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PubMed1991

Power spectrum analyses of electromyographic activity. Discriminators in the differential assessment of patients with chronic low-back pain.

Some parameters of the electromyographic power spectrum of the paraspinal muscles were recorded and analyzed with regard to their ability to discriminate between normal controls and patients with back pain classified as "avoiders" or "confronters" by their responses to the Pain Behavior Checklist. In terms of the activity of the multifidus muscle, the avoider group displayed spectral changes towards lower frequencies, reduced variability in the density spectrum, and higher values of estimated initial frequencies. Measures of the activity of the iliocostalis lumborum did not contribute in any significant way to these group differences. Based on these findings, and on the available literature concerning the histology and physiology of paraspinal muscles, it is proposed that the observed characteristics of the avoider group may be due to a reduced ratio of slow twitch to fast twitch muscle fibers in the multifidus.

Back Pain↗
PubMedDate not supplied

Median frequency estimates of paraspinal muscles: reliability analysis.

The technique of monitoring the frequency shift of the electromyographic signal through a single parameter, the median frequency (MF), was investigated with regard to its reliability characteristics as tested on two back muscle groups: the multifidus and iliocostalis lumborum. The proportion of variance in the MF parameters accounted for by the test/retest reliability as well as by the left versus right side analysis is satisfactory for the multifidus, it is, however, consistently lower for the iliocostalis. For the purpose of measuring muscular function, the MF recording technique appears to be well suited for clinical research, its application in the assessment of muscular dysfunction of back muscles is nevertheless far from simple.

Adult↗
PubMed1986

Comparison of muscle spindle concentrations in large and small human epaxial muscles acting in parallel combinations.

A small short muscle acting across a joint in parallel with vastly larger and longer muscles is clearly unable to play more than a minimal mechanical role in such a "parallel muscle combination" (PMC). This research investigates a feed back role for the small muscles of PMCs, proposing a significantly higher muscle spindle concentration therein to be consistent with this role. Epaxial PMCs (semispinalis and multifidus versus rotatores brevis) from the C5-C6, T6-T7, and L4-L5 regions of three 36-week-old male fetuses and two adult cadavers were removed and fixed in Carnoy's fluid. Tissue samples were embedded in paraffin, cut into 10 microns thick sections perpendicular to the muscle's longitudinal axis and stained by Harris' hematoxylin and eosin. Representative tissue sections were projected onto a sterological grid and the percentage volume of spindles determined. Data were analyzed with Student's unpaired t test. In all PMCs, rotators brevis spindle percentage volumes ranged from 4.58 to 7.30 times higher than those of multifidus and semispinalis. Differences in mean spindle percentage volumes between large and small members of all PMCs were significant (P less than .0001). Our findings are consistent with the notion of a "kinesiological monitor" or feedback role for rotatores brevis.

Adult↗
PubMed1982

The human lumbar dorsal rami.

The L 1-4 dorsal rami tend to form three branches, medial, lateral, and intermediate, which are distributed, respectively, to multifidus, iliocostalis, and longissimus. The intertransversarii mediales are innervated by a branch of the dorsal ramus near the origin of the medial branch. The L 4 dorsal ramus regularly forms three branches while the L 1-3 levels the lateral and intermediate branches may, alternatively, arise from a short common stem. The L 5 dorsal ramus is much longer than the others and forms only a medial and an intermediate branch. Each lumbar medial branch innervates two adjacent zygapophysial joints and ramifies in multifidus, supplying only those fascicles which arise from the spinous process with the same segmental number as the nerve. The comparative anatomy of the lumbar dorsal rami is discussed and the applied anatomy with respect to 'rhizolysis', 'facet denervation' and diagnostic paraspinal electromyography is described.

Adult↗
PubMed1980

The dorsal lumbar muscles of the cat.

