Cross-sectional area of the lumbar back muscles as a function of torso flexion.

OBJECTIVE Quantification of the maximum anatomical cross-sectional area of the lumbar back muscles as a function of torso flexion angle and development of prediction equations as a function of torso flexion and anthropometric measures. BACKGROUND Cross-sectional areas of the lumbar back muscles used as inputs into biomechanical models have traditionally been derived from subjects lying in the neutral supine posture. However, it is known that the cross-sectional area of muscle is altered as the torso angle changes. DESIGN Experimental design consisted of a two-factor multivariate analysis of variance on the cross-sectional area of the lumbar torso muscle across the lumbar levels, as a function of gender and torso angle. Hierarchical linear regression was utilized to assess the association between cross-sectional area and individual and torso posture characteristics. METHOD Axial MRI scans, through and parallel to each of the lumbar intervertebral discs at four torso flexion positions were obtained from subjects in a lateral recumbent posture. Cross-sectional areas were quantified and converted into anatomical cross-sectional areas utilizing known fascicle orientations. RESULTS The maximum anatomical cross-sectional area was located between the L(3)/L(4) and L(4)/L(5) level in the neutral posture. The anatomical cross-sectional areas at the L(4)/L(5) and L(5)/S(1) decreased during torso flexion, however, the percent change varied as a function of the individual level. The majority of the anatomical cross-sectional area variability was explained by gender and body mass. Lumbar curvature explained a larger proportion of the anatomical cross-sectional area variability at the lower lumbar levels than at the higher lumbar levels. CONCLUSIONS The maximum anatomical cross-sectional area of the lumbar back muscles occur at the neutral torso posture and did not decrease as a function of torso flexion. When using maximum anatomical cross-sectional area or specific lumbar level anatomical cross-sectional areas, it appears necessary to account for gender and body mass. At the lower lumbar levels, knowledge of spinal curvature plays an increasing role in the estimation of the size of the lumbar torso muscle cross-sectional area. RELEVANCE This research indicates the lower lumbar level trunk muscle anatomical cross-sectional area decrease as torso flexion increases, however, the maximum lumbar trunk muscle anatomical cross-sectional area does not vary as a function of torso flexion. Accounting for gender, body mass, torso characteristics and lumbar curvature may help increase accuracy of anatomical cross-sectional area prediction, as well as muscle force predictions from biomechanical models.