The lateral fibres of quadratus lumborum connect the iliac crest to the twelfth rib, with a primary role in stabilising the last rib for diaphragmatic function. They are distinct from the medial fibres that connect to the lumbar transverse processes.
| Origin | Posterior iliac crest — lateral lip |
|---|---|
| Insertion | Twelfth rib — inferior border, lateral portion |
| Nerve Supply | Ventral rami of T12, L1-L4 |
| Blood Supply | Segmental lumbar arteries |
| Actions | Fixes the twelfth rib during inspiration — prevents its elevation by the diaphragm; Assists ipsilateral lateral lumbar flexion |
|---|
Twelfth rib resection must account for the lateral QL fibres that fix this rib — their detachment is required for the retroperitoneal flank approach to the upper urinary tract and adrenal gland. Lateral QL trigger point injection targets these fibres for chronic flank and hip pain.
Palpated in the lateral flank between the iliac crest and the lowest rib.
Myofascial trigger point in the lateral quadratus lumborum lateral fibres producing referred flank and hip pain, treated by dry needling or steroid injection.
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