Observations made in the present study of the dorsal lumbar muscles of the cat are at variance with descriptions in the available literature. The morphology of these muscles is described in detail, and a revised interpretation of this morphology is made. There are 5 muscles -- multifidus, intertransversarii mediales, lumbococcygeus, iliocostalis lumborum and longissimus lumborum. They are arranged in 5 parallel polysegmental columns and are covered by the dorsal layer of thoracolumbar fascia and the erector spinae aponeurosis. The multifidus consists of fibres connecting mamillary and spinous processes. From each mamillary process 4 sets of fasciculi arise. Each set has constant specific attachments. The intertransversarii mediales are fibres connecting accessory and mamillary process. 3 principal fasciculi arise from each accessory process and insert into particular mamillary processes at more caudal levels. The iliocostalis and longissimus arise from the ilium and from opposite surfaces of an intermuscular septum. The lumbococcygeus arises in the lumbar region from the accessory processes but inserts in the tail. Reasons for the revised nomenclature and interpretation are discussed. A specific definition of the longissimus lumborum and iliocostalis lumborum is made on the basis of their observed morphology and nerve supply. It is argued that the lumbococcygeus should be considered as the lumbar portion of sacrocaudalis dorsalis lateralis rather than part of a common muscle mass.

Animals↗
PubMed1994

Electromyography of back muscles during quadrupedal and bipedal walking in primates.

Despite the extensive electromyographic research that has addressed limb muscle function during primate quadrupedalism, the role of the back muscles in this locomotor behavior has remained undocumented. We report here the results of an electromyographic (EMG) analysis of three intrinsic back muscles (multifidus, longissimus, and iliocostalis) in the baboon (Papio anubis), chimpanzee (Pan troglodytes), and orangutan (Pongo pygmaeus) during quadrupedal walking. The recruitment patterns of these three back muscles are compared to those reported for the same muscles during nonprimate quadrupedalism. In addition, the function of the back muscles during quadrupedalism and bipedalism in the two hominoids is compared. Results indicate that the back muscles restrict trunk movements during quadrupedalism by contracting with the touchdown of one or both feet, with more consistent activity associated with touchdown of the contralateral foot. Moreover, despite reported differences in their gait preferences and forelimb muscle EMG patterns, primates and nonprimate mammals recruit their back muscles in an essentially similar fashion during quadrupedal walking. These quadrupedal EMG patterns also resemble those reported for chimpanzees, gibbons and humans (but not orangutans) walking bipedally. The fundamental similarity in back muscle function across species and locomotor behaviors is consistent with other data pointing to conservatism in the evolution of the neural control of tetrapod limb movement, but does not preclude the suggestion (based on forelimb muscle EMG and spinal lesion studies) that some aspects of primate neural circuitry are unique.

Animals↗
PubMed2004

Static load magnitude is a risk factor in the development of cumulative low back disorder.

Occupations requiring frequent periods of static lumbar flexion are known epidemiologically to be risk factors for the development of cumulative low back disorder. The impact of the load magnitude sustained during a series of short static lumbar flexions followed by an equally long rest period on the development of a cumulative low back disorder was addressed in an in vivo feline model. Static loads of 20, 40, and 60 N were applied over 10 min of flexion followed by 10-min rest sessions that were repeated six times (for a total of 2 h) while monitoring lumbar viscoelastic creep (laxity) and reflex electromyographic (EMG) activity from the multifidus muscles. Creep and EMG were also monitored over 7 h of rest following the six flexion-rest sessions. It was found that the creep developed in the 10-min flexion periods did not recover completely during the following 10 min of rest, giving rise to a large cumulative creep at the end of the work-rest session. Muscle activity demonstrated spasms during the static flexion periods as well as initial and delayed hyperexcitability during the 7-h rest period. Loads of 20 and 40 N did not result in delayed hyperexcitability, whereas loads of 60 N resulted in delayed hyperexcitability. Statistical analysis demonstrated that increased load significantly intensified the magnitude of the hyperexcitabilities (P < 0.05). Thus, repeated periods of static lumbar flexion were found to result in a transient neuromuscular disorder with an intensity directly related to the load magnitude, which should be considered a compounding risk factor.

Animals↗
PubMed2006

High-repetition cyclic loading is a risk factor for a lumbar disorder.

