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Abstract
A trigger point is frequently found over the iliac crest at 7 to 8cm from the midline
in low-back-pain syndromes. Previously, this was described as either a painful insertion
site of the iliolumbar ligament or pain in the distribution of the cutaneous dorsal
ramus of the first or second lumbar nerve. The authors performed 37 dissections, and
they report their anatomic findings. The iliac insertion of the iliolumbar ligament
is inaccessible to palpation, being shielded by the iliac crest. The dorsal rami of
L1 or L2 nerve roots, however, cross the crest at 7cm from the midline, and this distance
closely correlates with the dorsal projection of the iliolumbar ligament insertion.
These rami are superficial and dorsal to the crest, easily accessible to palpation.
In two of the 37 dissections performed, some rami were found to be narrowed as they
crossed through an osteofibrous orifice over the crest, thus being susceptible to
an entrapment neuropathy. The authors conclude that the trigger point sometimes localized
over the iliac crest at 7cm from the midline likely corresponds to elicited pain from
a cutaneous dorsal ramus originating from the thoracolumbar junction rather than from
the iliac insertion of the iliolumbar ligament.
Keywords
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References
- Ligament and tendon relaxation (skeletal disability) treated by prolotherapy (fibro-osseous proliferation).3rd ed. Thomas, Springfield IL1958
- Iliolumbar syndrome as a common cause of low back pain: diagnosis and prognosis.Arch Phys Med Rehabil. 1979; 60: 415-419
- Low back pain of thoracolumbar origin.Arch Phys Med Rehabil. 1980; 61: 389-395
- The iliolumbar ligament: a study of its anatomy, development and clinical significance.J Bone Joint Surg [Br]. 1986; 68: 197-200
- Gray's anatomy.in: 35th ed. Saunders, Philadelphia1973: 414
Article info
Publication history
Accepted:
October 1,
1990
Received:
June 22,
1990
Identification
Copyright
© 1991 Published by Elsevier Inc.
