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The original description of the paraspinal posterior approach to the lumbar spine was for spinal fusion, especially regarding lumbosacral spondylolisthesis treatment. In spite of the technical details described by Wiltse, exact location of the area where the sacrospinalis muscle has to be split remains somewhat unclear. The goal of this study was to provide topographic landmarks to facilitate this surgical approach. Thirty cadavers were dissected in order to precisely describe the anatomy of the trans-muscular paraspinal approach. The level of the natural cleavage plane between the multifidus and the longissimus part of the sacrospinalis muscle was noted and measurements were done between this level and the midline at the level of the spinous process of L4. A natural cleavage plane between the multifidus and the longissimus part of the sacrospinalis muscle was present in all cases. There was a fibrous separation between the two muscular parts in 55 out of 60 cases. The mean distance between the level of the cleavage plane and the midline was 4 cm (2.4–5.5 cm). In all cases, small arteries and veins were present, precisely at the level of the cleavage plane. We found it possible to easily localize the anatomical cleavage plane between the multifidus part and the longissimus part of the sacrospinalis muscle. First the superficial muscular fascia is opened near the midline, exposing the posterior aspect of the sacrospinalis muscle. Then, the location of the muscular cleft can be found by identifying the perforating vessels leaving the anatomical inter-muscular space.

Freeze-fracture replicas have been prepared from two fast-acting vertebrate muscles (frog sartorius and rabbit sacrospinalis) and are described with particular reference to the distribution of intercalated particles in the plasma membrane, T-tubule and SR cisternae. Orthogonal assemblies of small particles are present on the A face plasma membrane in each instance, and their distribution (in sartorius) is found to be random with respect to the underlying myofibrillar sarcomere repeat. Such assemblies are not present on A or B faces of T-tubule or SR cisternae. Asymmetric particle distribution is described for fracture faces of the T-tubules and SR: the profuse particle packing of the SR A face is uniform from terminal cisternae to medial fenestrated collar. Intercalated particles are present on A and B faces of T-tubule fractures: more commonly on the latter. These results are compared with studies on insect muscles, and a comparative approach to further studies on the correlation between membrane structure and function is discussed.

1. Eighty-seven patients treated with lateral (intertransverse) fusion for several lumbar disease at Tamatsukuri Koseinenkin Hospital from 1968 through 1977 were followed up.2. Total estimation of results is “nearly good” on Kono's Evaluation.3. Most of operation were performed with using of Hasting's frame, midline incision and lateral approach to transverse process by splitting sacrospinalis muscle and without operating intervertebular joints.

The size and density of the major psoas and sacrospinalis muscles in humans were measured in vivo by X-ray computed tomography to determine the relationship of age and sex of these two muscles. Measurements of 44 men and 52 women clarified patterns of development and aging. Differences due to age were significant in the density of both muscles. There existed also a difference between the sexes in the size of the two muscles.

Adult albino rabbits were implanted with 304 stainless steel discs and cylinders (rods) in the following sites: beneath periosteum of the anterior calvarium, under the masseter muscle of the left mandibular ramus and in the body of the sacrospinalis muscle. (1) The tissue reaction around the disc implants was compared with that observed around the cylinder implants through the study of histological sections. (2) The degree of reactions observed at the various sites was contrasted with that seen at the other sites. In all cases the muscle implants showed the greatest reaction. Discs showed many micro areas of tissue reaction randomly around their periphery. In contrast all the rod shaped implants in muscle showed a greater reaction towards the ends than in the mid portion of the shaft (clubbing) but rods implanted at other sites did not show this phenomenon. The results show that much of the histological tissue reaction seen around muscle implants is really caused by mechanical trauma which must be differentiated from a non-compatibility reaction. It is important to choose a test site where mechanical trauma will be minimal (submasseteric site) and use an implant shape (discs) which will not produce clubbing.

The toxicity of a variety of plastics medical devices used in medicine and of a number of polyvinyl chloride (PVC) samples of known constitution was evaluated by tissue culture techniques, implantation tests in rabbit muscle and rat subcutaneous tissue, and examination of the systemic effects of administering extracts of the plastics to rats and mice. PVC samples containing known concentrations of an organotin compound were used as positive controls. None of the test plastics exhibited toxicity as high as that of the positive control plastics. The tissue culture technique was the most sensitive method used and toxic effects were detected with a few of the test plastics. Implantation in rabbit sacrospinalis muscle for 7 days was the most sensitive of the implant systems tested and the results showed a good correlation with tissue culture. The systemic tests on extracts failed to demonstrate toxicity, even with the positive control plastics. In view of the high sensitivity of tissue culture, positive results should not necessarily indicate rejection of a plastics material for medical use. In such a situation, additional experimental evidence is required.

