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Beitragstitel Passive resistance of dorsal muscle and connective tissues against flexion of the spine
Beitragscode P15
Autoren
  1. Samuel Haupt Spital Oberengadin Vortragender
  2. Frédéric Cornaz University Spine Center Zürich, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland
  3. Anna L. Falkowski Radiology, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland
  4. Jonas Widmer University Spine Center Z8 Zurich, Switzerland; Institute for Biomechanics, ETH Zuürich, Balgrist University Hospital, University of Zurich, 800rich, Zurich, Switzerland
  5. Mazda Farshad Balgrist University Hospital
Präsentationsform Poster
Themengebiete
  • A03 - Wirbelsäule
Abstract Purpose
The passive resistance against flexion of the spine (e.g. during slumped sitting) arises by ligaments, fascia, and myoelectrically silent paraspinal muscles. The aim of this cadaveric study was to quantify contributions of the thoracolumbar fascia, paraspinal muscles and inter- & supraspinous ligaments (ISL/SSL) to the passive resistance to spinal flexion.

Materials and Methods
The pelvis of five freshly frozen human torsos was rigidly fixed and the model was passively flexed. The thoracolumbar fascia and paraspinal muscles were longitudinally separated from the bony structures, first from Th12-S1 and then from Th4-S1 in a stepwise manner. The inter- & supraspinous ligaments (ISL/SSL) were then incised horizontally and in plane in the same sequence. The angulation of S1 (control), Th12 and Th4 were measured with fluoroscopy.
Results
Dissection of the lumbar fascia led to an increase of 0.9 ± 0.3° of spinal angulation (Th4 to S1) and 1.8 ± 0.5° for the total thoracolumbar fascia. Dissection of the lumbar musculature increased this angulation by 3.1 ± 2.3 ° and 4.2 ± 1.8° in the whole thoracolumbar area. ISL/SSL incision led to a spinal angulation increase of 3.3 ± 1.8° for the lumbar area and 4.9 ± 2.5° for the total thoracolumbar incisions. Lumbar spinal angulation (Th12 to S1) increased by 1.9 ± 1.2° for lumbar fascial incision, by 2.7 ± 0.9° for muscular dissection and 4.8 ± 2.1° for ISL/SSL dissection.
Conclusion
The thoracolumbar fascia, the paraspinous muscles, and the ISL/SSL resist passively against spinal flexion with ISL/SSL contributing mostly. This biomechanical observation could be useful in choosing the best surgical technique for e.g. spinal decompression.