The  Evolution  of  the  Vertebral  Column:  The  why's  and  how's  of  what  
makes  us  stand  tall  
 
 
Boyana  Grigorova  
Medical  University-­‐  Plovdiv  
Medicine  1st  year  
Group  9  
15687  

 
 
 
 
 

 
 
 
 
 
 
 
 
2    
 
1. Introduction    
 
             Everyday   our   bodies   perform   amazing   movements-­‐   we   run,   walk,   climb   or   simply  
stand   erect,   without   giving   any   of   these   trivial   activities   much   thought.   We   seldom,   if  
ever,   ask   ourselves,   what   makes   it   all   possible?   How   and   why   do   we   stand   tall?   The  
answer  to  these  questions  lies  within  the  remarkably  effective  and  complex  structure  of  
the   human   vertebral   column,   which   not   only   serves   to   protect   the   spinal   cord,   but   to  
also   provide   strength   and   flexibility   to   the   trunk.   The   extraordinary   unison   between  
form   and   function   within   the   structure   of   the   human   vertebral   column   not   only   permits  
it   to   perform   a   variety   of   movements-­‐   flexion,   extension,   lateral   movement,  
circumduction   and   rotation-­‐   but   it   also   facilitates   human   bipedalism.   What   makes   the  
spinal   column   even   more   remarkable   is   its   ability   to   withstand   major   internal   forces  
and   weights   far   exceeding   the   body   weight   of   a   particular   individual.   The   origin   of  
bipedalism   was   a   turning   point   in   hominid   evolution   and   the   importance   of   the  
mechanical   structure   of   the   spine   in   this   process   cannot   be   overemphasized.   The  
modern  anatomy  of  the  spine  has  built  upon  strengths  and  weaknesses  of  a  body  plan,  
inherited   from   our   ancestors,   giving   us   an   efficient   and   graceful   gait,   but   also   a   wide  
range  of  potential  injuries  and  painful  problems.  It  is  therefore  important  to  study  and  
appreciate   the   intricate   structure   and   mechanics   of   the   vertebral   column,   as   well   as  
understand  its  evolution.    
 
2. Macroscopic  anatomy  of  the  vertebrae  and  spine  
 
           The  vertebral  column  physically  supports  the  weight  of  the   head  and  trunk,  allows  
the   movement   of   the   rib   cage   for   respiration,   protects   the   spinal   cord   from   injuries   and  
absorbs   stresses   produced   by   walking,   running   and   lifting.   It   also   provides   an  
attachment   for   the   limbs,   thoracic   cage   and   muscles   and   not   the   least   important,   it  
enables  bipedalism.  The  vertebral  column  is  made  up  of  33  vertebrae,  24  of  which  are  
distinct   and   9   are   fused   to   form   the   sacrum   and   the   coccyx.     The   individual   vertebrae  
are   attached   to   one   another   through   a   system   of   intervertebral   cartilaginous   discs,  
ligaments  and  interlocking  processes.  These  structural  arrangements  allow  for  limited  
movements  of  the  separate  vertebrae,  but  give  extensive  mobility  to  the  spinal  column  
as  a  whole.  When  viewed  from  the  side,  the  vertebral  column  has  four  curvatures.  The  
thoracic  and  sacral  curvatures  develop  during  the  embryonic  and  fetal  periods,  whereas  
the  cervical  and  lumbar  curvatures  develop  after  birth  (Van  de  Graaff  2001).  There  are  
some   typical   abnormalities   of   the   spinal   cord   curvature,   such   as   kyphosis,  lordosis   and  
scoliosis.    

             There  are  five  categories  of  vertebrae:  7  cervical  vertebrae  in  the  neck,  12  thoracic  
vertebrae  in  the  chest,  5  lumbar  vertebrae  in  the  lower  back,  5  sacral  vertebrae  at  the  
base   of   the   spine   and   4   coccygeal   vertebrae.   A   typical   vertebra   consists   of   a   body,   and   a  
vertebral   arch,   which   encircles   the   vertebral   foramen.   Collectively,   all   of   the   vertebral  
foramina   form   the   vertebral   canal,   where   the   spinal   cord   is   situated.   The   arch   has   a  
pedicle   and   a   lamina.   In   addition,   each   vertebra   has   a   spine   (processus   spinalis),   two  
transverse   processes   (processus   transversus),   and   four   articular   facets.   Between   two  
neighboring   vertebral   pedicles,   an   opening   exists,   called   foramen  intervertebrale,  where  
the  segmental  spinal  nerves  pass  through  (Van  de  Graaff  2001).  Some  differences  exist  
in   the   overall   structure   of   the   vertebrae   from   the   five   categories.   Mainly,   the   cervical  
vertebrae   are   the   smallest   and   they   have   unique   characteristics,   which   allow   for   head  
3    
 
