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Chiropractic Research Review

ES Thickness on Ultrasound: A Case of Flexion vs. Extension

Back pain during or following prolonged lumbar spine flexion may be caused, at least in part, by muscular factors; pain may in fact be caused by transient ischemia of the erector spinae (ES) muscle, as a result of elevated intramuscular compartmental pressure.

However, insufficient data support this hypothesis. Because ultrasound has the capacity to evaluate the volume of skeletal musculature, it may hold promise in assessing ES morphology and changes in the volume of the ES muscle under varying curvatures of the lumbar spine.

In this study, researchers utilized ultrasound to evaluate the thickness of the ES muscle with subjects in three distinct trunk postures maximum flexion, neutral posture and maximum extension and at five vertebral levels. Researchers recruited 30 volunteers (average age: 29.5 years) with no history of low back problems and no spinal symmetry abnormalities (scoliosis, etc.). The ultrasound probe was placed vertically 4 cm lateral to the midline on the left side of the lower back; the thickness of the ES muscle was measured from L1-L5 as the distance between the posterior portion of the lumbodorsal fascia and the surface of the transverse process of the lumbar vertebrae. These measurements were reproducible by several different examiners.

Conclusion: "The thickness of the ES muscle decreases as the lumbar spine flexes and increases as it extends," note the authors, adding: "We used ultrasonography successfully for quantitative evaluation of changes in thickness of the ES muscle with postural changes in the lumbar spine."

Watanabe K, Miyamoto K, Masuda T, Shimizu K. Use of ultrasonography to evaluate thickness of the erector spinae muscle in maximum flexion and extension of the lumbar spine. Spine 2004;29(13):1472-77. www.spinejournal.com

Chiropractic Research Review

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