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Thoracolumbar fascia
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The thoracolumbar fascia is a large, roughly diamond-shaped area of connective tissue constituted by the thoracic and lumbar parts of the deep fascia enclosing the intrinsic back muscles. More specifically, the thoracolumbar fascia separates the paraspinal muscles from the muscles of the posterior abdominal wall.
This fascia extends from the vertebrae to the sacrum. The thoracolumbar fascia serves as an attachment site for various muscles of the back.
This article will describe the anatomy and function of the thoracolumbar fascia.
| Attachments | Nuchal ligament, spinous processes, supraspinous ligament, median crest of sacrum |
| Function | - Involved in movement and load transfer between the trunk and the limbs. - Houses several deep muscles of the back (e.g. quadratus lumborum, transversospinalis, spinal erectors and multifidus). - Contains a number of nociceptive nerve endings that may be responsible for some forms of back pain. |
Anatomy
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The deep fascia of the back attaches medially to the nuchal ligament, the tips of the spinous processes of the vertebrae, the supraspinous ligament.
When it reaches the thoracic and lumbar regions, the deep fascia of the back changes its name to thoracolumbar fascia. The thoracolumbar fascia ends by inserting into the median crest of the sacrum.
Like the most fasciae in the body, the thoracolumbar fascia surrounds the deep muscles of the back, and divides the muscles into compartments.
In the thoracic region, the thin layer of fascia that project from the spinous processes to the ribs, provide a thin covering for the extensor muscles of the spine. In the lumbar region, the thoracolumbar fascia is comprised of three thick layers (anterior, middle and posterior layers);
- The posterior layer is attached to the spines of the lumbar and sacral vertebrae and to the supraspinous ligaments.
- The middle layer is attached medially to the lumbar transverse processes, and laterally to the iliac crest, twelfth rib and the lumbocostal ligament.
- The anterior layer is attached to the lumbar transverse processes and the iliolumbar ligament.
Together, these layers provide a strong, thick covering for muscles in the lumbar region where it is widest.
Avoid these common anatomy learning mistakes to improve efficiency and propel your studies!
Function
The thoracolumbar fascia acts as an attachment site for the trapezius muscle, latissimus dorsi, gluteus maximus and the hamstrings group of muscles. Being such an important attachment point, this fascia has an important role in body movements (e.g. lifting). In addition the fascia plays an important role in load transfer between the trunk and the limbs.
The fascia houses the quadratus lumborum, transversospinalis, spinal erectors (erector spinae) and multifidus muscles and their tendons, among other intrinsic muscles of the posterior thoracic and lumbar regions.
The thoracolumbar fascia contains nociceptive nerve endings that may be responsible for some forms of back pain.
Test your knowledge on the deep muscles of the back with this quiz.
Find out more about the anatomy of these muscles below:
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Clinical correlation
Chronic low back pain
The thoracolumbar fascia has been implicated in pains of the lower back region buttocks (piriformis syndrome) and sacroiliac joint pains.
Injury to the thoracolumbar fascia usually manifests as tightness, spasticity and increased tone in the lower thoracic spine and lumbar spine / paraspinal regions causing severe pains.
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