Immunohistochemical Demonstration of Nerve Endings in Iliolumbar Ligament

Kiter, Esat; Karaboyun, Teyfik; Tufan, A. Çevik; Acar, Kemalettin

doi:10.1097/brs.0b013e3181ae561d

Cited by 26 publications

(16 citation statements)

References 27 publications

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“…Yahia et al. (1992) reported the presence of both Ruffini and Pacini endings in the supraspinous and interspinous ligaments, and a recent examination of the iliolumbar ligament found this tissue to be abundantly innervated by Pacinian receptors and Ruffini endings as well as a few Golgi tendon organs (Kiter et al. 2010).…”

Section: Innervation Of the Tlfmentioning

confidence: 99%

The thoracolumbar fascia: anatomy, function and clinical considerations

et al. 2012

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In this overview, new and existent material on the organization and composition of the thoracolumbar fascia (TLF) will be evaluated in respect to its anatomy, innervation biomechanics and clinical relevance. The integration of the passive connective tissues of the TLF and active muscular structures surrounding this structure are discussed, and the relevance of their mutual interactions in relation to low back and pelvic pain reviewed. The TLF is a girdling structure consisting of several aponeurotic and fascial layers that separates the paraspinal muscles from the muscles of the posterior abdominal wall. The superficial lamina of the posterior layer of the TLF (PLF) is dominated by the aponeuroses of the latissimus dorsi and the serratus posterior inferior. The deeper lamina of the PLF forms an encapsulating retinacular sheath around the paraspinal muscles. The middle layer of the TLF (MLF) appears to derive from an intermuscular septum that developmentally separates the epaxial from the hypaxial musculature. This septum forms during the fifth and sixth weeks of gestation. The paraspinal retinacular sheath (PRS) is in a key position to act as a 'hydraulic amplifier', assisting the paraspinal muscles in supporting the lumbosacral spine. This sheath forms a lumbar interfascial triangle (LIFT) with the MLF and PLF. Along the lateral border of the PRS, a raphe forms where the sheath meets the aponeurosis of the transversus abdominis. This lateral raphe is a thickened complex of dense connective tissue marked by the presence of the LIFT, and represents the junction of the hypaxial myofascial compartment (the abdominal muscles) with the paraspinal sheath of the epaxial muscles. The lateral raphe is in a position to distribute tension from the surrounding hypaxial and extremity muscles into the layers of the TLF. At the base of the lumbar spine all of the layers of the TLF fuse together into a thick composite that attaches firmly to the posterior superior iliac spine and the sacrotuberous ligament. This thoracolumbar composite (TLC) is in a position to assist in maintaining the integrity of the lower lumbar spine and the sacroiliac joint. The three-dimensional structure of the TLF and its caudally positioned composite will be analyzed in light of recent studies concerning the cellular organization of fascia, as well as its innervation. Finally, the concept of a TLC will be used to reassess biomechanical models of lumbopelvic stability, static posture and movement.

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Section: Innervation Of the Tlfmentioning

confidence: 99%

The thoracolumbar fascia: anatomy, function and clinical considerations

et al. 2012

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“…44,45 Furthermore, the author now knows the ligaments of the SIJ have a more complex neural structure, 1,46 which provide not only a potential as well as a pain generator but also likely important proprioceptive feedback. [47][48][49] Thus, the author could argue that the ligamentous structure of the SIJ not only contribute to form closure or passive stability but are also likely involved in the dynamic stability of the pelvic ring. The term 'force closure' was coined by Vleeming et al 11 and used to describe the compression forces acting on the SIJ related to dynamic stability of the joints.…”

Section: Mechanical Stability Of the Sijmentioning

confidence: 99%

“…Moreover, recent research has found nociceptors to be present throughout the joint capsule, ligaments and potentially into the subchondral bone, which suggests that trauma to any of the surrounding structures may be an aetiology of posterior pelvic or low back pain. 3,47,84 There are two mechanical mechanisms described in the literature that drive posterior pelvic pain in failed load transfer. The primary driver for both mechanisms is failed force closure, one is related to altered motor control (Right side of model; Fig.…”

Section: Motor Control and Lumbar -Pelvic Stabilitymentioning

confidence: 99%

Mechanics of pelvic girdle stability and self-bracing in SIJ-related pelvic girdle pain: a review

