Transversospinales

Original Editor - Lilian Ashraf Top Contributors - Lilian Ashraf and Kim Jackson

Description

Deep muscles of the back.

Transversospinales muscle group is a deep group of back muscles that lies deep to the Erector Spinae. It consists of 3 major subgroups: semispinalis, multifidus and rotatores.

The transversospinalis muscles group runs obliquely and medially from the transverse process of the vertebra below to the spinous process, filling the groove on either side of the spinous process.[1]

Semispinalis 

They are the most superficial of the transversospinalis muscle group. Its attachment sites are the thoracic vertebrae (semispinalis thoracis), cervical vertebrae (semispinalis cervicis) and occipital bone at the base of the skull (semispinalis capitis). It originates from the transverse process and crosses between 4 and 6 vertebra to attach in the spinous process.[1] 

Multifidus

Multifidus muscle lies deep to the semispinalis and spans the whole length of the vertebral column, it is most developed in the lumbar region.It originates from the transverse process and crosses between 2 and 4 vertebra to attach in the spinous process.[1]

Rotatores

Rotatores muscle lies deep to the multifidus and spans the whole length of the vertebral column, it is most developed in the thoracic region. It consists of 2 part long and short rotatores.

Long rotatores passes from the transverse process medially to the spinous process, crossing 2 vertebrae, while short rotatores passes from the transverse process and inserts in the adjacent spinous process at the same level.

Its attachment sites are the lumbar vertebrae (rotatores lumborum), thoracic vertebrae (rotatores thoracis) and cervical vertebrae (rotatores cervicis).[1]

Muscle Origin Insertion
Semispinalis thoracis Transverse process of T6 to T10 Spinous process of T1 to T4 and C6,C7
Semispinalis cervicis Transverse process of upper 4-6 thoracic vertebrae Spinous process of C2 to C5
Semispinalis capitis Transverse process of T1 to T6 or T7 and C7

Articular process of C4 to C6

Base of the skull, at the occipital bone medially between the inferior

superior nuchal lines

Multifidus Posterior sacrum, origin of erector spinae, posterior superior iliac spine, mammillary process of lumbar vertebrae, transverse process of thoracic vertebrae and articular process of lower cervical vertebra C4-C7. Base of spinous process of all vertebrae from L5 to C2
Rotatores lumborum Transverse process of lumbar vertebrae Spinous process of lumbar vertebrae
Rotatores thoracis Transverse process of thoracic vertebrae Spinous process of thoracic vertebrae
Rotatores cervicis Transverse process of cervical vertebrae Spinous process of cervical vertebrae

Action

The transversospinalis muscles group share the same action, bilateral contraction extends the spine and unilateral contraction rotates the vertebral column to the opposite side.

With the exception of the semispinalis capitis, bilateral contraction pulls the head posteriorly and unilateral contraction pulls the head posteriorly and rotates the chin to the same side of the contracting muscle.[1]

Nerve Supply

The transversospinalis muscles group share the same nerve supply from the dorsal rami of the spinal nerves.[1]

Blood Supply

Branches of the vertebral, deep cervical, occipital, transverse cervical, posterior intercostal, subcostal, lumbar and lateral sacral arteries.[1]

Clinical Relevance

The transversospinalis muscle group functions in spinal stability, proprioception and posture, stabilizing the vertebral column. While the more superficial back muscles have a role in the movement of the vertebral column.[2]

Degenerative changes in the lumbar multifidus and erector spinae observed by imaging have been associated with lumbar disc herniation and facet joint osteoarthritis.[3]

Assessment

Imaging techniques are used to detect degenerative changes in the muscle as decreased muscles density, decreased cross section area and increased fatty infiltration.[3]

  • CT
  • MRI ( done when a tumour, infection, an insufficiency fracture, or disc protrusion is suspected)
  • US

Treatment

For treatment check the Core Stability page.

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Drake R, Vogl AW, Mitchell AW. Gray's Anatomy for Students E-Book. Elsevier Health Sciences; 2009 Apr 4.
  2. Henson B, Edens MA. Anatomy, Back, Muscles. InStatPearls [Internet] 2018 Dec 23. StatPearls Publishing.
  3. 3.0 3.1 Kalichman L, Carmeli E, Been E. The association between imaging parameters of the paraspinal muscles, spinal degeneration, and low back pain. BioMed research international. 2017;2017.