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Deep Multifidus Laminar Attachment

insertio laminaris profunda musculi multifidi

The deepest fibres of the lumbar multifidus attach via short, stout tendinous bands directly to the laminae of the vertebrae, distinct from the more superficial fibres that attach to the spinous processes. These laminar attachments are the most intersegmentally specific component of the multifidus, providing direct control of individual motion segments.

Region: Lower Back

Clinical Relevance

Clinical Notes

The deep laminar multifidus attachments are disrupted during posterior lumbar laminectomy and fusion procedures, contributing to post-operative multifidus atrophy and chronic low back pain. Minimally invasive tubular techniques preserve these deep laminar fibres. Selective activation of the deep multifidus is the target of specific stabilisation exercises using real-time ultrasound biofeedback. MRI demonstrates selective atrophy of the deep multifidus ipsilateral to symptomatic disc pathology.

Pathology

Common Injuries & Conditions

Post-Laminectomy Multifidus Atrophy

Denervation and mechanical disruption of the deep multifidus laminar attachments during open posterior lumbar surgery, producing ipsilateral paraspinal atrophy and fatty infiltration that correlates with persistent low back pain outcomes.