{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:34:12Z","timestamp":1789169652778,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,8,9]],"date-time":"2020-08-09T00:00:00Z","timestamp":1596931200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100008005","name":"Yonsei University College of Medicine","doi-asserted-by":"publisher","award":["6\u20102019\u20100181"],"award-info":[{"award-number":["6\u20102019\u20100181"]}],"id":[{"id":"10.13039\/501100008005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The long thoracic nerve (LTN) has a risk of being damaged during chest surgery and should be considered when performing anesthesia such as a serratus anterior plane block (SAPB). We analyzed the relationship between landmarks\u2014the fourth to ninth intercostal space (ICS) at the midaxillary line (MAL), through which the distal part of the LTN passes\u2014and the LTN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>We used 25 specimens from 17 embalmed Korean cadavers. The MAL, level of rib and ICS, and regions 5 cm anteroposterior to the MAL (aMAL\/pMAL) were established to measure the position of the LTN crossing the MAL, pathway of the LTN, and entering points of the LTN to the SA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The LTN crossed the MAL in 76% of the specimens. The LTN crossed the MAL within the fifth to sixth rib level in 70.8%. Seventy\u2010six percent of the branches entered the SA within the fourth to sixth ICS. The fifth rib and ICS were the most frequent regions aMAL; however, several branches were found pMAL. The LTN entered the SA in 92.6% of the specimens within 3 cm anterior and 1 cm posterior to the MAL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We set the danger zone as 4 cm near the MAL at the fourth to sixth ICS for thoracotomy. In addition, we proposed the fifth ICS in aMAL at the superficial plane as the alternative injection point for SAPB when blocking the LTN, and the fifth ICS in pMAL at the deep plane to prevent blocking the LTN.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ca.23647","type":"journal-article","created":{"date-parts":[[2020,7,9]],"date-time":"2020-07-09T15:20:41Z","timestamp":1594308041000},"page":"617-623","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Analysis of the positional relationship of the long thoracic nerve considering clinical treatment"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4351-3183","authenticated-orcid":false,"given":"Jehoon","family":"O","sequence":"first","affiliation":[{"name":"Department of Anatomy Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7752-6172","authenticated-orcid":false,"given":"Hyun\u2010Jin","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Anatomy Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7230-620X","authenticated-orcid":false,"given":"Tae\u2010Hyeon","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Anatomy Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9245-7088","authenticated-orcid":false,"given":"Sung\u2010Yoon","family":"Won","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy Semyung University  Jecheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1954-0114","authenticated-orcid":false,"given":"Hun\u2010Mu","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Anatomy Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Surgical Anatomy Education Centre, Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951103000519"},{"issue":"2","key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"251","DOI":"10.4103\/joacp.JOACP_294_16","article-title":"Comparison of two different techniques of serratus anterior plane block: A clinical experience","volume":"34","author":"Bhoi D.","year":"2018","journal-title":"Journal of Anaesthesiology, Clinical Pharmacology"},{"issue":"8","key":"e_1_2_7_4_1","first-page":"854","article-title":"Serratus plane block: A cadaveric study to evaluate optimal injectate spread","volume":"43","author":"Biswas A.","year":"2018","journal-title":"Regional Anesthesia and Pain Medicine"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12344"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1370364"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.191665"},{"issue":"2","key":"e_1_2_7_8_1","first-page":"288","article-title":"Severe incisional pain and long thoracic nerve injury after port\u2010access minimally invasive mitral valve surgery","volume":"91","author":"Chaney M. 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