movements.   The   atlas   supports   the   skull   and   has   no   body   and   no   spine,   but   is   a  
component  of  the  atlantooccipital  joint  upward,  and  the  atlantoaxial  joint  downwards.  
The  axis  has  a  dens  (a  type  of  process),  which  forms  the  surface  around  which  the  atlas  
rotates.  The  thoracic  vertebrae  have  costal  facets  that  allow  them  to  articulate  with  the  
corresponding   ribs.   Large   sturdy   bodies   and   lack   of   costal   facets   distinguish   the   lumbar  
vertebrae.  Five  fused  sacral  vertebrae  compose  the  sacrum,  which  forms  the  posterior  
part   of   the   pelvis   and   provides   it   with   strength   and   stability.   The   four   coccygeal  
vertebrae  make  up  the  coccyx.  The  various  characteristics  of  the  vertebral  groups  are  an  
important  manifestation  of  the  evolutionary  adaptations  of  the  spinal  column  to  bipedal  
locomotion.    
 

 
 
 
The   vertebrae   are   bound   together   by   fibrocartilaginous   intervertebral   discs,   as  
well  as  several  different  types  of  ligaments.  An  intervertebral  disc  consists  of  a  central  
mucoid   substance,   called   nucleus   pulposus,   and   the   surrounding   fibrocartilaginous  
lamina,   or   annulus  fibrosus.  The   discs   act   as   a   kind   of   cushion,   which   absorbs   shocks,  
caused  by  walking,  jumping  or  walking.  They  also  allow  motion  between  the  vertebrae,  
so   that   a   person   can   bend   forward,   backward   or   from   side   to   side.   The   surgical   removal  
of  any  intervertebral  disk  would  cause  a  decrease  in  the  body’s  flexibility  (Mader  2004).  
4    
 
Ligamentum   longitudinale   anterius   runs   from   the   scull   to   the   sacrum   on   the  
anterior   surface   of   the   disks,   while  ligamentum  longitudinale  posterius  starts   from   the  
clivus   and   interconnects   vertebrae   posteriorly.    
These  ligaments  reinforce  the  linking  between  the   Ligamentum   nuchae   can   be   found  
vertebral   bodies,   and   prevent   excessive   extension   between  the  muscles  on  the  posterior  side  
and   flexion   of   the   vertebral   column,   as   well   as   of   the   neck,   while   ligamenta   interspinalia,  
resist  the  gravitational  pull.  Ligamentum  flavum  is   ligamentum   supraspinale   and   ligamenta  
located   between   the   arches   of   two   adjacent   intertransversalia   connect   neighboring  
vertebrae,   and   its   function   is   not   to   limit   the   processes,   spinal   processes   or   transverse  
forward  flexion  of  the  vertebral  column,  but  rather   processes,   respectively.   Ligamentum  
to   assist   its   extension,   thus   saving   muscle   power.   supraspinale   restricts   the   forward   flexion  
This   ligament   also   function   to   maintain   upright   of   the   vertebral   column,   whereas  
posture  (Baltadjiev  et.al.  2006).     ligamenta   intertransversalia   it’s   bending  
from   side   to   side.   The   articular   facets  
  articulate   vertebrae   with   each   other,  
forming   flat,   semi-­‐mobile   joints,   which  
facilitate   minor   displacements.  
Nonetheless,   when   all   of   these   are  
summed   up,   the   result   is   an   impressive  
mobility  and  agility  of  the  entire  vertebral  
column.   Nodding   and   lateral   flexion   occur  
at   the   atlanto-­‐occipital   joint,   whereas  
rotation  of  the  skull  occurs  at  the  atlanto-­‐
axial   joint.   These   two   joints   represent   a  
complex  system  of  connections  between  os  
occipitale   cranii,   the   atlas   (first   vertebra)  
and   the   axis   (second   vertebra).   The   spine  
ligaments   contribute   to   the   physiological  
motions   of   the   spine   and   provide  
 
structural   stability   by   preventing  
The   spinal   ligaments.   (Adapted  from  Save  Your  Aching   excessive   motions   between   vertebrae   and  
Back  and  Neck:  A  Patient’s  Guide).   protecting  the  spinal  cord  during  trauma.    
   
