Lumbosacral Spine Anatomy

& Physiology

dr. Argo Ismoyo

Anatomi Lumbar Spine
Anatomi Lumbar Spine
The lumbar vertebrae, numbered L1-L5,
have a vertical height that is less than
their horizontal diameter. They are
composed of the following 3 functional
parts:
1. The vertebral body, designed to
bear weight
2. The vertebral (neural) arch,
designed to protect the neural
elements
3. The bony processes (spinous and
transverse), which function to
increase the efficiency of muscle
action
Anatomi Lumbar Spine
• Each vertebral arch is composed of 2
pedicles, 2 laminae, and 7 different
bony processes (1 spinous, 4 articular,
2 transverse) joined together by facet
joints and ligaments.
SACRUM
SACRUM
 Lumbar Intervertebral Discs
• Discs form the main connection
between vertebrae. They bear
loading during axial compression
and allow movement between
the vertebrae.
• Their size varies depending on
the adjacent vertebrae size and
comprises approximately one
quarter the length of the
vertebral column.
Lumbar vertebral joints

The 3-joint complex is formed

between 2 lumbar vertebrae.
• Joint 1: Disc between 2 vertebral
bodies
• Joint 2: Left facet
(zygapophyseal) joint
• Joint 3: Right facet
(zygapophyseal) joint.
Lumbar vertebral joints
• The mobility of the vertebral column is provided by the symphyseal
joints between the vertebral bodies, formed by a layer of hyaline
cartilage on each vertebral body and an intervertebral disc between
the layers
• The synovial joints between the superior and inferior articular
processes on adjacent vertebrae are termed the facet joints (also
known as zygapophysial joints or Z-joints).
• The movement of the lumbar spine is largely confined to flexion and
extension with a minor degree of rotation
• The region between the superior articular process and the lamina is
the pars interarticularis.
• Each disc consists of the nucleus pulposus, a
central but slightly posterior mucoid substance
embedded with reticular and collagenous
fibers, surrounded by the annulus fibrosus,
• The annulus fibrosus can be divided into the
outermost, middle, and innermost fibers.
LIGAMENTS
 LIGAMENTS
• Connected between adjacent
vertebrae along length of spine
• Act to limit excessive motion
• Anterior and posterior
longitudinal ligaments
• Ligamentum flavum
• Inter- and supraspinosus
ligaments
• Intertransverse ligaments
• Facet joint capsules
LIGAMENTS
Anterior longitudinale ligaments
• covers and connects the anterolateral aspects of the vertebral bodies
and IV discs
• strongly attached to the the vertebral bodies but loosely attached to
AF
• maintains stability of the joints between the vertebral bodies and
help prevent hyperextension of the spine
LIGAMENTS
Posterior longitudinale ligaments
• runs within the vertebra canal along the posterior aspects of the
vertebral bodies
• strongly attached to the AF and the posterior edges of the vertebral
bodies
• helps prevent hyperflexion of the spine and posterior protrusion of
the discs
 Lumbosacral Ligaments
LIGAMENTS
Iliolumbar ligament extend
from the transverse processes
of L4 and L5 to the iliac crest.

ANTERIOR POSTERIOR
Spine Musculature
Spine Musculature
• Muscle of the spine are part of the
trunk musculature
• Three groups of muscles in the back :
• superficial,
• intermediate,
• deep group
• Deep / intrinsic back muscles are
grouped according to their
relationship to the surface :
superficial, intermediate, and deep
layer
• Muscle injury generally occurs during
forcible lengthening while the muscle
is activated (contracting)
Lumbar Spine Vasculature
Lumbar Spine Vasculature
Spinal Nerve Structures
Spinal Nerve Structures
31 pairs of spinal nerves
• 8 cervical
• 12 thoracic
• 5 lumbar
• 6 sacrococcygeal
Spinal Nerve Structures
 Spinal Nerve Structures
Lumbar Plexus
• Femoral nerve
• Cutaneous branches
• Thigh, leg, foot (e.g. saphenous nerve)
• Motor branches
• Anterior thigh muscles (e.g. quadriceps, sartorius,
iliopsoas)
• Obturator nerve
• Sensory
• Skin medial thigh; hip, knee joints
• Motor
• Adductor muscles
• Lateral femoral cutaneous
• Sensory
• Skin lateral thigh
• Genitofemoral
• Sensory
• Skin scrotum, labia major, anterior thigh
• Motor
• Cremaster muscle
 Sacral plexus
• L4-S4
• Supplies muscles and
skin of posterior thigh
and almost all of the
leg
• Main branch is the
large sciatic nerve,
which consists of:
– Tibial nerve – to most of
hamstrings, calf and sole
– Common fibular nerve –
to muscles of anterior
and lateral leg and skin
• Other branches supply
pelvic girdle (gluteus
muscles) and perineum
(pudental nerve)
 Sacral plexus
• L4 – S4
• Superior & inferior
gluteal nerves
– To gluteus muscles
• Sciatic nerve
– To hamstrings & other
posterior thigh & leg
muscles
• Pudendal nerve
– Sensory from penis,
clitoris, labia minora,
anus
29 Oct. 2012 Spinal-Nerves.ppt 26
TERIMA KASIH