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THE VERTEBRAL COLUMN

The vertebral column is formed by 33-34 vertebrae : 7 cervical vertebrae (C1-C7), 12

thoracic vertebrae (T1-T12), 5 lumbar vertebrae (L1-L5), 5 sacral vertebrae (S1-S5, fixed
together forming sacrum) and 4-5 coccygeal vertebrae (coccyx). The sacrum and the coccyx
are parts from the pelvis. Each vertebra is separated from its neighbour by an intervertebral
disc.
In sagittal plan, the vertebral column has several curvatures: lordosis = convex
forwards – cervical curve, lumbar curve; Kyphosis = convex dorsally – thoracic curve, pelvic
(sacral) curve. The functions of the column are to support the trunk, to protect the spinal cord
and nerves, and to provide attachments for muscles. It is also an important site of
haemopoiesis throughout life.
GENERAL FEATURES of the vertebrae
A typical vertebra has:
1. Vertebral body: is a cylindrical mass of bone, situated anterior (ventral); opposed
surfaces of adjacent bodies are bound together by intervertebral discs of
fibrocartilage. The vertebral bodies are internally trabecular, and have an external
shell of compact bone perforated by vascular foramina.
2. Vertebral (neural) arch: situated behind the vertebral body; it has several parts:
- Pedicles are short projections, from the superior part of the vertebral body to the
lateral and dorsal parts of the vertebral arch; they had a small notch in the upper
edge and a larger notch in the lower edge; together the upper and the lower edge
formed intervertebral foramen through each spinal nerve emerge.
- Laminae: are directly continuous with the pedicles. They are vertically flattened.
- Processes: spinous process situated approximately in the median plane and project
posteriorly, transverse processes on each side (left and right) , articular processes
( 2 superior and 2 inferior)
3. Vertebral foramen: is delimitated between the back of the vertebral body and the
neural arch; the superposition of all the vertebral foramen formed a tubular space that
protects the spinal cord and its meningeal shell and vessels, named the vertebral
canal.

REGIONAL FEATURES of the vertebrae:

a. Cervical vertebra:
- Vertebral body: is small, the upper surface is saddle-shaped, has two processes
which arise from the lateral circumference of the vertebral body – uncinated
processes;
- Neural arch: the apex of spinous process is short and bifid; the transverse process
has a foramen at the base – the foramen transversarium (through which the
vertebral artery and vein passes), and has also two tubercles – anterior and
posterior tubercle where scalene muscles are attached.
- Vertebral foramen has a triangular form.

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 b. Thoracic vertebra:
- Vertebral body: is a cylinder, display lateral costal facets and all but the lowest
two or three transverse processes also have facets. The facets articulate with the
head of the rib and its tubercle respectively. On each side there are two costal
facets : the superior and the inferior.
- Neural arch: the spinous process slants downward. The articular processes are
vertical. Thoracic transverse processes have the costal facets concave and
face anterolaterally.
- Vertebral foramen is small and circular.
c. Lumbar vertebra
- Vertebral body: wider transversely.
- Vertebral (neural) arch: The spinous process is almost horizontal; the superior
articular processes bear vertical concave articular facets, the inferior articular
processes have vertical convex articular facets. The transverse processes are thin
and long and have one mammillary process each side; a small accessory
process marks the posteroinferior aspect of the root of each transverse process.
- Vertebral foramen is triangular, larger than at thoracic levels. The first lumbar
vertebral foramen contains the conus medullaris of the spinal cord, while lower
foramina contain the cauda equine and spinal meninges.
SPECIAL FEATURES of the vertebrae:
ATLAS:
- The first cervical vertebra that articulates with the occipital bone forming the
atlanto- occipital joints. The atlas consists of two lateral masses connected by a
short anterior and a longer posterior arch. The transverse ligament retains the dens
(a cranial protuberance from the axis) against the anterior arch.
- the transverse ligament divides the vertebral canal into two compartments. The
anterior compartment is occupied by the dens, and the posterior compartment is
occupied by the spinal cord and its coverings.
- the anterior arch has a roughened anterior tubercle. The posterior surface of the
anterior arch carries a concave facet for the dens. The superior surface of the
posterior arch bears a wide groove for the vertebral artery and the first cervical
nerve. The posterior arch has also a posterior tubercle.
- each lateral mass has a superior articular facet for the
respective occipital condyle.
AXIS:
- the second cervical vertebra, acts as an axle for rotation of the atlas and head
around the strong dens (odontoid process), which projects cranially from the
superior surface of the vertebral body. The anterior surface of dens has an articular
facet for the anterior arch of the atlas, and the posterior surface has a groove for
the transverse
ligament.
C7: has a long spinous process, and for that it is called the vertebra prominens.

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SACRUM: is a large, triangular fusion of five sacral vertebrae and forms the posterosuperior
wall of the pelvic cavity. We describe the following parts of the sacrum:
a. Base: is the upper surface of the first sacral vertebra. The vertebral body (anterior)
is large and wider transversely, and its anterior projecting edge is the sacral
promontory. The vertebral foramen is triangular. The superior articular processes
articulate with the inferior articular processes of the fifth lumbar vertebra. The ala is
situated in the lateral part of the base.
b. Pelvic surface: is orientated anteroinferior, concave. Four pairs of pelvic sacral
foramina communicate with the sacral canal through intervertebral foramina, and
transmit ventral rami of the upper four sacral spinal nerves. The large area between
the right and left foramina, which is formed by the sacral vertebrae bodies, bears
evidence of their fusion at four transverse ridges.
c. Dorsal surface: is orientated posterosuperior. It has a median sacral crest which
represent fused sacral spines. Lateral to this are four pairs of dorsal sacral foramina
and each transmits the dorsal ramus of a sacral spinal nerve. Medial to the foramina is
the intermediate sacral crest that represent fused articular processes. The inferior
articular processes of the fifth sacral vertebra are free and project downwards at the
sides of the sacral hiatus as sacral cornua. To the lateral side of the dorsal sacral
foramina is the lateral sacral crest which is formed by fused transverse processes.
On this surface we observe a sacral hiatus in the posterior wall of the sacral canal
d. Lateral surface: in its upper part bears an auricular surface for articulation with the
ilium, and the area posterior to this, sacral tuberosity, is rough by the attachment of
sacroiliac ligaments.
e. Apex: articulates with the coccyx
f. Sacral canal: is formed by sacral vertebral foramina, and is triangular in section. Its
upper opening is seen on the basal surface. Its caudal opening is the sacral hiatus. The
canal contains the cauda equine ( the rami of sacral nerves) and the filum terminale,
and the spinal meninges.

COCCYX: is a small triangular bone. It usually consists of four fused rudimentary

vertebrae, although the number varies from three to five. The bone is directed downwards and
ventrally from the sacral apex