 
   
3.   Evolution   of   the   vertebral   column   and   bipedalism:   How   and   why   we  
came  to  stand  tall?  
The   transition   to   upright   walking   occurred   in   the   early   stages   of   hominid  
evolution,  when  vast  grasslands  and  savannahs  replaced  the  forests  of  Africa  (about  4.5  
million   years   ago)   (Saladin   2003).   The   now   flat   environment   demanded   that   early  
hominids  be  able  to  stand  up  on  their  hind  legs  so  they  could  look  around  for  potential  
dangers.   Erect   posture   presented   these   early   ground-­‐dwellers   with   yet   one   more  
advantage:   free   forelimbs   to   accomplish   tasks   other   than   walking.   This   transition   to  
bipedal   locomotion   demanded   a   significant   range   of   adaptions   of   the   human   skeleton:  
the  anatomy  of  the  pelvis,  femur,  knee,  great  toe,  arches,  spinal  column,  skull  and  arms  
changed,   while   brain   volume   increased   dramatically.   The   first   bipedal   primates   were  
the   members   of   the   Australopithecus  genus,   which   about   2.5   million   years   ago   gave   rise  
to   Homo   habilis,   the   first   representative   of   its   genus.   However,   it   was   not   until  
5    
 
anthropologists   discovered   a   nearly   complete   Home   erectus   skeleton   in   Kenya,   that  
scientists   saw   skeletal   adaptations   indicating   a   highly   efficient   bipedalism.   The  
“Nariokotome  boy”  had  narrow  hips  and  long-­‐necked  femurs,  which  would  have  helped  
him   maintain   his   balance   and   be   a   very   efficient   walker   and   runner   (Walker   and  
Shipman  1997).  Another  interesting  feature  of  Nariokotome  boy's  anatomy  is  his  inner  
ear,  which   is  more  developed  than   that  of  any  earlier  hominids,  who  had  ape-­‐like  inner  
ears.  This  suggests  that  Homo  erectus  was  a  more  efficient  walker  than  his  predecessors  
because  a  developed  inner  ear  is  necessary  to  sustain  balance  (Spoor  1994).  However,  
the   spine   of   the   Nariokotome   boy   still   contained   an   extra   lumbar   vertebra,   which   is  
representative  of  earlier  hominids,  because  modern  humans  only  have  five  vertebrae  in  
their  lower  backs.  Taken  together,  these  features  of  Nariokotome  boy's  anatomy  show  
that   Homo  erectus  walked   differently   from   earlier   hominids,   but   not   exactly   the   same   as  
modem   humans.   Thus,   Homo   erectus   were   the   first   highly   efficient   bipeds,   and   they  
show   the   gradual   change   that   occurred   in   the   evolution   of   bipedalism.   Homo   habilis  
gave   rise   to   Homo   erectus   about   1.1   million   years   ago,   which   in   turn   led   to   our   own  
species,  Homo  sapiens,  about  300,000  years  ago.    

