Anatomical locations of the motor endplates of sartorius muscle for botulinum toxin injections in treatment of muscle spasticity

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Authors: Kyu-Ho Yi ; Ji-Hyun Lee ; Dongkeun Kenneth Lee ; Hye-Won Hu ; Kyle K Seo ; Hee-Jin Kim

MeSH: Aged ; Aged, 80 and over ; Botulinum Toxins / administration & dosage* ; Cadaver ; Female ; Humans ; Injections, Intramuscular ; Male ; Middle Aged ; Motor Endplate / anatomy & histology* ; Muscle Spasticity / drug therapy* ; Muscle, Skeletal / anatomy & histology* ; Muscle, Skeletal / innervation ; Thigh / anatomy & histology ; Thigh / innervation

Keywords: Botulinum neurotoxin ; Sartorius muscle ; Sihler’s staining ; Spasticity

Abstract: Purpose: This study aimed to detect the idyllic locations for botulinum neurotoxin injection by analyzing the intramuscular neural distributions of the sartorius muscles.

Methods: An altered Sihler's staining was conducted on sartorius muscles (15 specimens). The nerve entry points and intramuscular arborization areas were measured as a percentage of the total distance from the most prominent point of the anterior superior iliac spine (0%) to the medial femoral epicondyle (100%).

Results: Intramuscular neural distribution were densely detected at 20-40% and 60-80% for the sartorius muscles. The result suggests that the treatment of sartorius muscle spasticity requires botulinum neurotoxin injections in particular locations.

Conclusions: These locations, corresponding to the locations of maximum arborization, are suggested as the most suggestive points for botulinum neurotoxin injection.