Rotatores and Multifidi – Functional Anatomy

Overall Structure

Multifidi and rotatores form a thick muscle band that fills the lamina groove.

The shortest strand is the deepest. As the strands lengthen to span more vertebrae, they become more superficial.

This forms a thick web of guy wires that allow vertebrae to move in relationship to each other. They are reported to extend, laterally flex, and rotate vertebrae in relationship to each other.

Innervation

The posterior rami innervate these muscles.

Rotatores are the deepest muscles in the lamina groove. Rotatores connect the transverse process of a vertebra to the spinous processes of the spinous process of two vertebrae just above it.

Notably, most studies focus on the thoracic rotatores. Largely, they report that the rotatores are inconsistent and often non-existent in the lumbar and cervical regions.

The multifidi originate on or near the transverse process of the inferior vertebra. Then, they skip the two vertebrae just superior to that vertebra and where the rotatores attach. Instead, they insert on the 3rd to 5th vertebrae above the origin.

Multifidi lay superficial to the rotatores.  Multifidi also originate on or near the transverse process of a vertebra. Together, they extend to the spinous processes of the five vertebrae superior to the origin. This configuration traps vertebrae between the attachments.

The posterior rami of spinal nerves innervate these small muscles.

Cervical

Cervical multifidi are much smaller than the lumbar multifidi. Rotatores tend to be less consistent in the cervical spine. Also, many texts seem to refer to the muscles that only span one or two vertebrae in the cervical spine as multifidi.

Origin

• articular process (of the lower four vertebrae)

Insertion

• spinous processes of the vertebrae 2-4 segments above, up to the axis

There are cervical region has exceptions to the typical multifidi structure. The sections originate on C4-C7 and insert on C2-C5, leaving some single strands that only skip over one vertebra.

Studies vary, but the thoracic spine consistently has rotatores. However, The multifidi are reported as inconsistent through this section.

Origin

• transverse process

Insertion

• the spinous process of the vertebrae 3-5 vertebrae above the origin

Lumbar vertebrae tend to have thick multifidi. However, the rotatores are inconsistent. Additionally, the lumbosacral multifidi tend to get fatty, weak, and slow to recover in people over 40.

Origin

• mamillary process

Insertion

• the spinous process of the vertebrae 3-5 segments above the origin

Lateral View

The lumbar multifidi form a thick pillar of overlapping muscle in the low back. That complex structure continues onto the sacrum.

These muscular sections tend to vary a great deal in thickness. Additionally, they get fattier and more easily inflamed as one ages.

Origin

• lateral border of the sacrum via an aponeurosis

Insertion

• spinous processes of the lumbar vertebrae

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