There  are  a  few  mammals  that  can  stand,  hop  or  walk  briefly  on  their  hind  legs,  
but   humans   are   the   only   species,   which   has   adopted   bipedalism   as   its   exclusive   form   of  
locomotion.   For   example,   chimpanzees   can   sit   upright,   stand   upright,   and   even   walk  
upright,   but   not   for   long,   and   not   very   efficiently.   In   difference   to   humans,   though,  
chimps  cannot  extend  their  legs,  or  lock  them  straight  as  we  can,  and  their  upright  gait  
involves  the  use  of  much  muscle  power,  which  can  be  very  tiring  (Saladin  2003).  Among  
other   adaptations   to   the   human   skeleton,   those   of   the   human   vertebral   column   made  
bipedal   locomotion   possible.   Our   spines   have   a   characteristic   double   curve,   lumbar  
curve  (lordosis),  which  positions  the  head  and  torso  into  a  vertical  line  above  our  feet.  
Thus,   the   body   center   of   gravity   is   shifted   to   the   rear,   above   and   slightly   behind   the   hip  
joint,   which   allows   for   an   easily   accomplished   and   maintained   upright   posture.   The  
sigmoid  (S-­‐)-­‐shaped  spinal  column  allows  for  the  weight  of  the  body  to  be  distributed  in  
such   a   way   that   the   feet   can   carry   it.   Also   important   is   the   fact   that   the   spinal   cord  
enters  the  skull  through  the   foramen   magnum,   situated  near  the  center  of  the  cranium,  
allowing   human   heads   to   balance   easily   atop   our   spines   rather   than   automatically   tilt  
backwards  as  it  is  in  other  primates.  Because  of  these  adaptations,   humans  need  little  
muscular  effect  to  keep  their  balance.    

The   lumbar   spine   has   been   the   focus   of   early   adjustments   to   habitual   bipedal  
locomotion,   as   its   anatomical   structure   is   linked   to   fatigue,   mobility   levels,   and   the  
effectiveness   of   upright   walking   and   standing.   Without   the   lumbar   curve,   our   body  
would   perpetually   lean   forward,   and   much   more   effort   would   be   required   for   us   to  
maintain  bipedal  posture.  Lumbar  column  studies  of  great  apes  indicate  that  they  have  
little   flexibility   to   their   lower   backs.   They   have   a   reduction   of   “free”   lumbar   column,  
decreased   number   of   vertebrae   with   the   lowest   two   vertebrae   entrapped   and   thus  
immobilized  between  the  ilia-­‐  all  factors,  which  lead  to  severely  decreased  plasticity  of  
the  lower  back  (Lovejoy  2004).  On  the  contrary,  the  human  vertebral  column  exhibits  
significant  mobility  compared  to  other  primates,  owing  to  diverse  and  unique  changes  
to   its   anatomy.   Both   human   and   ape   spines   are   shortened.   However,   our   vertebral  
column   still   has   a   greater   overall   length,   and   the   sacrum   and   the   ilium   are   short   and  
broad,   which   eliminates   any   potential   contact   with   the   lower   vertebrae,   allowing   for  
more   flexibility.   In   addition,   hominid   lumbar   vertebrae   also   exhibit   a   posterior  
widening   of   their   laminae   and   the   space   separating   their   articular   processes,   thereby  
6    
 
presumably  facilitating  lordosis  (Fig.  2).    
 

 
 
In   addition   to   changes   in   the   vertebral   column,   numerous   other   adaptations  
occurred   in   the   human   skeletomuscular   system   in   order   to   allow   for   habitual   bipedal  
locomotion.   Anatomically   the   pelvis   evolved   from   a   long,   narrow   structure,   suited   for  
quadruped  motion,  to  the  short,  broad  version  of  the  modern  human.  The  curved  iliac  
blades   of   the   current   pelvis   provide   far   more   stability   and   support   for   the   weight   of   the  
upper   body,   thus   facilitating   upright   walking.   There   were   also   many   changes   in   the   legs  
to  allow  humans  to  walk  bipedally.  Humans  have  straight  toes  that  are  none-­‐opposable  
to  help  propulsion  while  walking.  The  human  calcaneus,   which  bears  the  weight  of  the  
body,   is   very   large.   Apes   are   flat-­‐footed,   but   humans   have   an   arch   to   their   feet,   which  
acts  like  a  spring  that  absorbs  shock  while  the  body  is  moving.  Also,  humans  have  fully  
extendable   legs   due   to   a   lockable   knee   joint,   and   a   natural   knock-­‐kneed   stance,   which  
differs  from  the  chimpanzee  bow-­‐legged  stance  (Nickels  2003).  Additionally,  the  human  
femur  attaches  at  an  inward  angle  to  the  pelvis,  which  makes  the  knees  lie  underneath  
the   body   (Tattersall   and   Schwartz   2001).   As   a   result   of   this   orientation,   humans   can  
stand  upright  for  hours  without  much  energy  expenditure.  
 
