The Spine 89
FIGURE 3.19 The deep posterior spinal muscles
(posterior view).
dus (L. divided into many clefts or segments) between
transverse and spinous processes. All of these muscles
share the common action of spinal extension when
both sides contract. In addition, unilateral contraction
of the intertransversales and multifidus can produce
small amounts of lateral flexion, while the rotatores
and multifidus can produce small amounts of rotation
to the opposite side. However, many of these deep
muscles have poor mechanical advantage and are
believed to be more important for helping stabilize the
spine, and helping to control segmental movement,
rather than producing the large forces associated with
movements of the spine as a whole (Basmajian and
DeLuca, 1985; Donisch and Basmajian, 1972; McGill,
2001; Panjabi et al., 1989). These muscles also have
higher densities of receptors (muscle spindles); these
provide feedback that can be used to detect and moni-
tor precise positions of vertebrae (Moore and Dalley,
1999; Smith, Weiss, and Lehmkuhl, 1996). Due to their
deep location, the deep posterior spinal group cannot
be readily palpated.
Lateral Muscles of the Spine
There is one paired muscle, the quadratus lumborum,
that is located posterolaterally versus anteriorly or
posteriorly. This lateral location gives it the unique
capacity to produce lateral flexion of the spine without
additional movements. The other muscles that can
Attachments and Primary Actions of the Quadratus Lumborum Muscle
Muscle Inferior attachment(s) Superior attachment(s) Primary action(s)
Quadratus lumborum
(kwod-RA-tus lum-BOR-um)
Posterior iliac crest,
iliolumbar ligament
12th rib, tips of transverse
processes L1-4
Fixes or depresses lower rib
Spinal lateral flexion (same)
Stabilizes spine and pelvis
Quadratus Lumborum
The quadratus lumborum (quad, four sided + lumb, lumbar region) is a flat muscle located on either
side of the spine behind the abdominal cavity in the low back area as shown in figure 3.20. Its fibers
run upward from the iliac crest to the lowest rib, with side slips running medially to attach to the top
four lumbar vertebrae. When one side of this muscle contracts it can produce lateral flexion of the
spine to the same side. Posturally, the quadratus lumborum can help depress the last ribs, stabilize
the spine, and keep the pelvis level. This latter function of not allowing one side of the pelvis to drop
relative to the rib cage is very crucial on the swing side during walking gait and on the gesture leg
during upright dance movements.
Palpation: Sitting in a chair with the upper torso hanging forward, place your fingertips below the last
rib and toward the spine (under some of the erector spinae if possible) on the right side. Then, hike
the right hip (bring the right iliac crest toward the ribs). The tension you feel is partly due to contraction
of the quadratus lumborum.
produce lateral flexion are located either anteriorly, and so tend to also cause flexion (the abdominal
muscles), or posteriorly, and so tend to also produce extension (spinal extensors).