Surgical and Radiologic Anatomy

, Volume 33, Issue 10, pp 855–862 | Cite as

3D reconstruction of the crural and thoracolumbar fasciae

  • L. Benetazzo
  • A. Bizzego
  • R. De Caro
  • G. Frigo
  • D. Guidolin
  • C. SteccoEmail author
Original Article



To create computerized three-dimensional models of the crural fascia and of the superficial layer of the thoracolumbar fascia.


Serial sections of these two fasciae, stained with Azan-Mallory, van Gieson and anti-S100 antibody stains, were recorded. The resulting images were merged (Image Zone 5.0 software) and aligned (MatLab Image Processing Toolkit). Color thresholding was applied to identify the structures of interest. 3D models were obtained with Tcl/Tk scripts and Paraview 3.2.1 software. From these models, the morphometric features of these fasciae were evaluated with ImageJ.


In the crural fascia, collagen fibers represent less than 20% of the total volume, arranged in three distinct sub-layers (mean thickness, 115 μm), separated by a layer of loose connective tissue (mean thickness, 43 μm). Inside a single sub-layer, all the fibers are parallel, whereas the angle between the fibers of adjacent layers is about 78°. Elastic fibers are less than 1%. Nervous fibers are mostly concentrated in the middle layer. The superficial layer of the thoracolumbar fascia is also formed of three thinner sub-layers, but only the superficial one is similar to the crural fascia sub-layers, the intermediate one is similar to a flat tendon, and the deep one is formed of loose connective tissue. Only the superficial sub-layer has rich innervation and a few elastic fibers.


Computerized three-dimensional models provide a detailed representation of the fascial structure, for better understanding of the interactions among the different components. This is a fundamental step in understanding the mechanical behavior of the fasciae and their role in pathology.


Crural fascia Thoracolumbar fascia Connective tissue 3D models Collagen 



The authors are grateful to Prof. Natali and his collaborators for their skillful assistance.

