Visualization of the epimysium and fascia thoracolumbalis at the lumbar spine using MRI

Abstract

Background The fascia thoracolumbalis (FTL) is an important component for stabilization and motion control of the lumbar spine. It coordinates the traction forces of the autochthonous muscles of the back (AM) and connects them to the muscles of the abdominal wall, shoulder, and buttocks. Objectives The aim of our study was to describe the assessment of the normal FTL and epimysium of the AM in MRI and to identify patterns associated with pathological changes in the lumbar spine. Material and methods A total of 33 patients were retrospectively evaluated: 15 patients had no pathology at the lumbar spine; six patients had previous hemilaminectomy, three had spondylodesis, two had ventrolisthesis, and seven had scoliosis. The thickness of the FTL and EM was measured, and the adhesion of both structures was assessed. Results The fascial thickness at the levels of the lumbar vertebral bodies LVB 3 was 1.8, of LVB 4 it was 2.0, of LVB 5 it was 2.1, and at the sacral vertebra SVB 1 it was 1.8 mm. Fascial adhesions together with thickening of the EM occurred at the level of LVB 4 in 36% of the cases independently of the underlying disorder. Only thickening of the EM was seen in 48% of cases at the level of SVB 1. By contrast, adhesion of the FTL without epimysial changes occurred in 36% of cases at the level of LVB 3. Conclusion Thickening and adhesions at the EM and FTL occurred both postoperatively and in the case of scoliosis. Furthermore, lipomatous and muscular herniation could be detected in the FTL postoperatively. Epimysial and fascial alterations may be imaging manifestations of chronic myofascial back pain and should be included in radiological assessments.

The incidence and risk factors of lumbodorsal fasciitis in osteoporotic vertebral compression fractures: a retrospective study in 1182 cases

“…Besides, males were at higher risk than females to develop edema in lumbodorsal fascia. As paravertebral muscle degeneration is common in aged population [17,18], the age-related increase of lumbodorsal fasciitis may indicate a degenerative change of multi dus and erector spinae muscle during aging [5], and in males the degeneration is probably accelerated by chronic heavy burdens and lumbar muscle strain [19,20]. As spine trauma remains the leading cause of vertebral fractures, it is possible the lumbodorsal fasciitis is also caused by the trauma that compressed vertebrae [13].…”

“…On T2weighted fat suppression Magnetic Resonance (MR) imaging of spine, a fresh OVCF shows hyperintense signal indicating of vertebral bone marrow edema [3]. In some patients, an edema signal could also be detected subcutaneously dorsal to the thoracolumbar fascia, suggesting a comorbidity of lumbodorsal fasciitis in the OVCF [3][4][5]. While the epidemiology and pathogenesis of lumbodorsal fasciitis remain elusive, evidence accumulates that the lumbodorsal fascia is innervated with terminal nerves and could be a potential source of acute or chronic low back pain [6][7][8][9][10][11][12].…”

Influence of sports activity, thoracolumbar fascia morphology and myofascial release treatment on lumbar microcirculation: a randomized, placebo-controlled trial

“…The study was a single-blind, randomized, placebo-controlled trial with two groups. Measurements were taken before and after the intervention and at a 60-minute follow-up according to the SPIRIT guidelines [21]. The study protocol was prospectively registered with the German Clinical Trials Register (DRKS00028780) on 08.04.2022.…”

“…The TLF is also thought to play an important role in lumbar proprioception [5,17]. There is increasing evidence that not only thickening but also ultrasonic echogenicity and disorganization of the fascia are critical factors in the development of nLBP, ROM limitations, and sensory disturbances [2,[18][19][20][21]. Therefore, these morphologic differences in TLF characteristics may re ect how mechanical forces are transmitted across different tissues, second, be part of the explanation for limited trunk ROM, and third, cause sensory disturbances (e.g., pain from nociceptor stimulation or inadequate proprioceptive response).…”

Influence of Sports Activity, Thoracolumbar Fascia Morphology and Myofascial Release Treatment on Lumbar Microcirculation: A Randomized, Placebo-Controlled Trial

“…The TLF is also thought to play an important role in lumbar proprioception [5,17]. There is increasing evidence that not only thickening but also ultrasonic echogenicity and disorganization of the fascia are critical factors in the development of nLBP, ROM limitations, and sensory disturbances [2,[18][19][20][21]. Therefore, these morphologic differences in TLF characteristics may reflect how mechanical forces are transmitted across different tissues, second, be part of the explanation for limited trunk ROM, and third, cause sensory disturbances (e.g., pain from nociceptor stimulation or inadequate proprioceptive response).…”