Electromyographic Technique for Lumbar Multifidus Examination: Comparison of Previous Techniques Used to Localize the Multifidus Byung Jo Kim, MD, PhD,

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Presentation transcript:

Electromyographic Technique for Lumbar Multifidus Examination: Comparison of Previous Techniques Used to Localize the Multifidus Byung Jo Kim, MD, PhD, Elaine S. Date, MD, Richard Derby, MD, Sang-Heon Lee, MD, PhD, Kwan Sik Seo, MD, Kwang Joon Oh, MD, Mi Jung Kim, MD Archives of Physical Medicine and Rehabilitation Volume 86, Issue 7, Pages 1325-1329 (July 2005) DOI: 10.1016/j.apmr.2004.12.027 Copyright © 2005 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 1 Anteroposterior (AP) fluoroscope image showing contrast dye in the multifidus fascicle (arrow). Archives of Physical Medicine and Rehabilitation 2005 86, 1325-1329DOI: (10.1016/j.apmr.2004.12.027) Copyright © 2005 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 2 The Haig and the Stein method needle positions. (A) AP fluoroscope view showing needle positions of the Haig (arrow) and the Stein (arrowhead) methods. (B) Lateral view. Needle tip is positioned into a fascicle close to the origin using the Stein method. With the Haig method, the needle tip is located more superficially and inserted into a muscle belly originating from the upper segment spinous process. Abbreviations: SP, spinous process; VB, vertebral body; VF, intervertebral foramen. Archives of Physical Medicine and Rehabilitation 2005 86, 1325-1329DOI: (10.1016/j.apmr.2004.12.027) Copyright © 2005 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 3 (A) Cadaver dissection. Colored latex dye is located in the muscle fascicle. (B) Schematic diagram of multifidus muscle fascicles originating from L2 and innervated by the L2 nerve root.11 Abbreviations: CT, common tendon of longer fascicles that diverge caudally to attach separately to mamillary processes, the iliac crest, and the sacrum; LF, lamina fiber arising from the caudal end of the dorsal surface of the vertebral lamina, inserted into the mamillary process of the vertebra 2 levels caudad; USMF, multifidus fascicles originating from the upper vertebra. *Inferior margin of the L2 spinous process. Archives of Physical Medicine and Rehabilitation 2005 86, 1325-1329DOI: (10.1016/j.apmr.2004.12.027) Copyright © 2005 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions