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Fig. 3 | BMC Musculoskeletal Disorders

Fig. 3

From: A guide for standardized interpretation of lumbar multifidus ultrasonography; an observational study

Fig. 3

40 year old specimen. Lumbar anatomical cross-sections (figs A, D), corresponding ultrasonographic (US) views with linear transducer 15 MHz in human volunteer (Figs B, E) and coronal reconstruction (fig. C). (A) Transversal cross-section halfway spinous process L4, (see yellow line in Fig. C). The erector spinae (ES) lies lateral to LM (dashed contour) and the interspinal muscles (asterisk) are directly adjacent to spinous process L4. The yellow line depicts the location of the plane shown in Fig. C. Inset shows the location of a deep LM electrode [19]. (B) Detailed transversal US view of LM and interspinal muscles (dashed contour with asterisk at the level of spinous process (SP) L4. (C) Reconstruction of coronal plane at the level of spinous processes L1-L5. It shows the oblique lateromedial orientation of LM, of which the most lateral muscles (band L1, 2) appear to have the same orientation as the adjacent ES fibers. Medial to LM, interspinal muscles (asterisks) connect the lateral sides of adjacent spinous processes. In this specimen L4-5 and L5-S1 interspinal muscles are absent at one side (right side). (D) Paramedian sagittal reconstruction at level L4-5 showing the adjacent interspinal muscles (asterisks). The contour and location of spinous processes of L4 and L5 is demarcated in white. (E) Paramedian sagittal US view of LM at level L4-5, with slightly laterally tilted probe, which enables simultaneous display of interspinal muscles (asterisk) and spinous processes L4-5; inset shows probe positioning

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