Thus,  the  evolution  of  bipedal  locomotion  has  led  to  a  determinate  morphology  
of   the   human   vertebral   column   and   skeleton.   This   includes   lordosis  of   the   lumbar   spine,  
bigger   and   sturdier   lumbar   vertebrae,   a   medulla   spinalis,   which   enters   the   cranium  
more   vertically,   broadened   sacrum   and   ilium,   the   loss   of   a   tail,   the   coming   about   of   a  
lumbar  balance  along  the  hip-­‐knee-­‐ankle-­‐foot  axis,  and  strong  hip  muscles  to  enhance  
stability.    
 
3. Clinical  features  of  the  spine  
Bipedalism  is  marked  by  several  skeletal  changes,  many  of  which  were  adaptive  
compromises,   meaning   they   came   at   certain   costs   to   the   hominids   that   evolved   them.  
These   include   lower   back   problems   due   to   pressures   on   the   spine,   persistent   chronic  
pain  and  debilitating  injuries.  In  the  section  below  I  seek  to  explore  some  of  the  more  
common  affliction  of  the  spinal  column,  their  symptoms  and  potential  treatments.    

Abnormal   spinal   curvature   can   result   from   improper   posture,   paralysis   of   the  
upper-­‐body   muscles,   or   other   diseases.   Most   common   in   the   thoracic   region   is   the  
development   of   scoliosis,   which   results   when   the   body   and   arch   of   a   particular   vertebra  
fail   to   develop   properly.   This   leads   to   lateral   tilting   of   the   body.   If   caught   in   early  
childhood  it  may  be  possible  to  correct  it  with  a  back  brace.    
7    
 

 
Increased   thoracic   curvature   or   kyphosis   could   result   from   osteoporosis,  
spondylomalacia,   spinal   tuberculosis   or   when   a   particular   individual   participates   in  
sports   such   as   weightlifting.   Scheurmann’s   disease   occurs   when   the   front   parts   of   the  
thoracic   vertebrae   do   not   grow   as   fast   as   the   back   parts,   leading   to   kyphosis.   Kyphosis  
(rounding  of  the  back,  or  a  hunchback  posture)  can  result  from  Pott’s  disease  as  well.  In  
this  condition,  called  also  tuberculosis  of  the  spine  or  vertebra,  there  is  a  softening  and  
collapse   of   the   vertebrae,   which   may   result   in   paraplegia,   back   pain,   swelling,   fever,  
cough   and   weight   loss.   On   the   other   hand,   an   exaggerated   lumbar   curvature   is   also  
called   lordosis.   It   may   be   caused   by   the   same   reasons   as   kyphosis,   or   when   the   body  
weight  is  significantly  increased  compared  to  normal  (Saladin  2004).  
Fractures   of   the   spine   are   most   common   at   L1,   L2   and   T12.   This   injury   is  
common   when   a   large   weight   false   on   the   body   or   when   landing   on   your   feet   from   a  
considerable   height.   In   such   an   instance   a   vertebra   may   displace   from   it   proper  
position,   moving   forward   from   its   neighbor.   In   this   case   there   may   be   a   break   in   the  
articular   facets   of   one   or   more   vertebra,   or   rupture   of   the   supporting   ligaments.  
Spondylolisthesis  is  the  forward  displacement  of  one  vertebra  to  the  one  below,  common  
between  the  body  of  L5  and  the  sacrum,  and  often  due  to  underdeveloped  pedicle  of  the  
vertebra   that   got   displaced   (Fig.   3).   Such   an   injury   may   press   on   the   spinal   nerve,  
resulting  in   sciatica   or   low   backache   (Chung   and   Chung   2004).     Spondylitis,  on   the   other  
hand,   is   a   chronic   inflammation   of   the   joints   between   the   vertebrae   and   the   sacroiliac  
region.  It  causes  pain,  stiffness,  swelling  and  limited  motion.  
 

 
 

 One   in   every   1000   babies   is   born   with   spina   bifida-­‐   a   condition,   in   which  
vertebrae   fail   to   form   a   complete   arch   and   enclose   the   spinal   cord   (Fig.   4).   There   are  
8    
 
two  types  of  this  condition  –  spina  bifida  occulta  and  spina  bifida  cystica.  Of  the  two,  the  
first  one  is  less  serious,  as  its  symptom  is  simply  a  tuft  of  hair  above  the  affected  spot.  
However,  spina  bifida  cystica  can  be  very  serious,  as  an  external  sac  is  formed  outside  of  
the  body,  in  which  meninges,  cerebral  fluid  and  parts  of  the  spinal  cord  and  nerves  can  
be  contained.    

