Anatomy and Biomechanics

of Spine
1

BY: FRESELAM B.(GSR1)

MODERATOR: DR. KIBRUYISFAW
(CONSULTANT NEUROSURGEON)

June 19, 2019

 Outlines
2

Objectives of the session

Introduction
Anatomy and function of the vertebral column.
Biomechanics of the spine
References

June 19, 2019

 Objectives
3

Discuss the gross anatomy and regional variations of

the spine.
List common functions of the spine.
Describe the biomechanics of spine.

June 19, 2019

4

June 19/2019
 Introduction
5

Vertebral column is the largest segment of body.

It extends from the cranium (skull) to the apex of
the coccyx.
Is composed of alternating bony vertebrae and fibro
cartilaginous discs.
Most significant functional unit for general
movement.

June 19, 2019

 The Vertebral Column
6

In an adult typically consists of 33 {32-35} vertebrae

arranged in five regions:

 Cervical (7)
 Thoracic (12)
 Lumbar (5)

 Sacral (5 - fused)
 Coccygeal (4 – fused)

June 19, 2019

Regional characteristics of the vertebral
column
7

Vertebrae vary in size and other characteristics from

one region to another.
Vertebral components: anterior, posterior and lateral

A typical vertebra consists of:

• Vertebral body
• Vertebral arch, and
• processes.
June 19, 2019
Contd.
Internal aspects of vertebral bodies and
vertebral9 canal

June 19, 2019

Vascular supply
Contd.
Cervical vertebrae
 Cervical Vertebrae

Cervical vertebrae form the skeleton of the neck

 The body is small in size.

 Relatively thick IV disc.

 The facets have horizontal orientation.

 Responsible for greatest range and variety of

movement of all the vertebral regions.
 Foramen transversarium (transverse foramen)

 Classified into typical and atypical (C1 and C2)

 Kinematically divided in to regions

 Atlas (C1)
15
Is ring-shaped vertebra.
Has an anterior and
posterior arch with
tubercles.
Has a lateral mass on each
side with articular
surfaces
Allows the head to nod up
and down on the vertebral
column
 Does not possess a body
or a spinous process. June 19, 2019
 Steel’s rule of thirds
The C1 vertebral foramen can be divided into thirds where
one third of the foramen is filled with the odontoid process,
one third with the spinal cord, and the final third is referred
to as “free space”.
 AXIS ( C2 )
17

Is the strongest of the cervical vertebrae

Has two large, superior articular facets.
Odontoid process , dens, projects superiorly from the
body of C2 which acts as a pivot.
Transverse ligament of the atlas and alar ligament.

10/04/2020
 THORACIC VERTEBRAE
18

Have costal facets for articulation with ribs (superior

and inferior costal facets)
Body is heart shaped
Circular and smaller vertebral foramen.
The transverse process is long and strong and extend
posterolaterally.
Spinous processes is long and slope posteroinferiorly

June 19/ 2019

19

June 19/2019
 LUMBAR VERTEBRAE
20

Lumbar vertebrae have massive bodies

Vertebral foramen is triangular.
The pedicles are strong and directed backward and
the laminae are thick.
The transverse processes are long and slender.
The spinous processes are short, flat, and
quadrangular and project backward.
Small accessory process, which provides an
attachment for the inter-transversarii muscles.

June 19/2019
Fifth lumbar vertebra
LUMBAR VERTEBRAE
22

June 19/2019
 SACRUM
23

 Is wedged-shaped part of the spine.

 Composed of five fused sacral vertebrae in adults.
 Functions of sacrum:

 Transmits the weight of the body.

 Supports the vertebral column and
 Forms the posterior part of the bony pelvis.
 provides strength and stability to the pelvis

 The sacral canal is the continuation of the vertebral canal.

