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Clin Anat. 2017 Sep;30(6):774-780. doi: 10.1002/ca.22903. Epub 2017 Jun 12.

Feasibility assessment of shear wave elastography to lumbar back muscles: A Radioanatomic Study.

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Radiology Department, Bicêtre Hospital, APHP, Le Kremlin-Bicêtre, France.
Imagerie par Résonance Magnétique Médicale et Multi-Modalités, IR4M, CNRS, University Paris-Sud, Université Paris-Saclay, Orsay, France.
Obstetrics and Gynecology Department, Hopital Universitaire de Rennes, University Rennes 1, Rennes, France.
Orthopedic Department, Bicêtre Hospital, APHP, Le Kremlin-Bicêtre, France.


Low back pain is often associated with tensional changes in the paraspinal muscles detected by palpatory procedures. Shear wave elastography (SWE), recently introduced, allows the stiffness of muscles to be assessed noninvasively. The aim of this work was to study the feasibility of using SWE on the three main lumbar back muscles (multifidus, longissimus, and iliocostalis) in vivo after analyzing their muscular architecture ex vivo. We determined the orientation of fibers in the multifidus, longissimus, and iliocotalis muscles in seven fresh cadavers using gross anatomy and B-Mode ultrasound imaging. We then quantified the stiffness of these three muscles at the L3 level ex vivo and in 16 healthy young adults. Little pennation was observed in the longissimus and iliocostalis, in which the direction of fibers was almost parallel to the line of spinous processes. The multifidus appeared as a multiceps and multipennate muscle. Given the random layering of millimetric fascicles, tendons, and fatty spaces, the multifidus had multiple fiber orientations. Muscular fascicles and fibers were oriented from 9° to 22° to the line of spinous processes. The shear moduli related to stiffness were 6.9 ± 2.7 kPa for the longissimus, 4.9 ± 1.4 kPa for the iliocostalis, and 5.4 ± 1.6 kPa for the multifidus. SWE is a feasible method for quantifying the stiffness of the lumbar back muscles. Clin. Anat. 30:774-780, 2017.


anatomy; dissection; elastic modulus; elasticity imaging techniques; paraspinal muscles

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