   
 

A  baby  with  spina  bifida  should  be  delivered  by  cesarean  section,  as  the  sac  could  
burst   during   passage   through   the   birth   canal,   and   its   content   can   be   damaged.   Pregnant  
women  can  significantly  reduce  their  risk  of  carrying  a  baby  with  spina  bifida  by  taking  
folic  acid  supplements  early  during  pregnancy  (Saladin  2004).  
The  most  common  abnormal  condition  of  the  intervertebral  discs  is  a  herniated  
disk.   This   is   a   protrusion   of   the   nucleus   pulposus   through   the   annulus   fibrosus,   which  
may   rupture   due   to   its   thinner   posterior   part,  into   the   intervertebral   foramen   or   into  
the  vertebral  canal.  The  nerve  root  is  often  compressed,  which  may  lead  to  chronic  pain,  
which  radiates  into  the  buttock  and  lower  limb  (sciatica).  It  mostly  affects  the  lumbar  
region,   where   the   nucleus   pulposus   is   not   supported   by   ligamentum   longitudinalis  
posterior.   Lumbar   spondylosis   is   another   degenerative   joint   disease   associated   with   a  
displacement   of   the   intervertebral   disks   or   the   occurrence   of   bony   outgrowths,   which  
press  upon  the  spinal  nerves  and  cause  sciatica.    
 

 
9    
 
4. Mechanical  and  kinetic  properties  of  the  spine  
 
The   evolution   of   the   spinal   column   from   the   time   of   our   earliest   ancestors   to   the  
modern   human   has   led   to   not   only   a   progressively   more   complex   morphological  
structure,   but   also   to   the   development   of   intricate   motion   patterns   associated   with   it.  
Understanding  the  fundamental  biomechanical  principles  that  guide  spinal  movements  
is   extremely   crucial   when   aiming   to   perform   a   surgical   correction   of   various   spinal  
disorders,   which   are   either   due   to   congenital   or   acquired   pathologies.   Surgeons,   who  
have  deep  understanding  of  these  principles,  are  more  likely  to  understand  the  forces  
that   create   specific   deformities   and   devise   a   successful   scheme   for   their   management.  
Such  medical  procedures  are  vital  to  patients  with  spinal  abnormalities  as  they  can  be  
used  successfully  for  curvature  correction,  prevention  of  further  deformity,  restoration  
of   balance   and   improvement   of   neurological   function   (Schlenk   et.al.   2003).   The  
mechanical  and  kinetic  properties  of  the  spine  are  complex,  as  the  forces  that  act  upon  
its  components  and  on  it  as  a  whole,  affect  it  on  multiple  levels.  The  forces,  applied  to  
the   spine,   can   be   generally   broken   down   into   multiple   vectors   (a   vector   is   a   force  
directed  towards  a  fixed  point  in  space);  however  their  effects  across  the  distinct  spinal  
regions   mostly   follow   a   common   pattern.   Namely,   when   a   load   is   impressed   upon   a  
single  vertebra  or  a  unit  of  vertebrae,  they  respond  by  first  displacing  themselves  from  
their   normal   position   until   resistance   is   encountered.   There   is   an   initial   lax   region   to  
these  motions  and  it  is  termed  a  neutral  zone  (NZ)  (From  Spine   biomechanics;   also  see  
Fig.  5).  The  presence  of  such  a  neutral  zone  is  responsible  for  the  spine’s  capability  to  
perform   relatively   large   motions   without   employing   much   muscular   force.   Following  
the   NZ,   the   motion   reaches   its   limit,   termed   the   elastic   zone   (EZ).   The   magnitude,   to  
which  a  spinal  unit  can  displace  under  maximum  load,  is  called  a  range  of  motion  (ROM).  
Mainly   these   three   parameters   characterize   the   displacement   movements   of   the  
vertebrae.    
 

