Attachments of the Posterior Layer of Lumbar Fascia

Barker, Priscilla; Briggs, Christopher

doi:10.1097/00007632-199909010-00002

Cited by 71 publications

(87 citation statements)

References 35 publications

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“…Cadaveric dissections of the lumbar region clearly identify a well-developed compartment of posterior spinal muscles encased by the posterior and middle layer of the lumbodorsal fascia [2,13]. The posterior layer divides the intrinsic (paraspinal) from the extrinsic (upper limb and serratus posterior) muscles of the back.…”

Section: Discussionmentioning

confidence: 99%

“…The posterior layer divides the intrinsic (paraspinal) from the extrinsic (upper limb and serratus posterior) muscles of the back. The posterior layer is composed of two clearly distinct superficial and deep layers that encompass the iliocostalis, longissimus, and multifidus muscles [2,13,14]. Fascial continuity of the posterior layer exists with the latissimus dorsi superiorly with that of the superficial layer with the fascia in the dorsal spine, and inferiorly with its extensive attachments to the gluteus medius and maximus and the sacrum and ilium.…”

Section: Discussionmentioning

confidence: 99%

“…It has been postulated [13] that these accessory ligaments may semi-compartmentalise the paraspinal muscles, particularly the multifidus, which increases the chances of development of unilateral or bilateral paraspinal compartment syndrome in response to an insult. Vleeming et al [15] described the "foreclosure of sacroiliac joint", which is a displacement of the deep layer up to L5-S1 as load transfer occurs across the sacrotuberous ligaments, leading to increased pressure within the compartment.…”

Section: Discussionmentioning

confidence: 99%

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Lumbar paraspinal compartment syndrome

Nathan

Roberts

Deliberato

2011

International Orthopaedics (SICOT)

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The purpose of this study was to systematically review the available evidence on lumbar paraspinal compartment syndrome with specific reference to patient demographics, aetiology, types, diagnosis, clinical features, and treatment. This was an Institutional Review Boardexempt study performed at a Level 1 trauma center. A PubMed search was conducted with the title query: lumbar paraspinal compartment syndrome. Eleven articles met our search criteria. Three of the patients with acute paraspinal compartmental syndrome treated with fasciotomy had a full recovery and were able to resume skiing after four months.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Lumbar paraspinal compartment syndrome

Nathan

Roberts

Deliberato

2011

International Orthopaedics (SICOT)

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“…We recommend that researchers develop more comprehensive reference standards for PNP to accurately assess the concurrent validity of ULNTs and continue investigating the predictive validity of ULNTs for prognosis or treatment response. J Orthop Sports Phys Ther 2012;42 (5) ity when it changes with movement of a distant body part that further loads or unloads the nervous system (eg, contralateral neck sidebending increases a sensory response in the forearm). 12,38 Moving a distant body part to evaluate a ULNT response is referred to as structural differentiation.…”

Section: T T Synopsismentioning

confidence: 99%

The Validity of Upper-Limb Neurodynamic Tests for Detecting Peripheral Neuropathic Pain

Nee¹,

Jull²,

Vicenzino³

et al. 2012

Journal of Orthopaedic & Sports Physical Therapy

126

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Synopsis The validity of upper-limb neurodynamic tests (ULNTs) for detecting peripheral neuropathic pain (PNP) was assessed by reviewing the evidence on plausibility, the definition of a positive test, reliability, and concurrent validity. Evidence was identified by a structured search for peer-reviewed articles published in English before May 2011. The quality of concurrent validity studies was assessed with the Quality Assessment of Diagnostic Accuracy Studies tool, where appropriate. Biomechanical and experimental pain data support the plausibility of ULNTs. Evidence suggests that a positive ULNT should at least partially reproduce the patient's symptoms and that structural differentiation should change these symptoms. Data indicate that this definition of a positive ULNT is reliable when used clinically. Limited evidence suggests that the median nerve test, but not the radial nerve test, helps determine whether a patient has cervical radiculopathy. The median nerve test does not help diagnose carpal tunnel syndrome. These findings should be interpreted cautiously, because diagnostic accuracy might have been distorted by the investigators' definitions of a positive ULNT. Furthermore, patients with PNP who presented with increased nerve mechanosensitivity rather than conduction loss might have been incorrectly classified by electrophysiological reference standards as not having PNP. The only evidence for concurrent validity of the ulnar nerve test was a case study on cubital tunnel syndrome. We recommend that researchers develop more comprehensive reference standards for PNP to accurately assess the concurrent validity of ULNTs and continue investigating the predictive validity of ULNTs for prognosis or treatment response. J Orthop Sports Phys Ther 2012;42(5):413–424, Epub 8 March 2012. doi:10.2519/jospt.2012.3988

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“…The alignment of the collagen fibres reveals the direction of the load bearing function and is the basis for the effective load transfer from spine to pelvis, legs and arms [1,23]. It has been shown that tensional stiffness of the different layers of the TLF influences spinal stability, such as in resisting spinal flexion or extension [2,3].…”

Section: Structural Function Of the Tlfmentioning

confidence: 99%

Letter to the Editor concerning “A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction” (M. Panjabi)

Schleip¹,

Vleeming²,

Lehmann‐Horn³

et al. 2007

Eur Spine J

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In his article Panjabi gives a concise overview on the current knowledge and understanding of low back and neck pain [12]. He introduces the hypothesis that chronic back pain originates from subfailure injuries of three types of spinal ligamentous structures and their embedded mechanoreceptors: namely the spinal ligaments, the disc annulus and the facet capsules. These injured tissues then send out corrupted transducer signals to the neuromuscular control unit, and as a result corrupted muscle response patterns are generated leading to adverse consequences such as higher stresses, muscle fatigue, further injuries, and inflammation.While paying less attention to the central learning processes involved in chronic back pain [5, 6,19], this model focuses mainly on the structural mechanisms of pain generation. We are appreciative about the value of the hypothesis within this structural field and are optimistic about its successful application to the understanding and treatment of many cases of back pain. While we agree with the basic hypothesis and its emphasis on the transducer (mechanosensory) function of ligamentous tissues, we suggest to refine the model in terms of an inclusion of the thoracolumbar fascia (TLF). We present evidence that the TLF is significantly involved in all three levels of the hypothesis concerning spinal ligamentous structures: the transducer function of these tissues, their structural spinal function, and their proneness for subfailure injuries.

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Attachments of the Posterior Layer of Lumbar Fascia

Cited by 71 publications

References 35 publications

Lumbar paraspinal compartment syndrome

Lumbar paraspinal compartment syndrome

The Validity of Upper-Limb Neurodynamic Tests for Detecting Peripheral Neuropathic Pain

Letter to the Editor concerning “A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction” (M. Panjabi)

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