Epidemiological data suggest that prolonged exposure to cyclic lumbar flexion elicits a chronic neuromuscular disorder and disability in workers. This study provides a physiological and biomechanical assessment of various repetitions of cyclic lumbar flexion sessions as a risk factor for development of an acute neuromuscular disorder. An in vivo feline model was subjected to 10 minutes of cyclic (0.25-HZ) loading, followed by a 10-minute rest period, repeated three times in one experimental group, six times in a second group, and nine times in the third group, followed by rest for 7 hours. Displacement of the lumbar viscoelastic tissue and reflex electromyographic (EMG) activity from the lumbar multifidus muscle were monitored. Creep developed and accumulated during each load/rest period and partially recovered during the subsequent rest. Loading periods were characterized by a decrease in reflex EMG activity with superimposed spasms. In the 7-hour recovery period, initial hyperexcitability was present in all groups, whereas only the six- and nine-repetition groups displayed significant delayed hyperexcitability, indicating the presence of acute inflammation. The mathematical model developed fit the data reasonably well, as the R2 values were generally near 0.90. It was concluded that the resulting delayed muscular hyperexcitability constitutes an acute neuromuscular disorder associated with exposure to many repetitions of cyclic lumbar flexion. The acute disorder can become chronic if not allowed sufficient rest to resolve itself. Workers engaged in cyclic lumbar flexion (e.g., loading/unloading, assembly workers) should avoid long-term exposure in order to prevent the development of a chronic neuromuscular condition known as cumulative trauma disorder.

Animals↗
PubMed1992

Response of the trunk muscles to training assessed by magnetic resonance imaging and muscle strength.

A group of 12 sedentary medical students (1 man and 11 women aged 21-27 years) participated in a strength training programme for the trunk muscles lasting 18 weeks. The maximal isometric flexion and extension forces of the trunk muscles were measured before the training and at 18 weeks by dynamometer. The cross-sectional area of the back muscles, i.e. erector spinae, multifidus and psoas muscles, was measured from magnetic resonance images (spin echo sequence TR/TE 1500/80, slice thickness 10 mm) obtained at the L4-L5 disc level before the training, at 11 and 18 weeks. During training, no significant change in the body mass or body fat content was found. Muscle forces or muscle cross-sectional area were not related to body mass. There was a significant increase in both trunk muscle cross-sectional area (psoas muscle P < 0.001 and back muscles P < 0.01) and trunk muscle forces (flexion and extension forces P < 0.01) during the training but no direct association between the muscle cross-sectional area and strength of the flexors and extensors was detected before or after the training.

Adipose Tissue↗
PubMed1988

Low back muscle activity and pelvic rotation during walking.

Gait variables, pelvic rotations in the frontal and sagittal plane and RA-EMG (rectified and averaged EMG) of the three columns of the intrinsic lumbar back muscles (= ILBM) were recorded simultaneously during 48 succeeding strides of 11 subjects on a treadmill. Bilateral activity is found in all parts of the ILBM during the double support phase. After right heel strike the right ILBM (and after left heel strike the left) show in most cases more activity than the contralateral ILBM. This is especially so in the intermediate and lateral columns, which consist mainly of the longissimus thoracis and the iliocostalis lumborum muscle and less so in the medial column, made up mainly by the multifidus and spinalis muscle. This difference is probably due to the difference in moment arm for the two directions. Pelvic rotations are described, but no evident relationships between pelvic rotations in the different planes and ILBM-activity could be seen, probably because the changes in the position of the torso are of more importance.

Adult↗
PubMed1987

The human muscle-tendon junction. A morphological study during normal growth and at maturity.

The myotendon junction of human paravertebral skeletal muscle was studied by light and electron microscopy. Transverse and longitudinal sections of myotendinous regions of normal multifidus muscles were examined at three chronological stages from birth to maturity. Variations in the appearance of surface extensions at the terminal ends of muscle fibers consisted of brush-like evaginations at birth and villous-like projections in the adult. Regardless of age, they were invariably covered by a prominent external lamina, and mutually interdigitated with connective-tissue elements in the adjacent tendon. Various stages of myofibrillar assembly and sarcomere alignment were evident in the muscle fiber terminus at birth. With advancing age, splitting of terminal sarcomeres at Z bands commonly gave rise to diverging myofilament bundles that attached to electron-dense patches under the sarcolemma. In these regions, leptomeric organelles were also encountered in neonatal and adolescent myotendons. At all stages, the ends of muscle fibers possessed cytological features consistent with active synthesis and secretion. Densely-packed sarcoplasmic organelles including multiple Golgi complexes, clusters of ribosomes, mitochondria, cytoplasmic vesicles, and elements of rough- and smooth-surfaced endoplasmic reticulum were prevalent. Peripheral and centrally-placed heterochromatic nuclei with prominent nucleoli were arranged singly or in groups at the ends of muscle fibers. Satellite cell profiles and unmyelinated axons in the subjacent tendon were also identified at these sites in the adult. Fibroblasts in growing tendon were plentiful, and at all stages, possessed morphological features indicative of high metabolic and secretory activities.