 
10    
 
Other   kinematic   terms   that   can   be   employed   to   describe   spinal   motions   are  
flexion,  extension,  axial  rotation  and  lateral  bending.  Upon  the  employment  of  targeted  
force   towards   the   vertebral   column,   its   components   not   only   begin   to   displace,   but   they  
also   tend   to   rotate   around   an   axis,   called   the   IAR   or   instantaneous   axis   of   rotation  
(Schlenk   et.al.   2003).   The   IAR   is   the   focal   point   around   which   flexion   and   extension  
transpire.  Six  fundamental  movements  of  the  spinal  column  around  the  IRA  can  occur:  
1)  rotation  or  translation  around  the  long  axis  (A);  2)  rotation  or  translation  around  the  
coronal   axis   (B);   3)   rotation   or   translation   around   the   sagittal   axis   (C)   (Fig.   6   A-­‐C).     The  
IRA   for   any   of   these   types   of   motion   is   confined   to   a   relatively   small   area   within   the  
spinal   unit;   if   this   area   is   enlarged,   that   may   be   a   symptom   for   a   spinal   disorder.   In  
comparison,   ape   vertebral   columns   are   considerably   less   flexible,   as   their   spines   lack  
the   extensive   morphological   changes   that   permit   humans   to   perform   such   a  
comprehensive  range  of  vertebral  movements.  Upon  the  application  of  an  external  force,  
the  spinal  column  undergoes  a  rotational  deformation  at  an  angle  in  relation  to  either  
the  coronal,  sagittal  or  long  axis.  

 
When  there  is  translational  deformation,  it  can  occur  along  any  axis.  Changes  in  
the  normal  motion  patterns  of  the  spine  under  external  or  internal  stresses  may  be  also  
an  indication  of  abnormality.  Spinal  deformities  can  be  separated  into  three  categories:  
1)   coronal   plane   2)   sagittal   plane   3)   axial   plane   (Schlenk   et.al.   2003).   Usually,   the  
application  of  excessive  force  or  other  stressors  upon  an  already  damaged  spine,  leads  
to  abnormalities.  Various  activities  of  daily  living,  which  put  in   vivo   loads  on  the  spine,  
can  be  the  cause  of  spinal  deformities  as  well,  because  some  behaviors  may  put  as  much  
as  2,270  N  of  force  upon  a  spinal  unit,  
which  amazingly  can  exceed  50  times  
the   body   part   weight   above   the   joint  
of  interest  (From  Spine  biomechanics).  
Spinal   deformities   can   be   corrected  
surgically   by   means   of   various  
implants   such   as   stabilizing  
constructs,   the   cross-­‐rod   technique  
for  correction  of  lumbar  and  thoracic  
kyphotic   deformities,   a   crossed-­‐
screw   fixation   technique   to   fix  
sagittal   and   coronal   plane  
abnormalities,   in   vivo   implant  
contouring   to   alter   segmental  
 
11    
 
relationships,   spinal   derotation   to   alter   a   scoliotic   to   kyphotic   curve,   etc.   (Fig.   7).  
Naturally,   the   above-­‐mentioned   surgical   procedures   comprise   only   a   few   of   the  
established  techniques,  currently  employed  for  the  correction  of  vertebral  deformities.  
These  methods  can  be  varied  upon  as  seen  necessary  by  the  surgeon,  in  order  to  adapt  
them  to  the  specificities  of  the  various  spinal  regions,  which  have              unique  anatomical  
and  biomechanical  properties.    
The   biomechanical   properties   of   the   modern   human   spine   are   determined   not  
only   by   the   specific   morphological   characteristics   of   the   vertebrae,   but   by   the   unique  
features  of  the  spine  ligaments  and  the  intervertebral  discs  as  well.  The  discs  normally  
have   a   very   high   water   content-­‐   up   to   90%   of   their   volume-­‐   and   this   is   what   largely  
guides  their  biomechanical  properties  (from  Spine  Biomechanics).  As  force  is  applied  to  
a  disc,  the  water  within  starts  to  diffuse  slowly  throughout  the  disc  layers,  affecting  its  
relaxation   times   (the   time   it   takes   the   disc   to   return   to   its   initial   state   after   a  
disturbance).  Loss  of  moisture  causes  disc  degeneration,  thus  increasing  its  relaxation  
time  and  reducing  the  mobility  of  the  spine.    It  is  also  important  to  note  that  one  of  the  
reasons   the   human   spine   loses   much   of   its   elasticity   with   age   is   that   the   spinal   discs’  
water   content   decreases   to   74%   and   less   of   their   total   volume.   dIn   general,   the   inner  
portion   of   the   disc,   the   nucleus   puposus,   is   made   up   of   collagen   type   II,   while   the  
concentric  annulus  fibrosus  is  comprised  exclusively  of  type  I  collagen.  With  age,  these  
proportions   change   and   collagen   type   III   appears,   also   causing   the   discs   to   lose   some   of  
their  flexibility  and  sturdiness.    
 
