Deep, posterior muscles of the neck. A proposal for injection procedures

The emergence of the col-cap concept in the 2010s led to a focus on previously neglected muscles, hoping to improve the benefit of botulinum toxin injections in patients with movements disorders of the head and neck. The deep posterior cervical muscles are part of this. They include sub-occipital muscles, the semi-spinalis cervicis muscle and even deeper muscles such as the multifidus. Injecting them requires the use of ultrasound. This article will take up the anatomical notions necessary to perform these injections in an accurate and safe manner. We will also describe how to find these muscles using ultrasound.