Adolescent↗
PubMed1996

Atrophy of the nuchal muscle and change in cervical curvature after expansive open-door laminoplasty.

We analyzed computed tomography (CT) images and plain X-ray films of 53 patients who had undergone expansive open-door laminoplasty, in a 3-year study. The relationship between the postoperative changes in the nuchal muscles and those in the cervical curvature was investigated. On postoperative CT images, the cross-sectional area of all nuchal muscles was reduced to approximately 80% of its preoperative size. This atrophic change was especially intense in the multifidus muscle and the semispinalis cervicis muscle. Postoperative cross-sectional area of the deep nuchal muscles was reduced approximately 30% from its preoperative size. No significant correlation was found between the all cross-sectional area of the nuchal muscles and the cervical curvature. However, a weak correlation was found between the deep nuchal muscles area and the curve index (correlation coefficient 0.29).

Adult↗
PubMed1993

An investigation into the relevance of the pattern of temporal activation with respect to erector spinae muscle endurance.

The aim of the present study was to evaluate the viability of a relationship between the temporal activation pattern of parts of the erector spinae muscle and endurance. Seven subjects performed intermittent isometric contractions [4s at 70% maximal voluntary contraction (MVC), 2 s rest] until exhaustion, during which the electromyographical (EMG) activity of the multifidus, iliocostalis thoracis and longissimus muscle segments was recorded. Endurance was defined as the time until exhaustion. Subjects were divided into a high and a low endurance group. The high endurance group showed significantly more variability of EMG amplitude over succeeding contractions. This group demonstrated significantly more alternations of EMG activity between parts of the muscle also. Variability of the EMG amplitude within the contractions did not differ between the groups, nor did MVC. The results indicated that alternating activity between different parts of the erector spinae muscle may function to postpone exhaustion of this muscle as a whole.

Adult↗
PubMed1995

The surgical anatomy of thoracic facet denervation.

Thoracic percutaneous facet denervation has been employed for the treatment of thoracic zygapophysial joint pain. But the surgical anatomy of this procedure has been assumed to be the same as for lumbar medial branch neurotomy. To establish the anatomical basis for thoracic medial branch neurotomy, an anatomical study was undertaken. Using an X40 dissecting microscope, a total of 84 medial branches from 7 sides of 4 embalmed human adult cadavers were studied. The medial branches of the thoracic dorsal rami were found to assume a reasonably constant course. Upon leaving the intertransverse space, they typically crossed the superolateral corners of the transverse processes and then passed medially and inferiorly across the posterior surfaces of the transverse processes before ramifying into the multifidus muscles. Exceptions to this pattern occurred at mid-thoracic levels (T5-T8). Although the curved course remained essentially the same, the inflection occurred at a point superior to the superolateral corner of the transverse process. At no time during the dissection were nerves encountered crossing the junctions between the superior articular processes and transverse processes which have been the target points advocated for thoracic facet denervation. Rather, the results of this study indicate that the superolateral corners of the transverse processes are more accurate target points.

Adult↗
PubMed1997

Feedforward contraction of transversus abdominis is not influenced by the direction of arm movement.

