[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Spine](https://durgical.com/en/anatomy/region/spine/) › Longissimus [Muscular system](https://durgical.com/en/anatomy/system/muscular-system/) · [Spine](https://durgical.com/en/anatomy/region/spine/) # Longissimus The longissimus is the middle and longest column of the erector spinae, from the [pelvis](https://durgical.com/en/anatomy/region/pelvis/) to the skull base; it straightens the back and neck. Official name: Longissimus muscles [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=spine&select=longissimus&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The middle and longest column of the erector spinae, from the pelvis up to the [base of the skull](https://durgical.com/en/anatomy/occipital-bone/). ## What it does Straightens the back and neck; on one side it bends and turns the head and trunk to that side. ## Key points - Middle and largest column of the erector spinae, and the only one that reaches the skull (longissimus capitis to the mastoid process) - The Wiltse paraspinal approach to the lumbar [spine](https://durgical.com/en/anatomy/region/spine/) enters the cleft between it and multifidus - The erector spinae plane block is usually given deep to it, on the tip of a thoracic transverse process ## Key facts **Origin** Common erector spinae tendon; transverse processes of thoracic and lower cervical vertebrae **Insertion** Thoracic and cervical transverse processes; [ribs](https://durgical.com/en/anatomy/ribs/) between tubercles and angles; mastoid process (capitis) **Action** Bilateral: extends spine and head; unilateral: lateral flexion, turns head to the same side **Nerve** Dorsal rami of spinal nerves (lateral branches; cervical, thoracic and lumbar) **Blood supply** Dorsal branches of posterior intercostal and [lumbar arteries](https://durgical.com/en/anatomy/lumbar-arteries/); occipital and deep cervical arteries (capitis) ## Relations **Lateral** [Iliocostalis](https://durgical.com/en/anatomy/iliocostalis-muscles/) **Medial** [Spinalis](https://durgical.com/en/anatomy/spinalis-muscles/) in the thoracic region; in the lumbar region [multifidus](https://durgical.com/en/anatomy/multifidus-muscles/), along the Wiltse plane **Superficial** [Thoracolumbar fascia](https://durgical.com/en/anatomy/thoracolumbar-fascia/), [latissimus dorsi](https://durgical.com/en/anatomy/latissimus-dorsi-muscle/) and the [serratus posterior](https://durgical.com/en/anatomy/serratus-posterior-superior-muscle/) muscles; in the neck, [splenius](https://durgical.com/en/anatomy/splenius-capitis-muscle/) **Deep** Transverse processes, [levatores costarum](https://durgical.com/en/anatomy/levatores-costarum/) and the transversospinal muscles ([semispinalis](https://durgical.com/en/anatomy/semispinalis-muscles/), multifidus) ## How to find it Lying face down with a gentle back extension, it forms most of the paraspinal ridge beside the lumbar spinous processes. On ultrasound for an erector spinae plane block it is the thick muscle seen just above the bright, flat line of a transverse process. ## On imaging On axial MRI or CT it is the large middle column of the erector spinae, between iliocostalis laterally and multifidus medially; the thin fat cleft between it and multifidus is the Wiltse plane. Ultrasound over a transverse process shows it as the thick layer above the bright bony line, where the erector spinae plane block is given. MRI shows strain as oedema, atrophy as fat. ## Common problems - Muscle strain and spasm: one of the most common causes of sudden low back pain. - Weakness and fatigue add to chronic back pain. ## How it is diagnosed History and exam; imaging is not needed for a simple strain. ## Treatment - Staying active, heat, pain medicine and an exercise programme. Most strains settle in days to weeks. ## Clinical notes - Wiltse approach: going between it and multifidus reaches the facet joints and pedicles without stripping muscle from the midline, used for pedicle screws and far-lateral disc herniations - Erector spinae plane block: local anaesthetic deep to it spreads up and down several levels to the dorsal and ventral rami, for [chest](https://durgical.com/en/anatomy/region/chest/), breast and spine surgery ## Development Epaxial muscle from the dorsal part of the myotomes, so its nerve supply comes from the lateral branches of the dorsal rami. Like the other long columns, it is built from several fused myotomes rather than a single segment. ## Memory aid I Love Spaghetti, from lateral to medial: Iliocostalis, Longissimus, Spinalis. ## Related conditions - [Mechanical low back pain](https://durgical.com/en/conditions/mechanical-low-back-pain/) ## Test yourself Think of the answer, then tap the question to see it. ## Which erector spinae column is the only one to reach the skull, and where does it insert? The longissimus: longissimus capitis inserts on the mastoid process. ## Which intermuscular plane does the Wiltse paraspinal approach use, involving the longissimus? The cleft between the longissimus and the multifidus, reaching facets and pedicles without stripping the midline. ## Where is the erector spinae plane block usually given in relation to the longissimus? Deep to the longissimus, on the tip of a thoracic transverse process; the anaesthetic spreads over several levels. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/anatomy/longissimus-muscles/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** musculi longissimi TA2 2262 **Official Spanish (DeCS)** Músculo longísimo DeCS D064170 **English (TA2)** Longissimus muscles **Also called** longissimus muscle ## Related - [Iliocostalis](https://durgical.com/en/anatomy/iliocostalis-muscles/) - [Spinalis](https://durgical.com/en/anatomy/spinalis-muscles/) - [Posterior intercostal arteries](https://durgical.com/en/anatomy/posterior-intercostal-arteries/) - [Lumbar arteries](https://durgical.com/en/anatomy/lumbar-arteries/) - [C4 vertebra](https://durgical.com/en/anatomy/c4/) - [C6 vertebra](https://durgical.com/en/anatomy/c6/) - [L1 vertebra](https://durgical.com/en/anatomy/lumbar-vertebra/) - [L2 vertebra](https://durgical.com/en/anatomy/lumbar-vertebra-spine-and-pelvis/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=55179&filter=ths_termall&q=M%C3%BAsculos%20Paraespinales); [Anatomy, Back](https://www.ncbi.nlm.nih.gov/books/NBK539746/); Anatomy of the Human Body (20th ed.): Development of the Muscles (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain. ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/longissimus-muscles/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/longissimus-muscles/