Attachments of the posterior layer of lumbar fascia
Attachments of the posterior layer of lumbar fascia
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DOI：
10.1097/00007632-199909010-00002
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发表时间：
1999-09-01
期刊：
影响因子：
3
通讯作者：
Briggs, CA
中科院分区：
文献类型：
--
作者：
Barker, PJ;Briggs, CA
研究设计.解剖腰筋膜后层浅、深层。测量腰椎部分是否存在节段性增厚的证据。对上级附件进行解剖、记录和拍照。目的：证实腰筋膜后副韧带的存在，确定腰筋膜后层的上级附着点和纤维角度。对后层进行了两项小型解剖研究。他们的发现在几个具有临床意义的领域相互矛盾。在一项研究中描述了腰椎区域的增厚，但尚未得到证实。后层的上级附着尚未正式记录。研究1：在21具防腐尸体中，解剖后层的腰椎区域。标记腰椎棘突及邻近筋膜。取出筋膜并检查，用手动千分尺测量其厚度。结果进行统计学分析。研究2：解剖20具尸体的后层上级附着体并拍照。结果：1.纤维的张力传递能力，纤维角度，纤维的张力传递能力，纤维的张力传递能力。研究1：在后层中没有肉眼可见节段性增厚的证据。研究二：浅层与菱形肌在上方连续，深层与颈夹肌腱和头夹肌腱在上方连续。这些以前没有文献记载的附件厚度和纤维化程度不同，并且能够传递张力。后层的浅层和深层都比以前认为的更广泛。这可能对用于评估和管理腰痛的某些测试有影响，例如塌陷和“非器质性”测试。上级附件的厚度是可变的。它们的承载能力还有待量化。
Study Design. Superficial and deep laminae of the posterior layer of lumbar fascia were dissected. The lumbar portion was measured for evidence of segmental thickenings. Superior attachments were dissected, documented, and photographed.Objectives. To verify the existence of posterior accessory ligaments and establish the superior attachments and fiber angles of the posterior layer of lumbar fascia.Summary of Background Data. There have been two small dissection studies on the posterior layer. Their findings are conflicting in several areas of clinical significance. Thickenings in the lumbar region were described in one study, but have not been verified. The superior attachments of the posterior layer have not been formally documented.Methods. Study 1: In 21 embalmed cadavers, the lumbar region of the posterior layer was dissected. The lumbar spinous processes and adjacent fascia were marked. The fascia was removed and examined, and its thickness measured with a manual micrometer. Results were statistically analyzed. Study 2: Superior attachments of the posterior layer in 20 cadavers were dissected and photographed. Capacity to transmit tension was estimated and documented photographically, and fiber angles measured in situ.Results. Study 1: There was no evidence of macroscopic segmental thickening in the posterior layer. Study 2: The superficial lamina was continuous superiorly with the rhomboids, and the deep lamina with the tendons of splenius cervicis and capitis. These previously undocumented attachments were of variable thickness and fibrosity, and capable of transmitting tension.Conclusions. Both superficial and deep laminae of the posterior layer are more extensive superiorly than previously thought. This may have implications for certain tests used in assessment and management of low back pain such as the slump and "nonorganic" tests. The thickness of the superior attachments is variable. Their capacity for load bearing is yet to be quantified.