Abstract
Background
Several theories have been put forward with respect to the mechanical role of the thoracolumbar fascia (TLF) but none have been substantiated in part due to an inability to explore its function in vivo. This study explored the use of ultrasound to image the layers of the TLF in vivo.
Methods
Initially a cadaveric dissection of the fascia was performed to gain an appreciation of the 3-D orientation and representation of the TLF in the lumbar region. A conventional ultrasound system (Diasus, Dynamic Imaging Ltd) was then used to image the 3 layers of the fascia on 40 normal subjects (18 males and 22 females, mean age 27.3±5.8 years) and the reliability of these measures was investigated on a subset of this population.
Results
Using ultrasound, the posterior and middle layer of the TLF could be readily identified, however it was not possible to visualise the anterior layer due to the limitations of the scanner used. The thickness of the posterior layer ranged from 1.3 ±0.4 to 1.5±0.4 mm depending on location relative to the spinous process. The middle layer tended to be thinner being 1.0±0.4mm on average. Intra-observer errors were within acceptable ranges, although not ideal.
Conclusion
Ultrasound may be an important tool for understanding the mechanical role of fascia, however this would necessitate the use of high resolution scanner to enhance the reliability of images. Further work is required to image changes in the presentation of fascia in different loaded functional positions.
Conflicts of interest - None
Sources of funding – None
It is confirmed that this abstract has not been published in whole or substantial part nor has it been presented previously at a national meeting.
