Variety of thoracodorsal nerve branching variants

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Abstract

Background. Accurate knowledge of the anatomy of all branches of peripheral nerves is necessary for successful neurotization and muscle plasty.

Aim. Anatomical substantiation of the use of branches of the thoracodorsal nerve in neurotization and muscle plasty.

Material and methods. The study was carried out on 121 preparations of the thoracodorsal nerve and the latissimus dorsi muscle from 105 cadavers of men and women aged 36–100 years. Variants of extra- and intramuscular branching of the thoracodorsal nerve were studied, a classification was developed and the possibilities of using it in reconstructive surgery were shown. A database was formed from the obtained indicators in the MS Excel 2012 program, and their processing was carried out using Statistica for Windows 12. The article presents only those indicators that do not follow the normal distribution according to the single-sample Shapiro–Wilk test. When describing the studied indicators, the median (Me) and quartile values (Q1, Q3) were determined.

Results. Anatomical layering and macro–microscopic dissection revealed 13 variants of extramuscular branching of the thoracodorsal nerve, which were combined into three groups. In the first group, which is 6.6%, the thoracodorsal nerve penetrates the latissimus dorsi muscle in one trunk and is divided into intramuscular branches of the first and second orders. In the second group (40.5%), the thoracodorsal nerve is divided into extramuscular branches of the first order, which penetrate into the latissimus dorsi muscle and branch into intramuscular branches of the first and second orders. In the third group (52.9%), the thoracodorsal nerve branches into extramuscular branches of the first and second orders, which are divided in the latissimus dorsi muscle into intramuscular branches of the first and second orders.

Conclusion. The thoracodorsal nerve is characterized by 13 variants of extramuscular and a wide variety of intramuscular branching, which is a factor that determines the tactics of nerve transposition and muscle plasty.

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About the authors

Nikolay S. Gorbunov

Krasnoyarsk State Medical University named after prof. V.F. Voyno-Yasenetsky; Scientific Research Institute of Medical Issues of the North

Author for correspondence.
Email: gorbunov_ns@mail.ru
ORCID iD: 0000-0003-4809-4491
SPIN-code: 7526-1993
Scopus Author ID: 57215012421
ResearcherId: W-4527-2017

M.D., D. Sci. (Med.), Prof., Depart. of the Operative Surgery and Topographic Anatomy; Leading Researcher

Russian Federation, Krasnoyarsk, Russia; Krasnoyarsk, Russia

Kristina V. Kober

Krasnoyarsk Regional Clinical Oncological Dispensary named after A.I. Kryzhanovsky

Email: k-kober@mail.ru
ORCID iD: 0000-0001-5209-182X
SPIN-code: 3427-9859
ResearcherId: D-9666-2019

M.D.

Russian Federation, Krasnoyarsk, Russia

Eduard V. Kasparov

Scientific Research Institute of Medical Issues of the North

Email: rsimpn@scn.ru
ORCID iD: 0000-0002-5988-1688

M.D., D. Sci. (Med.), Prof., Director

Russian Federation, Krasnoyarsk, Russia

Sergey I. Rostovtsev

Krasnoyarsk State Medical University named after prof. V.F. Voyno-Yasenetsky

Email: rostovcev.1960@mail.ru
ORCID iD: 0000-0002-1462-7379

M.D., D. Sci. (Med.), Assoc. Prof., Depart. of the Anesthesiology and Resuscitation

Russian Federation, Krasnoyarsk, Russia

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Supplementary files

Supplementary Files
Action
1. Рис. 1. Грудоспинной нерв трупов: мужчина 71 года (А), женщина 82 лет (Б), женщина 96 лет (В), мужчина 84 лет (Г); А — одним стволом; Б — с двумя внемышечными ветвями первого порядка; В — с двумя внемышечными ветвями первого и двумя второго порядков, а также с внутримышечными ветвями первого и второго порядков; Г — с двумя внемышечными ветвями первого и четырьмя второго порядков, а также с внутримышечными ветвями первого порядка

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2. Рис. 2. Схематичное изображение ветвления грудоспинного нерва

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