A Case of An Accessory Levator Scapulae Muscle
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Introduction: The levator scapulae is a posterior axioappendicular muscle that attaches the upper limb to the vertebral column. It originates from C1-C4 transverse processes and inserts on the margin of the superomedial angle of the scapula. This case report documents a variation of the musculature in the levator scapulae with a unilateral accessory muscle inserting into the trapezius instead of the scapula. Background: There have been some documented cases of anatomical variations of levator scapulae, however these variations were usually found to be of atypical origin or insertion. There have not been any documented cases of an accessory levator scapulae muscle belly matching the morphology noted here. The clinical implications of anatomical variants such as this one must be considered. Case Findings: During a detailed cadaver dissection of a 92 year-old female, a left unilateral accessory muscle of the levator scapulae was discovered. It originated just anterior to the bulk of the levator scapulae at the C2 level and inserted into the superior descending trapezius. This accessory levator scapulae measured 6.5 cm long and 0.5 cm wide. Conclusion: Knowledge of anatomical variants of levator scapulae is relevant to clinicians working in the fields of surgery, neurology, radiology and musculoskeletal medicine. This muscle is frequently implicated in the etiopathology of neck and shoulder pain and increased tension in levator scapulae has also been linked to increased cervicogenic headaches. Structural variations, such as this, may be a contributing factor to postural abnormalities leading to chronic myofascial pain and headaches.