 It contains the bundle of spinal nerve roots

June 19/2019
SACRUM, gross parts…
24

10/04/2020
coccyx
 COCCYX
26

Small triangular bone (tail bone)

The first coccygeal vertebra is usually not fused
or is incompletely fused with the second vertebra.
Does not participate in support of the body weight
when standing.
However , when sitting it receive some weight.
Provides attachments for parts of the gluteus
maximus and coccygeus muscles .

June 19/2019
Vertebral Body
 Intervertebral discs
28

Soft fibro-cartilaginous cushions.

They are interposed between the vertebral bodies.
Avascular and nutrients diffuse through end plates
There are 23 intervertebral discs
Most rostral--C2 C3 disc and distally L5--S1 disc.
They account for 1/3 to 1/5 of the height of vertebral
column.
Has two parts:
 Nucleus pulposus

 Anulus fibrosus +- cartilaginous end plates

June 19/2019
 Intervertebral discs
30

 Nucleus pulposus:

 Gel-like mass in center of

disk under pressure such
that it preloads disc
Is semifluid in nature.
Composed of 80-90%
water, 15-20% collagen.

Intervertebral
foramen ? June 19/2019
 Intervertebral discs
32

 Anulus Fibrosus:

Fibro-cartilaginous
material.
50-60% collagen
The fibers forming each
lamella run obliquely from
one vertebra to another

June 19/2019
 Ligaments
33

Two broad groups :

Intersegmental, and

Intrasegmental

June 19/2019
 Ligaments
34

I. The longitudinal ligaments

 Anterior
 Posterior
II. Ligamentum flavum
III. Supraspinous ligament
IV. Interspinous ligament
V. Intertransverse ligament
VI. Capsular ligament

june 19/2019
Ligaments
35

10/04/2020
Ligaments
36

10/04/2020
 Anterior Longitudinal Ligaments
37

 Very dense & powerful

From occiput to sacrum.
Covers a 1/4 to 1/3 of the ventral circumference of
vertebral bodies.
Attaches to ant disc & vertebral body
Limits hyperextension and Forward movement

10/04/2020
 Posterior longitudinal ligaments
38

Travels inside the spinal

canal
Narrower, weaker band
Connects to rim of
vertebral bodies & center
of disc
Offers resistance to flexion

10/04/2020
 Ligaments contd.
39

 Ligamenta flava

 Pass between the laminae of adjacent vertebrae

 Very elastic, aids in extension following flexion of the
trunk
 Extend from C1-2 level to L5-S1

 Supraspinous and interspinous

 Span spinous processes

 Resist shear and forward bending of spine

 Ligamentum Nuchae at cervical region

June 19/2019
 MUSCLES OF BACK

 Two major groups of muscles in the back:

I. The extrinsic back muscles
 Produce and control limb and respiratory movements
 Superficial (trapezius, latissimus dorsi, levator scapulae, and
rhomboids)
 Intermediate (serratus posterior superior and serratus
posterior inferior)
II. The intrinsic (deep) back muscles
 Muscles of back proper
 Specifically act on the vertebral column,
 Producing its movements and maintaining posture.
Muscles…
Muscles contd.
Mucles contd.
Interplay of anterior and posterior spinal muscles
Spinal curvatures
 Spinal curves contd.

The vertebral column in adults has four curvatures.

Primary curvature
 Thoracic and sacral
 Concave anteriorly
Secondary curvature
 Concave posteriorly

 Cervical (while starting sitting)

 Lumbar (while starting standing)

 Curvatures of Vertebral Column

1. Cervical Lordosis
20° - 40°
2. Thoracic Kyphosis
20° - 40°
3. Lumbar Lordosis
40° – 60°
4. Sacral Kyphosis
• Differs in males and females
 Functions48 of spine
Protects the spinal cord and spinal nerves.
Supports the weight of the body superior to the level
of the pelvis.
Provides a partly rigid and flexible axis for the body.
An extended base on which the head is placed and
pivots.
Plays an important role in posture and locomotion.
Shock absorption

june 19/2019
Biomechanics of spine

49

June 19/2019
 Biomechanics of spine
50

Biomechanics of spine is the study of the

consequences of application of external force on the
spine.
Concepts of biomechanics
A scalar quantity has a magnitude only
A vector quantity has both a magnitude and a
direction
Force can be defined as mechanical disturbance or
load
 May deform the object, change its state of motion, or
both June 19/2019
 Biomechanical Concepts
51
Deformations