Bussey

2015

Physical Therapy Reviews

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Background: Pelvic girdle mechanics and control is a rapidly evolving area of research. Our traditional understandings were firmly grounded in theory borrowed from the fields of engineering (mechanical and structural) but have since began to branch out into neuroscience and motor control. The melding of mechanical concepts with those of neuroscience have led to a much better understanding of the effect of pain on the function of the pelvic girdle, specifically functional load transfer. Yet our understanding of the aetiology of pain particularly, chronic pain and recurrent pain pathways, is elusive. Objectives: The aim of the current review was to assess the mechanical and motor control components to pelvic girdle stability and propose a hypothetical model for mechanical aetiology of chronic posterior pelvic girdle pain. Results: A potentially new paradigm is offered on the current models of insufficient versus excessive force closure. The proposed model takes into account dynamic movement scenarios where the effect of anticipatory postural adjustment (APA) would be responsible for engaging local muscles to effectively elicit self-bracing of the sacroiliac joints (SIJ) for load transfer. When this mechanism fails the system would rely on compensatory postural adjustment (CPA) reliant on aberrant global muscle activation to stiffen the lumbar-pelvic-hip complex. Conclusions: For load transfer to be successful the pelvic girdle must be stabilized. The author has shown how disturbance of a component of this dynamic link may destabilize and disrupt the load transfer mechanism, resulting in low back pain of SIJ origin.

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“…These include Homo erectus [87], Homo heidelbergensis [88], ancient Egyptians and Nubians [89], ancient Chinese populations [90] and Ötzi the Iceman [91]. This included disc herniation, spondylolisthesis, scoliosis, osteophytosis, rheumatoid arthritis, osteoarthritis, lumbar spur formation, and ankylosing spondylitis all of which have the potential to cause LBP [1,[20][21][22][23][24][25][26][27][28][29][30]. So in consideration of Anderson's [58] invocation of dual level control in determining LBP in humans it would seem that the cultural environment, despite varying considerably between populations, has little impact upon LBP prevalence.…”

Section: Lbp In Traditional Indigenous Populationsmentioning

confidence: 99%

“…Abnormality or injury in several structures in the lumbar spine, including the facet joints [22,23], intervertebral discs [24,25], and ligamentous tissues [26] are prevalent in LBP and can contribute to pain. In fact any of the anatomical structures of the spine may contribute to pain [22,[26][27][28][29][30]] though it is not always possible to directly attribute pain to a specific peripheral structure through diagnostic means in individual cases; hence 'non-specific' is offered as a label in up to 85% of cases [31]. In light of this Lee and Vleeming [32] have introduced an integrated multifactorial model of function in relation to the pelvic girdle which has been adapted here to focus on the lumbar spine.…”

Section: Introductionmentioning

confidence: 99%

An evolutionary hypothesis to explain the role of deconditioning in low back pain prevalence in humans

Steele¹

2017

jevohealth

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The aim of the present piece is to present an evolutionary hypothesis relating to the role of deconditioning in the prevalence of low back pain (LBP) in humans. LBP is a multifactorial issue with many associated symptoms and potential causes. Prevalence is high in westernised populations and also rural and indigenous populations. Other diseases common in western populations, such as obesity, diabetes, heart disease, and cancer are almost absent in populations devoid of western influence who follow a traditional diet and lifestyle. It therefore seems counter-intuitive that LBP should also be high in traditional populations. The hypothesis that an evolutionarily determined factor might predispose LBP across a wide range of Homo sapiens populations seems plausible to examine. Fossil data from the infra-order Anthropoidea suggest adaptations in predominant habitual locomotion styles from 1) arboreal quadruped, to 2) semi-terrestrial quadruped, to 3) biped over the past ~20 million years. These adaptations were accompanied and permitted by anatomical evolutionary changes occurring in the lumbar spine and pelvis including development from 1) a long mobile lumbar vertebral column, laterally facing pelvis and large lumbar extensors to 2) a short lumbar vertebral column, posterior location of the transverse process, lengthening of the ilia, general reduction of the lumbar extensor musculature and increase in passive rigidity through entrapment and invagination and 3) to relengthening of the vertebral column, reduction in length and broadening of the ilia and sacrum. Comparative musculature anatomy between old world monkeys and modern humans suggests the presence of relatively smaller, and potentially weaker, lumbar extensor musculature in humans. Further, hip/trunk extensor musculature of short backed primates is well developed. Anatomically modern humans therefore may bear the compromise of relatively strong hip/trunk extensors and relatively weak lumbar extensors in combination with a long flexible lumbar spine. This may contribute to disuse atrophy of the lumbar extensors which may explain the consistent association of their deconditioning in LBP, and also predispose modern humans to the high prevalence of LBP presently observed. KeywordsEvolution, Lumbar Spine, Pelvis, Erector Spinae, Multifidus, Gait ErratumThis erratum is for correcting the citation for ' An evolutionary hypothesis to explain the role of deconditioning in low back pain prevalence in humans' . The previous citation listed the following citation and article homepage

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Immunohistochemical Demonstration of Nerve Endings in Iliolumbar Ligament

Cited by 26 publications

References 27 publications

The thoracolumbar fascia: anatomy, function and clinical considerations

The thoracolumbar fascia: anatomy, function and clinical considerations

Mechanics of pelvic girdle stability and self-bracing in SIJ-related pelvic girdle pain: a review

An evolutionary hypothesis to explain the role of deconditioning in low back pain prevalence in humans

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