https://doi.org/10.4081/aapm.2026.60
Anatomical variation of the brachial plexus roots identified during pre-procedural ultrasound for an interscalene block
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Published: 2 February 2026
Dear Editor,
In shoulder surgery, the interscalene brachial plexus block (ISB) remains the most frequently employed technique. At this level, the brachial plexus roots are known to display several anatomical variations. In this letter, we report an anatomical variant of the brachial plexus roots observed during an ultrasound scan prior to performing an ISB. We illustrate the observed sono-anatomy features of the variant seen, offer an explanation as to why targeting this variant may clinically result in a failed block, and describe a rescue strategy. [...]
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1. Feigl GC, Litz RJ, Marhofer P. Anatomy of the brachial plexus and its implications for daily clinical practice: regional anesthesia is applied anatomy. Reg Anesth Pain Med 2020;45:620-7. DOI: https://doi.org/10.1136/rapm-2020-101435
2. Nadeau MJ, Lévesque S, Dion N. Ultrasound-guided regional anesthesia for upper limb surgery. Can J Anaesth 2013;60:304-20. DOI: https://doi.org/10.1007/s12630-012-9874-6
3. Keet K, Louw G. Variation of the brachial plexus roots in the interscalene groove: relevance in interscalene blocks. Anatomy (Istanbul) 2019;13:40-8. DOI: https://doi.org/10.2399/ana.19.030
4. Kılıçaslan A, Gök F, Korucu İH, et al. Anatomical variations detected during ultrasound-guided interscalene brachial plexus block and clinical implications. Marmara Med J 2020;33:221-6. DOI: https://doi.org/10.5472/marumj.816311
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