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- Title
The middle layer of lumbar fascia and attachments to lumbar transverse processes: implications for segmental control and fracture.
- Authors
Barker, Priscilla J; Urquhart, Donna M; Story, Ian H; Fahrer, Marius; Briggs, Christopher A
- Abstract
The anatomy of the middle layer of lumbar fascia (MLF) is of biomechanical interest and potential clinical relevance, yet it has been inconsistently described. Avulsion fractures of the lumbar transverse processes (LxTP's) are traditionally attributed to traction from psoas major or quadratus lumborum (QL), rather than transversus abdominis (TrA) acting via the MLF. This attachment is also absent from many biomechanical models of segmental control. The aims of this study were to document: (1) the morphology and attachments of the MLF and (2) the attachments of psoas and QL to the LxTP's. Eighteen embalmed cadavers were dissected, measuring the thickness, fibre angle and width of the MLF and documenting the attachments of MLF, psoas and QL. The MLF was thicker at the level of the LxTP's than between them (mean 0.62: 0.40 mm). Psoas attached to the anteromedial surface of each process and QL and TrA to its lateral border; QL at its upper and lower corners and TrA (via the MLF) to its tip. In three cadavers, tension applied to the MLF fractured a transverse process. The MLF has a substantial and thickened attachment to the tips of the LxTP's which supports the involvement of TrA in lumbar segmental control and/ or avulsion fracture of the LxTP's.
- Publication
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2007, Vol 16, Issue 12, p2232
- ISSN
1432-0932
- Publication type
Journal Article
- DOI
10.1007/s00586-007-0502-z