Cervical Spine

Cervical Spine
• Purpose
• Support head
• Shock absorption
• Allow large degree of
flexibility and ROM
• Allow passage of
nerves, vasculature, etc
 Cervical Spine
• CO - occipital
• C1 - Atlas
• C2 - Axis
• C3-6 - general basic
structure
• C7
 Cervical Spine
• C1 - no body, disk
and spinous
process
• Allows for free
space
• Large neutral zone
and cord
protection
• More motion
 Cervical Spine
• Approximately 50% of flexion/extension
or nodding occurs at occiput-C1
• Minimal to no lateral flexion/rotation

Occipital condyles

Foramen magnum
 Cervical Spine
• The Axis (C2)
• The dens, or
odontoid process
– is cradled in the
anterior arch of the
atlas
– is a pivot for the
rotation of the atlas
 Cervical Spine
anterior view

• C1-C2 segment
– The primary
motion at the C1-C2
joint is rotation
• Account for up to
posterior view
50% of rotation in
the neck and most
of the initial ROM
 Cervical Spine
• C2-7
– Facet orientation is
roughly 45 degrees
in the transverse
plane
– Allows for motion
in all planes
– More rotation and
lateral flexion than
other regions
•45 degrees （ transverse plane)
•0 degree (frontal plane)
Cervical Spine
• Cervical lordosis
1 C0-C7 averages 40°
2
– Most of the lordosis
3
occurs at the C1-C2
4
5 segment
6
7
Thoracic Spine
Thoracic Spine
Thoracic Spine
• 12 Thoracic
vertebrae: T1-T12
• Articulate with
ribcage
 Thoracic Spine
• The vertebral body equals width and depth.
• The ratio of disc diameter to height is
highest
– Decrease tensile forces
– Decrease possibility of disc injury
• Posterior aspect becomes thicker and more
compressive forces
• End-plates become larger (higher
compressive forces)
 Thoracic Spine
• Joints of
Thoracic Spine
– Costovertebral
Joint
– Costotransverse
Joint
• Flexion and
extension
limited
 Thoracic Spine
• Less flexible due to rib articulation
• Upper thoracic spine facet orientation
– Limits flexion extension
– 60 transverse/20 frontal
• Facets are more sagittal in T9-12 to allow
flex/ext and rot of spinous process will be
toward concavity (lumbar coupling)
• 60 degrees （ transverse plane)
• 20 degrees (frontal plane)
 Ribcage
• Spine, ribs and sternum
form a closed, cylindrical
cavity
• Protects internal organs
• Resists displacement
• Adds strength and stiffness
– Moment of inertia increased
to resist rotational motions
 Thoracic Spine
• Increased stiffness over osteoligamentous
spine in four major physiologic directions
• Increased axial stability over
osteoligamentous spine by 4x
• Decreased flexibility in traction over a
scoliotic spine
Lumbar Spine
Lumbar Spine
 Lumbar Spine
• Most load bearing
structures in the
skeletal system
• Largest body/disc,
lamina and
pedicles short and
thick for load
bearing
 Lumbar Spine
• L5 transitional, wedge shape of body and
disc – Anterior > posterior.
• L5-S1 most flexion extension.
• Coupling of motion - right lateral flexion
will result in right sidebend and left
rotation of vertebral body
 Lumbar Spine
Motion Segment D Left Side View
isc
L1

L2

L3

Sagittal View

L4

L5

http://www.spineuniverse.com/displayarticle.php/article65.ht
•90 degrees （ transverse plane)
•45 degrees (frontal plane)
 Lumbar Spine
• Lumbar lordosis
L1-S1 ranges
from 30°–80°
1
– The apex of
2
lumbar lordosis
3
L3-L4
4

5
Movement of the Spine
 Muscles of the Spine
• Superficial group
– Erector Spinae consists of 3 columns
– Extend from the vertebrae to the ribs
– Produce extension of the spine
 Muscles of the Spine
• Deep group
– Interspinales, multifidus, rotatores,
semispinalis, splenius
– Extend from one vertebra to another
– Extend and rotate the spine
Several factors influence
the loads on the spine

• The position of the object

• The size, shape, weight, and density
• The degree of flexion or rotation of
the spine
• The rate of motion
Loading of the spine during
standing
• The line of gravity of passes ventral to the
fourth lumbar vertebral body
• Forward-bending moment
– Counterbalanced by ligament forces and
erector spinal muscle
– The erector spinae muscles ,the abdominal
muscles are often intermittently active
 Static loads on the lumbar
spine during lifting
• The highest loads on the spine are
generally produced by external loads
• Holding the object close to the body
instead of away from it reduces the
bending moment the lever arm is
minimized
Line of Gravity
 Exaggerated spinal curves

• Lordosis - exaggerated lumbar curve

• Kyphosis - exaggerated thoracic curve

• Scoliosis - lateral spinal curvature

 Abdominal Muscles
• Rectus abdominis
• Internal obliques
• External obliques
rectus abdominis

external obliques
Internal obliques