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Abramoff MD, Magelhaes PJ, Ram SJ (2004) Image processing with ImageJ. Biophotonics Int 11:36–42Google Scholar
  2. 2.
    Avants B, Sundaram T, Duda JT, Jee JC, Ng L (2004) Non-rigid image registration. In: Yoo TS (ed) Insight into images. AK Peters Ltd., WellesleyGoogle Scholar
  3. 3.
    Azizi E, Roberts TJ (2009) Biaxial strain and variable stiffness in aponeuroses. J Physiol 587:4309–4318PubMedCrossRefGoogle Scholar
  4. 4.
    Barker PJ, Briggs CA (1999) Attachments of the posterior layer of lumbar fascia. Spine 24:1757–1764PubMedCrossRefGoogle Scholar
  5. 5.
    Benjamin M (2009) The fascia of the limbs and back—a review. J Anat 214:1–18PubMedCrossRefGoogle Scholar
  6. 6.
    Bogduk N, Macintosh JE (1984) The applied anatomy of the thoracolumbar fascia. Spine 9:164–170PubMedCrossRefGoogle Scholar
  7. 7.
    Cör A, Barbic M, Kralj B (2003) Differences in the quantity of elastic fibres and collagen type I and type III in endopelvic fascia between women with stress urinary incontinence and controls. Urol Res 31:61–65PubMedGoogle Scholar
  8. 8.
    Fawcett DW (1994) Bloom and Fawcett: a textbook of histology, 12th edn. Chapman & Hall, LondonGoogle Scholar
  9. 9.
    Frey PJ (2000) About surface remeshing. In: 9th International Mesh Round Table, Sandia National Laboratories, pp 123–136Google Scholar
  10. 10.
    Geneser F (1986) Textbook of histology. Munksgaard Lea & Febiger, CopenhagenGoogle Scholar
  11. 11.
    Gerlach UJ, Lierse W (1990) Functional construction of the superficial and deep fascia system of the lower limb in man. Acta Anat 139:11–25PubMedCrossRefGoogle Scholar
  12. 12.
    Gracovetsky S, Farfan HF, Lamy C (1977) A mathematical model of the lumbar spine using an optimized system to control muscles and ligaments. Orthop Clin North Am 8:135–153PubMedGoogle Scholar
  13. 13.
    Guidolin D, Crivellato E, Nico B, Andreis PG, Nussdorfer GG, Ribatti D (2006) An image analysis of the spatial distribution of perivascular mast cells in human melanoma. Int J Mol Med 17:981–987PubMedGoogle Scholar
  14. 14.
    Guidolin D, Zunarelli E, Genedani S, Trentini GP, De Gaetani G, Fuxe K, Benegiamo C, Agnati LF (2008) Opposite patterns of age-associated changes in neurons and glial cells of the thalamus of human brain. Neurobiol Aging 29:926–936PubMedCrossRefGoogle Scholar
  15. 15.
    Langevin HM, Stevens-Tuttle D, Fox JR, Badger GJ, Bouffard NA, Krag MH, Wu J, Henry SM (2009) Ultrasound evidence of altered lumbar connective tissue structure in human subjects with chronic low back pain. BMC Musculoskelet Disord 10:151PubMedCrossRefGoogle Scholar
  16. 16.
    Lorensen WE, Cline HE (1987) Marching cubes: a high resolution 3D surface construction algorithm. Comp Graphics 21:163–169CrossRefGoogle Scholar
  17. 17.
    Loukas M, Shoja MM, Thurston T, Jones VL, Linganna S, Tubbs RS (2008) Anatomy and biomechanics of the vertebral aponeurosis part of the posterior layer of the thoracolumbar fascia. Surg Radiol Anat 30:125–129PubMedCrossRefGoogle Scholar
  18. 18.
    Maintz J, Viergever MA (1998) A survey of medical image registration. Med Image Anal 2:1–36PubMedCrossRefGoogle Scholar
  19. 19.
    Mangin J, Poupon C, Clark C, Le Bihan D, Bloch I (2002) Distortion correction and robust tensor estimation for MR diffusion imaging. Med Image Anal 6:191–198PubMedCrossRefGoogle Scholar
  20. 20.
    Martini FH, Timmons MJ, Tallitsch RB (2004) Anatomia umana, 2nd edn. EdiSES, NaplesGoogle Scholar
  21. 21.
    McDonald S, Bearcroft P (2010) Compartment syndromes. Semin Musculoskelet Radiol 14:236–244PubMedCrossRefGoogle Scholar
  22. 22.
    McGill SM, Norman RW (1988) Potential of lumbodorsal fascia forces to generate back extension moments during squat lifts. J Biomed Eng 10:312–318PubMedCrossRefGoogle Scholar
  23. 23.
    Natali AN, Pavan PG, Stecco C (2010) A constitutive model for the mechanical characterization of the plantar fascia. Connect Tissue Res 22 (Epub ahead of print)Google Scholar
  24. 24.
    Ng L, Ibanez L (2004) Medical image registration: concepts and implementation. In: Yoo TS (ed) Insight into images. AK Peters Ltd, Wellesley, pp 239–306CrossRefGoogle Scholar
  25. 25.
    Russ JC (1995) The image processing handbook. CRC Press, Boca Raton, p 272Google Scholar
  26. 26.
    Russ JC, Dehoff RT (2000) Practical stereology, 2nd edn. Plenum Press, New YorkGoogle Scholar
  27. 27.
    Standring S, Ellis H, Healy J, Johnson D, Williams A (2005) Gray’s anatomy, 39th edn. Churchill Livingstone, LondonGoogle Scholar
  28. 28.
    Stecco A, Macchi V, Masiero S, Porzionato A, Tiengo C, Stecco C, Delmas V, De Caro R (2009) Pectoral and femoral fasciae: common aspects and regional specializations. Surg Radiol Anat 31:35–42PubMedCrossRefGoogle Scholar
  29. 29.
    Stecco C, Gagey O, Belloni A, Pozzuoli A, Porzionato A, Macchi V, Aldegheri R, De Caro R, Delmas V (2007) Anatomy of the deep fascia of the upper limb. Second part: study of innervation. Morphologie 91:38–43PubMedCrossRefGoogle Scholar
  30. 30.
    Stecco C, Porzionato A, Lancerotto L, Stecco A, Macchi V, Day JA, De Caro R (2008) Histological study of the deep fasciae of the limbs. J Bodyw Mov Ther 12:225–230PubMedCrossRefGoogle Scholar
  31. 31.
    Stecco C, Pavan PG, Porzionato A, Macchi V, Lancerotto L, Carniel EL, Natali AN, De Caro R (2009) Mechanics of crural fascia: from anatomy to constitutive modelling. Surg Radiol Anat 31:523–529PubMedCrossRefGoogle Scholar
  32. 32.
    Stecco C, Macchi V, Lancerotto L, Tiengo C, Porzionato A, De Caro R (2010) Comparison of transverse carpal ligament and flexor retinaculum terminology for the wrist. J Hand Surg Am 35:746–753PubMedCrossRefGoogle Scholar
  33. 33.
    Stecco C, Macchi V, Porzionato A, Morra A, Parenti A, Stecco A, Delmas V, De Caro R (2010) The ankle retinacula: morphological evidence of the proprioceptive role of the fascial system. Cells Tissues Organs 27 (Epub ahead of print)Google Scholar
  34. 34.
    Stilwell D (1957) Regional variations in the innervation of deep fasciae and aponeuroses. Anat Rec 23:94–104Google Scholar
  35. 35.
    Vleeming A, Pool-Goudzwaard AL, Stoeckart R, van Wingerden JP, Snijders CJ (1995) The posterior layer of the thoracolumbar fascia. Its function in load transfer from spine to legs. Spine 20:753–758PubMedCrossRefGoogle Scholar
  36. 36.
    Yahia H, Rhalmi S, Newman N (1992) Sensory innervation of human thoracolumbar fascia, an immunohistochemical study. Acta Orthop Scand 63:195–197PubMedCrossRefGoogle Scholar
  37. 37.
    Young B (2006) Wheater’s functional histology: a text and colour atlas, 5th edn. Churchill Livingstone/Elsevier, PhiladelphiaGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • L. Benetazzo
    • 1
  • A. Bizzego
    • 1
  • R. De Caro
    • 2
  • G. Frigo
    • 1
  • D. Guidolin
    • 2
  • C. Stecco
    • 2
    Email author
  1. 1.Department of Information EngineeringUniversity of PadovaPaduaItaly
  2. 2.Section of Anatomy, Department of Human Anatomy and PhysiologyUniversity of PadovaPaduaItaly

Personalised recommendations