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首页> 美国卫生研究院文献>Journal of Anatomy >A description of the lumbar interfascial triangle and its relation with the lateral raphe: anatomical constituents of load transfer through the lateral margin of the thoracolumbar fascia
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A description of the lumbar interfascial triangle and its relation with the lateral raphe: anatomical constituents of load transfer through the lateral margin of the thoracolumbar fascia

机译：腰椎筋膜三角形及其与外侧裂隙的关系的描述：通过胸腰椎筋膜外侧缘转移负荷的解剖学成分

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Movement and stability of the lumbosacral region is contingent on the balance of forces distributed through the myofascial planes associated with the thoracolumbar fascia (TLF). This structure is located at the common intersection of several extremity muscles (e.g. latissimus dorsi and gluteus maximus), as well as hypaxial (e.g. ventral trunk muscles) and epaxial (paraspinal) muscles. The mechanical properties of the fascial constituents establish the parameters guiding the dynamic interaction of muscle groups that stabilize the lumbosacral spine. Understanding the construction of this complex myofascial junction is fundamental to biomechanical analysis and implementation of effective rehabilitation in individuals with low back and pelvic girdle pain. Therefore, the main objectives of this study were to describe the anatomy of the lateral margin of the TLF, and specifically the interface between the fascial sheath surrounding the paraspinal muscles and the aponeurosis of the transversus abdominis (TA) and internal oblique (IO) muscles. The lateral margin of the TLF was exposed via serial reduction dissections from anterior and posterior approaches. Axial sections (cadaveric and magnetic resonance imaging) were examined to characterize the region between the TA and IO aponeurosis and the paraspinal muscles. It is confirmed that the paraspinal muscles are enveloped by a continuous paraspinal retinacular sheath (PRS), formed by the deep lamina of the posterior layer of the TLF. The PRS extends from the spinous process to transverse process, and is distinct from both the superficial lamina of the posterior layer and middle layer of the TLF. As the aponeurosis approaches the lateral border of the PRS, it appears to separate into two distinct laminae, which join the anterior and posterior walls of the PRS. This configuration creates a previously undescribed fat-filled lumbar interfascial triangle situated along the lateral border of the paraspinal muscles from the 12th rib to the iliac crest. This triangle results in the unification of different fascial sheaths along the lateral border of the TLF, creating a ridged-union of dense connective tissue that has been termed the lateral raphe (Spine, 9,1984, 163). This triangle may function in the distribution of laterally mediated tension to balance different viscoelastic moduli, along either the middle or posterior layers of the TLF.
机译：腰s区域的运动和稳定性取决于通过与胸腰筋膜（TLF）相关的肌筋膜平面分布的力的平衡。这种结构位于几个肢端肌肉（例如背阔肌和臀大肌），以及下肢（例如腹侧躯干肌）和外延（脊椎）肌的共同交点处。筋膜成分的机械性能确定了指导稳定腰s脊柱肌肉群动态相互作用的参数。了解这种复杂的肌筋膜交界处的结构，对于进行生物力学分析和在腰背及骨盆带腰痛的患者中进行有效的康复至关重要。因此，本研究的主要目的是描述TLF侧缘的解剖结构，尤其是椎旁肌周围筋膜鞘与腹横肌（TA）和内斜肌（IO）肌肉腱膜之间的界面。 。通过前路和后路的连续复位解剖，暴露了TLF的侧缘。检查了轴向切片（尸体和磁共振成像）以表征TA和IO腱膜与椎旁肌之间的区域。可以确认，椎旁肌被连续的椎旁副视网膜鞘（PRS）包裹着，该鞘由TLF后层的深层形成。 PRS从棘突延伸到横突，并且不同于TLF的后层和中间层的浅层。当腱膜接近PRS的侧边界时，它似乎分成两个不同的薄片，它们连接PRS的前壁和后壁。这种构造形成了沿脊柱旁肌从第十二肋骨到the的横向边界定位的先前未描述的充满脂肪的腰椎界面三角形。这个三角形导致沿着TLF的外侧边界的不同筋膜鞘的统一，形成了密集的结缔组织的脊状联合，被称为外侧缝（Spine， 9 ，1984，163） 。该三角形可在横向介导的张力分布中起作用，以平衡沿着TLF的中层或后层的不同粘弹性模量。

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