No abstract available.
Muscles* ; Superficial Back Muscles*

No abstract available.
Scalp* ; Superficial Back Muscles*

The management of post-radiation wound breakdown over the posterior cervico thoracic region can be a challenging task for a surgeon. The aim of the treatment is to produce a well vascularized and a low tensile flap which will close a large defect. We describe the use of the lower trapezius flap to reconstruct the wound breakdown and to obtain stable tissue coverage in a patient with postradiation necrosis. This flap minimizes the disruption of the scapula-thoracic function while preserving the range of movement over the shoulder. From the literature review, it was noted that the dorsal scapular artery (DSA) and transverse cervical artery (TCA) aid in the blood supply to the trapezius muscle and prevent local necrosis during rotation of the flap. The trapezius flap is widely accepted because of the minor donor site morbidity, large arc of rotation and adequate blood supply.
Superficial Back Muscles

No abstract available.
Orthopedics* ; Superficial Back Muscles*

Spasmodic torticollis (ST) is a focal dystonia caused by a tonic or intermittent spasms of the neck muscles. Botulinum toxin type A has been known to be one of the effective treatments for the cervical dystonia. We report the result of low dose botulinum toxin type A injection in 26 patients with spasmodic torticollis. In addition to the careful neurological examination, a needle polymyographic analysis was used to identify muscles responsible for ST. The most common combination of the involved muscles was splenius capitus and sternocleidomastoid muscle. The mean dose of botulinum toxin used in the patient was 100 units (range ; 80-140 units). Mean dose of 25 units (range ; 20-30 units) for levator scapula, 30 units (range ; 20-40 units) for semispinalis, 37 units (range ; 25-50 units) for sternocleidomastoid, 40 units for trapezius and 58 units (range ; 40-100 units) for splenius capitus muscle were injected. Using Tsui score (for objective response rating scale) and the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS ; for objective and subjective response rating scale), we assessed the patient before and 2, 6 and 10 weeks after the botulinum toxin injection. Seventeen of the 26 (65%) showed improvement on TWSTRS objective response rating scale, and 18 (69%) on Tsui scale. Comparing to the baseline score measured by Tsui scale, the amount of improvement was 37.1% (range 20-88%). Twenty one of the 26 (80.7%) reported improvement on subjective rating scale (TWSTRS). Twenty of the 21 responder on the subjective rating scale felt improvement within a week after the botulinum toxin injection. The beneficial effect lasted for 0.5 to longer than 9 months (mean ; 3.5months). We compared the result with that of the other studies in which larger doses of botulinum toxin were injected into the neck muscles selected on clinical ground. There was no significant difference of response rate and duration of beneficial effects. In our study, only two patients developed transient complications ; one
Botulinum Toxins* ; Botulinum Toxins, Type A ; Dystonic Disorders ; Humans ; Muscles ; Neck Muscles ; Needles ; Neurologic Examination ; Paraspinal Muscles ; Scapula ; Spasm ; Superficial Back Muscles ; Torticollis*

OBJECTIVE: To determine the function of the normal upper trapezius and scalenus medius muscles during neck motion by quantitative eletromyographic analysis. METHOD: Nine subjects were evaluated electromyographically with monopolar fine wire electrodes. The isometric tilting and rotation of neck with manual resistance were performed in the sitting position. The Root Mean Square (RMS) and Mean Rectified Voltage (MRV) were recorded. RESULTS: The RMS and MRV of upper trapezius muscle were significantly higher at each degree of ipsilateral rotation than contralateral rotation. But the RMS and MRV of scalenus medius muscle were significantly higher at each degree of contralateral rotation than ipsilateral rotation. The RMS and MRV of upper trapezius and scalenus medius muscles were significantly higher at ipsilateral tilting than at contralateral tilting. CONCLUSION: Based on these results, we concluded that the upper trapezius muscle acts more in ispilateral rotation, while scalenus medius muscle acts in contralateral rotation, and upper trapezius and scalenus medius muscles act in ipsilateral tilting.
Electrodes ; Muscles ; Neck* ; Superficial Back Muscles*

No abstract available.
Empyema, Tuberculous* ; Superficial Back Muscles*

No abstract available.
Neck* ; Scalp* ; Superficial Back Muscles*

The inferior trapezius flap (ITF) is useful as a primary means of head and neck reconstruction or as a salvage flap when a previous flap has failed. This report illustrates a neck bypass modification technique which places the pedicle external and lateral to the neck, thereby 1) increasing the flap's reach and 2) decreasing compression from subcutaneous tunneling. It also describes the authors' experience with this technique.

Surface electromyogram in the lumbar paraspinal muscles was studied to evaluate back muscle impairment in twenty chronic low back pain patients and twenty control subjects. Turns-amplitude and power spectrum analysis of electromyographic signals were performed at different force levels during fatigue from sustained isometric contraction and recovery from fatigue in trunk extensor muscles. Results indicated that with increasing force level mean amplitude and Root Mean Square (RMS) values were increased, but mean and median frequencies increased initially until 20% Maximal Voluntary Contraction (MVC) and decreased tendency after then. Turns, mean amplitude, RMS, mean and median frequencies were all higher in control subject than those of low back pain patients. During sustained isometric contraction at 70% MVC, mean and median frequencies were linearly decreased, and the slopes were steeper in the patients group. Mean amplitude and RMS value showed decreased tendency during fatigue. During recovery from fatigue turns, mean and median frequencies increased especially in the first 3 minutes and nearly completely recovered in the 7~8 minutes in both patients and control groups. Therefore the mean amplitude and RMS value could be used as indicators of the level of muscle contraction and the mean and median frequencies reflect well the muscle fatigue in paralumbar muscle. These results validate the use of surface EMG spectral parameters as an objective measure of back muscle impairment in chronic low back pain patients.
Back Muscles* ; Back Pain ; Fatigue ; Humans ; Isometric Contraction ; Low Back Pain* ; Muscle Contraction ; Muscle Fatigue ; Muscles ; Paraspinal Muscles ; Spectrum Analysis