5. Conclusion  
 
The  exact  period  when  our  ancestors  started  walking  on  two  feet  is  still  largely  
debatable,   but   it   is   universally   accepted   that   bipedalism   evolved   relatively   early   in  
human   history,   presumably   about   3.5   -­‐   4   million   years   ago.   One   of   the   earliest  
structures   to   adapt   to   a   habitually   upright   posture   was   the   human   spine.   Some   of   the  
vertebral  column  changes  included  a  lengthening  of  the  lumbar  spine,  the  appearance  of  
a  uniquely  human  spinal  curvature,  the  positioning  of  the  foramen  magnum  below  the  
skull,   which   is   supported   by   the   spine,   the   larger   surface   area   of   the   vertebrae,   which  
consequently   acquired   more   weight   bearing   capacity   than   those   of   our   ancestors,   etc.  
Bipedal   stance   must   have   provided   early   hominids   with   certain   benefits,   or   else   it  
would   not   have   evolved.   What   these   benefits   were,   remains   largely   a   mystery,   but  
among  them  freeing  of  the  hands  to  carry  food  items,  more  efficient  walking  over  long  
distances   or   spotting   predators   have   been   considered.   Most   importantly,   though,   the  
evolution   of   bipedalism   and   all   the   various   skeletal   adaptations   associated   with   it   set  
the   stage   for   advanced   tool   use   and   increased   brain   size   in   humans.   Today,   the  
adaptations   of   the   human   spine   have   allowed   us   to   forever   separate   ourselves   from   our  
primate  cousins;  nonetheless,  deformities  of  the  spine  can  be  the  curse  of  many  people’s  
existence.    It  is  therefore  essential  to  study  and  understand  the  evolution  of  the  spine,  
and  to  come  up  with  approaches  to  use  its  unique  adaptations  solely  to  our  benefit.    
 

 
 
12    
 
Bibliography  
 

Baltadjiev  G.,  Atanasova  P.,  Koeva  I.,  Sivkov  S.  (2006).  Human  anatomy,  third  edition.  
Raikov-­‐Medical  Publishing  House.    
Chung  K.  and  Chung  H.  Gross  anatomy,  sixth  edition.  Wolter  Kluwer:  Lippinctott,  
Williams  and  Wilkins.    
Lovejoy  C.O.  (2005).  The  natural  history  of  human  gait  and  posture  Part  1.  Spine  and  
pelvis.  Gait  and  Posture  21:  95-­‐112.  
Mader,  S.S.  (2004).  Understanding  human  anatomy  and  physiology,  sixth  edition.  The  
McGraw-­‐Hill  Companies.    
Nickels,  M.  (2003).  Humans  and  Chimpanzees  Compared.  Illinois  Wesleyan  University,  
Bloomington,IL.    
Saladin.  (2003).  Anatomy  and  physiology:  The  unity  of  form  and  function,  third  edition.  
The  McGraw-­‐Hill  Companies.  
Schlenk  R.,  Kowalski  R.,  Benzel  C.E.  (2003).  Biomechanics  of  spinal  deformity:  Spinal  
deformities.  Neurosurgery  Focus  14:1.      
Schwartz,  J.  &  Tattersall,  I.  (2001).  Extinct  humans.  Colorado:  Westview  Press.  
Spoor,  F.,  Wood,  8.,  and  F.  Zonneveld.  (1994).  Implications  of  early  hominid  
labyrinthine  morphology  for  evolution  of  human  bipedal  locomotion,  Nature,  369,  
645-­‐648.  

Van  De  Graaff,  MP.  (2001).  Human  anatomy,  sixth  edition.  The  McGraw-­‐Hill  Companies.  
Walker,  A.  and  Shipman,  P.  (1997).  The  wisdom  of  the  bones.  New  York:  Vintage.