• Paul Hodges, Allison Kaigle Holm, Sten Holm, Lars Ekström, Andrew Cresswell, Tommy Hansson, and Alf Thorstensson.
• Department of Physiotherapy, The University of Queensland, Brisbane, Australia. p.hodges@shrs.uq.edu.au
• Spine. 2003 Dec 1; 28 (23): 2594-601.

Study DesignIn vivo porcine study of intervertebral kinematics.ObjectivesThis study investigated the effect of transversus abdominis and diaphragm activity, and increased intra-abdominal pressure on intervertebral kinematics in porcine lumbar spines.BackgroundStudies of trunk muscle recruitment in humans suggest that diaphragm and transversus abdominis activity, and the associated intra-abdominal pressure contribute to the control of intervertebral motion. However, this has not been tested in vivo.MethodsRelative intervertebral motion of the L3 and L4 vertebrae and the stiffness at L4 were measured in response to displacements of the L4 vertebra imposed via a device fixed to the L4 vertebral body. In separate trials, diaphragm and transversus abdominis activity was evoked by stimulation of the phrenic nerves and via electrodes threaded through the abdominal wall.ResultsWhen intra-abdominal pressure was increased by diaphragm or transversus abdominis stimulation, the relative intervertebral displacement of the L3 and L4 vertebrae was reduced and the stiffness of L4 was increased for caudal displacements. There was no change in either parameter for rostral displacements. In separate trials, the diaphragm crurae and the fascial attachments of transversus abdominis were cut, but intra-abdominal pressure was increased. In these trials, the reduction in intervertebral motion was similar to trials with intact attachments for caudal motion, but was increased for rostral trials.ConclusionsThe results of these studies indicate that elevated intra-abdominal pressure, and contraction of diaphragm and transversus abdominis provide a mechanical contribution to the control of spinal intervertebral stiffness. Furthermore, the effect is modified by the muscular attachments to the spine.

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