3D reconstruction of the crural and thoracolumbar fasciae

Abstract

Computerized three-dimensional models provide a detailed representation of the fascial structure, for better understanding of the interactions among the different components. This is a fundamental step in understanding the mechanical behavior of the fasciae and their role in pathology.

Anatomical and histological study of human deep fasciae development

“…All specimens were measured using histological analysis. Adult specimen values were taken from the literature [3,13,15,16]. Fetal specimen values were obtained in the present study (Table 1).…”

“…The layers of densely packed connective tissue bundles of multi-layered deep fascia are arranged in the same direction within each layer; however, each layer shows a different direction to its adjacent ones. Moreover, between parallel adjacent layers, a persistent angulation in layer orientation of 78°-90°has been shown in thoracolumbar and crural fasciae [3,16]). The thickness of the deep fasciae, established by histological studies, ranges from 924 (±220) lm in crural deep fascia [16] to 265 lm at the level of the ankle and dorsum of the foot [2].…”

Fascia research – A narrative review

“…In the adjacent layer, fibers go the same direction within the layer, but in a different direction than the neighboring fibers. Surprisingly, a similar fiber orientation in adjacent fascia layers (78 difference between layers) has been observed in diverse locations and different species (Benetazzo et al, 2011;Purslow, 2010). Therefore, we recently examined the role of fiber orientation in fascia when analyzed as a composite material.…”

Quadratus lumborum block (QLB)

“…Centralni utrazvučni marker za izvođenje bloka je musculus quadratus lumborum (MQL), a ključ analgezije leži u torakolumbalnoj fasciji (TLF) 12,13,14,15 . TLF je kompleksna vezivnotkivna cevasta struktura, nastala spajanjem aponeuroza i fascijalnih slojeva, koja povezuje anterolateralni trbušni zid sa lumbalnom paravertebralnom regijom, obavijajući mišiće leđa.…”

“…Na fasciji postoje mehanoreceptori niske simpatičke aktivnosti, ali i visokopražni i niskopražni mehanoreceptori i receptori za bol, koji su osetljivi na dejstvo lokalnih anestetika i imaju ulogu u razvoju kako akutnog tako i hronič-nog bola. Blokadom pomenutih receptora lokalnim anestetikom, mogla bi da se objasni nastala analgezija 15,20 . U svakodnevnoj kliničkoj praksi se primenjuju različiti pristupi izvođenja bloka, a razlike u širi-ni anesteziranog polja i dužini trajanja analgezije su značajne.…”