Because the structure of the spine is inherently unstable, muscle activation is essential for the maintenance of trunk posture and intervertebral control when the limbs are moved. To investigate how the central nervous system deals with this situation the temporal components of the response of the muscles of the trunk were evaluated during rapid limb movement performed in response to a visual stimulus. Fine-wire electromyography (EMG) electrodes were inserted into transversus abdominis (TrA), obliquus internus abdominis (OI) and obliquus externus abdominis (OE) of 15 subjects under the guidance of real-time ultrasound imaging. Surface electrodes were placed over rectus abdominis (RA), lumbar multifidus (MF) and the three parts of deltoid. In a standing position, ten repetitions of shoulder flexion, abduction and extension were performed by the subjects as fast as possible in response to a visual stimulus. The onset of TrA EMG occurred in advance of deltoid irrespective of the movement direction. The time to onset of EMG activity of OI, OE, RA and MF varied with the movement direction, being activated earliest when the prime action of the muscle opposed the reactive forces associated with the specific limb movement. It is postulated that the non-direction-specific contraction of TrA may be related to the control of trunk stability independent of the requirement for direction-specific control of the centre of gravity in relation to the base of support.

Adult↗
PubMed2006

[Percutaneous dorsal versus open instrumentation for fractures of the thoracolumbar border. A comparative, prospective study].

STUDY DESIGN: A prospective clinical study. OBJECTIVE: To evaluate whether a percutaneous dorsal instrumentation of thoracolumbar fractures prevents irreversible damage to the spinal muscles. METHODS: A total of 57 patients with thoracolumbar fractures (Th12-L4) were divided into two groups, comparable in terms of gender, fracture level, classification and surgical concept. In the first, 24/57 patients were treated using an open procedure (OP-G); in the second, 33/57 were treated via percutaneous dorsal instrumentation (PER-G). Fracture localisation and classification, accuracy of pedicle screw placement, perioperative blood loss, OR- and image converter time as well as muscle damage (needle-EMG) were evaluated. RESULTS: OR- and image converter time as well as the accuracy of pedicle screw placement were not statistically different between groups. The difference in perioperative blood loss [43 (10-90) ml (PER-G) vs [870 (570-1,200 ml (OP-G)] was statistically significant (P <0.005). Needle EMG revealed no muscle damage, and the physiological activity and muscle potentials were normal (PER-G). In the OP-G, polyphasic EMG signals were most common (80%), a sign of the drop-out of numerous motor units. CONCLUSIONS: The open procedure caused permanent and significant damage to the strongest extensors of the autochthonus back musculature, the m. multifidus, which results from multisegment combined damage to the r. posterior nervi spinalis and muscle fibres. In contrast, percutaneous placement of an internal fixative reduces perioperative access morbidity causing little iatrogenic damage to back muscles and only a minor perioperative blood loss.

Adult↗
PubMed1999

[Surgical approach in lumbar intervertebral disk displacement. Topographical principles and characteristics].

For the operative procedure in lumbar disc extrusion it is important to expose the prolapsed disc and sequestrum without disintegration of the musculature and branches of r. dorsalis nervi spinalis or provoking lesions in the spinal canal. A classification helps to determine exact description of localization of disc material in craniocaudal and mediolateral directions. It can be correlated with the interlaminar window as a structure seen in the operative procedure. A speculum helps to limit the exposure for an interlaminar as well as a lateral access, thus reaching the structures concerned in the spinal canal with minimal irritation of the surrounding tissues. For interlaminar access partial excision of the lig. flavum is sufficient. The extrusions in the foraminal region that can be exposed laterally from a medial skin incision, as well as from a paramedial are between m. multifidus and m. longissimus. In revision surgery, the upper laminar corner is advantageous for entering the spinal canal.

Diskectomy↗
PubMed2006

Migrating lumbar facet joint cysts.

OBJECTIVE: The majority of lumbar facet joint cysts (LFJCs) are located in the spinal canal, on the medial aspect of the facet joint with characteristic diagnostic features. When they migrate away from the joint of origin, they cause diagnostic problems. MATERIALS AND METHODS: In a 7-year period we examined by computed tomography (CT) and magnetic resonance (MR) imaging five unusual cases of facet joint cysts which migrated from the facet joint of origin. RESULTS: Three LFJCs were identified in the right S1 foramen, one in the right L5-S1 neural foramen and one in the left erector spinae and multifidus muscles between the levels of L2-L4 spinous process. CONCLUSIONS: Awareness that spinal lesions identified at MRI and CT could be due to migrating facet joint cyst requires a high level of suspicion. The identification of the appositional contact of the cyst and the facet joint needs to be actively sought in the presence of degenerative facet joints.

Adult↗