Despite evidence of thermoregulatory ability from birth, neonates generally are unable to develop fever when challenged with endotoxin. This could be due to their small capacity for heat storage. To test this possibility, the pyrogenicity of S. enteritidis endotoxin (2 mug/kg, iv) was measured at both room (Ta = 25 degrees C) and neutral (Tn = 29–33 degrees C, depending on age) temperatures in 0- to 32-day-old unanesthetized guinea pigs, reared from birth at about 24 degrees C. Control guinea pigs received sterile saline injections in concurrent experiments. Shivering, O2 uptake, and colonic (Tre) and subcutaneous [over the interscapular fat pad (Tbat) and the sacrospinalis muscle (Tsc)] temperatures were recorded continuously for 4 h after injection. Endotoxin generally produced no febrile responses at both ambient temperaturess rises in animals aged 8 or more days; Tbat increased before the other sites in the 8- and 16-day-old animals, and shivering did not occur; by 32 days of age, however, Tbat no longer increased first, and there was shivering. In Tn significant febrile rises were not evident until 32 days of age; control temperatures, however, were elevated during this exposure as compared to at Ta. These results showed therefore that pyrogenic sensitivity is not apparent in guinea pigs during the first postnatal week; thereafter fever responses are evocable, but their detection may be masked by environmentally produced changes in body temperature. The data also indicated that the site of the heat production underlying, in part, endotoxic fevers gradually shifts from brown fat so skeletal muscle during the first month of life.

The purpose of this study was to determine if there is any significant difference in electromyographic activity in normal lumbar sacrospinalis musculature during static pelvic traction between the supine and prone positions. Electromyographic activity was monitored on 17 normal participants. Each participant received static pelvic traction in prone and in supine for 15 minutes. The analysis of variance for a repeated measures design found significantly less lumbar sacrospinalis muscle activity during traction in the prone position than during traction in the supine position (p0.05). An analysis of covariance determined that the difference between muscle activity during traction in the prone and supine positions was not significantly affected by differences in sex, age, height, weight, treatment order, time of treatment, electrical noise levels prior to treatment, and electrical noise levels after treatment. Implications for treatment are discussed. J Orthop Sports Phys Ther 1987;8(8):382-390.

Six subjects performed a tapping task during replicated pairs of trials involving three different degress of forward bend. The first and second trial of each pair was separated by either a 4 min or 1 min rest period. Integrated electromyographic (IEMG) records from the right Sacrospinalis muscle and estimates of back discomfort on a 5 point scale at 1 min intervals were collected. Reported back discomfort did not correlate with I.E.M.G. Increased forward bend and reduced rest interval generally led to increased levels of reported discomfort but not necessarily increased I.E.M.G.

This paper reports 2 patients who developed chronic overuse tendinitis of the pelvic insertion of the sacrospinalis muscle. Despite prolonged courses of conservative therapy their symptoms did not improve. Following operative release of the sacro-spinalis, the symptoms settled dramatically and the function of their backs returned to normal.

An analysis of the tissue sections from previous implant studies was performed to define additional criteria which could be considered in determinations of biocompatibility of implant materials. Adult albino rabbits were implanted with biomaterials in the sacrospinalis muscle for periods of 2, 6, 18, and 54 weeks. Fourteen different implant materials were used in this study. The tissues were examined histologically for the appearance of adipose fat cells within the membrane surrounding the implant as an important criterion of tissues implant compatibility. The results were compared with other previously used criteria in judging biocompatibility of implant materials. For the most compatible nonreactive materials, adipose tissue formation within the pseudomembrane began at 6 weeks and was quite extensive at 54 weeks. The reactive materials studied by us did not exhibit this phenomenon.

There is still a distinct place for the use of thoracoplasty in the treatment of tuberculosis and the occasional use of thoracoplasty in the poor risk type of patient can be very effective when supplemented by adequate anti-tuberculosis drugs. The method described is that of a classical thoracoplasty initiated by Alexander, and done in a single stage. Control of paradoxical respiration is easily accomplished by placing anchoring sutures from the sacrospinalis muscle to the pectoralis major, as indicated in Figure. From four to 11 ribs have been removed, including the transverse processes in 35 patients, with one death. The results of the surgery have been gratifying.

The lateral margin of the sacrospinalis muscle was visible on 24 of 100 supine abdominal radiographs. Its course is oblique, the reverse of that of the psoas. Findings on the plain radiograph and CT are correlated.