgVtXqCVgQrUXPJfj1Fq0fLM_Q85y3GWGCiTtGpkg3lUqzQ9hv0ZvQx5I0fqthV4waqPoa7csRkrLdVgLSHaowHKVszTL1J1eiHj9VFqIx3szYk2EOYi-aSIcU_fmf6JevDdkoPL9BJZ_oML5f3DP388vnH5XV9-_Xq5vLitraMN2MtiQRlhTJAO9cyhUVnsMJr6TrbYuYcI1SuHVilWsyZNIpKyteua1tHrWDNGXp97C0r7ifIo975bKHvTYA4ZV1QSaFaXozsaLQp5pyg00Mqq9ODJljPjPWBsZ4BaiX1gbFWJXe-fDCtd-AeUwvUor9adFNw9V0ywfr8r5xT1lBSbG-Oto2_2_z2CXQuyPpSSvR2tJmUAVwrjovz09EJBdveQ9LZeggWXEnZUbvo_zP5Lyiypsc</recordid><startdate>19981201</startdate><enddate>19981201</enddate><creator>Salazar, Jorge D.</creator><creator>Doty, John R.</creator><creator>Tseng, Elaine E.</creator><creator>Marin, Philip C.</creator><creator>Girotto, John A.</creator><creator>Roseborough, Glen S.</creator><creator>Yang, Stephen C.</creator><creator>Heitmiller, Richard F.</creator><general>Mosby, Inc</general><general>AATS/WTSA</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19981201</creationdate><title>Relationship of the long thoracic nerve to the scapular tip: An aid to prevention of proximal nerve injury</title><author>Salazar, Jorge D. ; Doty, John R. ; Tseng, Elaine E. ; Marin, Philip C. ; Girotto, John A. ; Roseborough, Glen S. ; Yang, Stephen C. ; Heitmiller, Richard F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c563t-818e9c79ae2fd45907fa090b8dfc405dd5128bdec9940658a92826bdf44d2c753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Cadaver</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Intercostal Muscles - innervation</topic><topic>Intercostal Muscles - surgery</topic><topic>Intraoperative Complications - prevention & control</topic><topic>Male</topic><topic>Peripheral nervous system. Autonomic nervous system. Neuromuscular transmission. Ganglionic transmission. Electric organ</topic><topic>Posture</topic><topic>Scapula - innervation</topic><topic>Sex Characteristics</topic><topic>Thoracic Nerves - anatomy & histology</topic><topic>Thoracic Nerves - injuries</topic><topic>Thoracotomy - adverse effects</topic><topic>Vertebrates: nervous system and sense organs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Salazar, Jorge D.</creatorcontrib><creatorcontrib>Doty, John R.</creatorcontrib><creatorcontrib>Tseng, Elaine E.</creatorcontrib><creatorcontrib>Marin, Philip C.</creatorcontrib><creatorcontrib>Girotto, John A.</creatorcontrib><creatorcontrib>Roseborough, Glen S.</creatorcontrib><creatorcontrib>Yang, Stephen C.</creatorcontrib><creatorcontrib>Heitmiller, Richard F.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Salazar, Jorge D.</au><au>Doty, John R.</au><au>Tseng, Elaine E.</au><au>Marin, Philip C.</au><au>Girotto, John A.</au><au>Roseborough, Glen S.</au><au>Yang, Stephen C.</au><au>Heitmiller, Richard F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship of the long thoracic nerve to the scapular tip: An aid to prevention of proximal nerve injury</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>1998-12-01</date><risdate>1998</risdate><volume>116</volume><issue>6</issue><spage>960</spage><epage>964</epage><pages>960-964</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><coden>JTCSAQ</coden><abstract>Objective: The objective was to determine the course of the long thoracic nerve relative to the scapula as an aid to the prevention of proximal long thoracic nerve injuries.
Methods: Eighteen fresh cadavers (7 male, 11 female) were studied. Each was sequentially placed in the transaxillary and posterolateral thoracotomy positions, and the distance of the long thoracic nerve from the scapular tip and anterior scapular border was measured. The measurements were made bilaterally; the mean, standard deviation, and 99% confidence interval were calculated for each position by gender.
Results: Distances from the scapular tip to the long thoracic nerve are listed as mean/outer range: transaxillary thoracotomy, male 4.9/7.0 cm left, 5.2/7.5 cm right; female 4.3/5.0 cm left, 4.7/6.0 cm right; posterolateral thoracotomy, male 3.1/6.0 cm left, 4.5/5.1 cm right; female 3.2/4.5 cm left, 3.8/5.5 cm right. In all instances, the long thoracic nerve was furthest from the scapula at its tip.
Conclusion: For patients positioned for a transaxillary thoracotomy, incision sites should be at least 7.5 and 6.0 cm anterior to the scapular tip for male and female patients, respectively. For patients in posterolateral thoracotomy positioning, incisions should be 6.0 and 5.5 cm anterior to the scapular tip for male and female patients, respectively. By using these anatomic guidelines, we believe that the incidence of iatrogenic proximal long thoracic nerve injury can be minimized. (J Thorac Cardiovasc Surg 1998;116:960-4)</abstract><cop>Philadelphia, PA</cop><pub>Mosby, Inc</pub><pmid>9832687</pmid><doi>10.1016/S0022-5223(98)70047-9</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Biological and medical sciences Cadaver Female Fundamental and applied biological sciences. Psychology Humans Intercostal Muscles - innervation Intercostal Muscles - surgery Intraoperative Complications - prevention & control Male Peripheral nervous system. Autonomic nervous system. Neuromuscular transmission. Ganglionic transmission. Electric organ Posture Scapula - innervation Sex Characteristics Thoracic Nerves - anatomy & histology Thoracic Nerves - injuries Thoracotomy - adverse effects Vertebrates: nervous system and sense organs |
| title | Relationship of the long thoracic nerve to the scapular tip: An aid to prevention of proximal nerve injury |
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