 Application of force to a rigid

body like the spine results
In deformation
 Translational: change in length
 Rotational : change in the angle
 Strain
Is a measure of the degree of
deformation.
Basic terms---
June 19/2019
 Stress-strain
52
response
 Stiffness
 It is the ratio of force to the
deformation
 Neutral zone
• Displacement beyond the
neutral position due to small
force
 Elastic zone
• Beyond the neutral zone and
up to the physiologic limit
 NZ +EZ=physiologic range

10/04/2020
 Functional biomechanics of the spine
53

Spinal stability

short definition of spinal stability?

Theories of spinal stability:

Two column and three column theories.

June 19/2019
 Theories of spine stability
54

The two column concept:

 Stressed upon the integrity

of PLC in maintaining
stability.

 Unstablefractures involved
disrupted PLC and one
component of anterior
Column
June 19/ 2019
 The three-column concept of spinal stability
55
The spinal column can be divided into three columns:
Injury involving 1 column is stable but more than 1 is
regarded unstable

10/04/2020
 Motion Segment
56

The smallest structure to perform biomechanics of

spine.
Consists of:
 Two vertebral bodies

 IVD
 Ligaments and joints
Movements between adjacent vertebrae are
relatively small.
But the summation of all the small movements
produces a considerable range of movement.
June 19/ 2019
 Spinal motion
57

Degrees of freedom is a
useful concept in the
description

 Six degrees of freedom

 Three translational
 Three rotational, along
three axes

June 19-2019
Facet joints
58

June 19/ 2019

 Facet Joints

Guide and limit inter segmental motion

Orientation of the facet joints is of key importance
for guiding spinal kinematics
Cervical facet→ coronal orientation
Thoracic → intermediate
Lumbar → sagittal
Facet joints

June 19/2019
 Range of Motion
61

Refers to the deformation from one extreme to

the other extreme under the physiologic range of
translation or rotation of an intervertebral joint.
• Is site specific
• Generally decreases with age
• Degeneration will affect ROM

June 19/ 2019

 Flexion/Extension
62

 O-C1,,,,,,,15°
 C1-C5,,,,,,10°
 C5-C7,,,,,,,15°
 T1-T10,,,,,,,5°
 T10-T12,,,,,12°
 L1-L5,,,,,,,,,12-15°
 L5-S1,,,,,,,,,, 20°

June 19/2019
 Lateral Flexion(bending)
63

 O-C1,,,,,,8°
 C1-C2,,,,,0°
 C2-C6,,,,,10°
 C7-L5,,,,,,5-
10°
 L5-S1,,,,,,,3°

June 19/2019
 Rotation
64

 O-C1,,,,,0°
 C1-C2,,,,50-60°
 C2-C7,,,,5-10°
 T1-T9,,,, 9°
 T10-L5,,, 2°
 L5-S1,,,,,, 5°

June 19/2019
 Static Loading
65

 The center of gravity passes ventral to the center of L4 spine.

 Body position affects the magnitude of the loads on the spine.
 Pelvic tilt can alter spine loading.
 A backward tilt of the pelvis results in:-

June 19/2019
 …con’t…
 A forward tilt of increases the sacral angle, accentuating
lumbar lordosis and thoracic kyphosis, and increasing
muscle forces

 Lying<standing<sitting<leaning forward<sitting leaning

forward
 67

 Concentric axial loads cause

equally distributed forces
within the disk.
 Eccentric loads result in
bulging of the annulus on
the side of the applied force
along with associated
displacement of the nucleus
to the opposite side.

June 19/2019
References
68

June 19/2019
 THANK YOU

Questions???...........you are
welcome.