Biomechanic of Spine

Structure of the Spine

a curved stack of 33 vertebrae
structurally divided into five regions:
cervical region - 7 vertebrae
thoracic region - 12 vertebrae
lumbar region - 5 vertebrae
sacrum - 5 fused vertebrae
coccyx - 4 fused vertebrae
Structure of the Spine
Vertebrae
Intervertebral Discs
Annulus fibrosus
Nucleus pulposus

Ligaments
Anterior longitudinal
ligament
Posterior longitudinal
ligament
Supraspinous ligament
Interspinous ligament
Intertransverse
ligaments
Ligamentum Flavum
Facet Capsular Ligament

Structure of the Spine
Spinal Curves
Influenced by heredity, pathological conditions,
individuals mental state, and forces to which the
spine is habitually subjected.
Primary Spinal Curve
Secondary Spinal Curve
Lordosis
Kyphosis
Scoliosis
Loads on the Spine
Forces acting on spine:
Body weight
Tension in the spinal ligaments
Tension in surrounding muscles
Intraabdominal pressure
Any applied external loads
Flexion Relaxation Phenomenon
Body Movement Speed
Cervical Spine
Seven vertebrae
C 1-7
More flexible
Supports the head
Wide range of motion
Rotation to left and right
Flexion
Peripheral nerves
Arms
Shoulder, Chest and diaphragm
Thoracic Spine
Mid-back or dorsal region
Twelve vertebrae
T 1-12
Ribs attached to vertebrae
Relatively immobile
Peripheral nerves
Intercostal
Lumbar Spine
Lower back
Five vertebrae
L 1-5
Carries the the weight of the upper body
Larger, broader
Peripheral nerves
Legs
Pelvis
Sacral and Coccygeal region
Sacrum
Triangular structure
Base of the spine
Connects spine to pelvis
Nerves to pelvic organs
Coccyx
Few small bones
Remnant of tail
Motion Segment
Two adjacent vertebrae
Intervertebral disc
Six degrees of freedom
Flexion-extension
Lateral flexion
Axial rotation
Types of motion
Motion Segment
Motion of Entire Spine
Compressive Strength of Spine
Stress-Strain Curve
Failure Strength of Spinal Ligaments
Weight bearing properties of
motion segment unit
I ntervertebral Disc
Soft fibro-cartilaginous cushions
Between two vertebra
Allows some motion
Serve as shock absorbers
Total 23 discs

th
of the spinal column's length
Avascular
Nutrients diffuse through end plates
I ntervertebral Disc Functions
Movement of fluid within the nucleus
Allows vertebrae to rock back and forth
Flexibility
Act to pad and maintain the space between the
twenty-four movable vertebrae
Act as shock absorbers
Allow extension and flexion
Mechanically:
Annulus fibrous acts like coiled spring
Nucleus pulposus acts like ball bearing

I ntervertebral Disc Anatomy
Spongy center
Nucleus pulposus
Surrounded by a
tougher outer
fibrous ring
Anulus fibrosus
Annulus Fibrosis
Collagen arranged in sheets called lamellae (outer layers).
These lamellae are arranged in concentric rings -10-12
layers that lessen in number with age and thicken
(fibrose).
Enclose the nucleus and oriented in opposite directions at
an angle of 120 degrees (or 45-65 degrees).
Controls the tensile loading from shear, accessory motions
in the anterior compartment and disc forces which can be
up to 5x the external compression force.
Annulus Fibrosis
Mostly avascular and lacking innervation but
the outermost layers are probably innervated
(sinovertebral nerve).
Thickest anteriorly.
Outermost 1/3 connects to vertebral body via
Sharpies fibers.
Outer 2/3 connect to the end plate.
Annulus
In Bending
Increased tensile force posteriorly
Increased compressive force anteriorly
In Rotation
Reorientation of collagenous fibers
Tightening of fibers traveling in one direction
Loosening of fibers traveling in opposite direction
Anulus Fibrosus
Strong radial tirelike structure
Series of lamellae
Concentric sheets of collagen fibers
Connected to end plates
Orientated at various angles
Under compression
Become horizontal
Encloses nucleus pulposus
Disc Structure
Nucleus Pulposus (NP) is located in the center
except in lumbar lies slightly posterior.
Gelatinous mass rich in water binding PG
(proteoglycan) AKA (glycoaminoglycos) GAG-protein
molecule.
Chondrotin-4 sulfate in PG molecule gives the disc a
fluid maintaining capacity (hydrophyllic) - decreases
with age.
Hydration of the disc will also decrease with
compressive loading - this loss of hydration
decreases its mechanical function.
80-90% is H
2
O decreases with age.
Disc volume will reduce 20% daily
(reversible) which causes a loss of 15-25
mm of height in the spinal column.
Acts as a hydrostatic unit allowing for
uniform distribution of pressure throughout
the disc.
Disc Structure
Compressive stresses on the disc translate into
tensile stresses in the annulus fibrosis
This makes the disc stiffer which adds stability and
support to the spine.
Bears weight and guides motion.
Avascular - nutrition diffusion through end-
plate.
Disc Structure
Theory of weight bearing
Nucleus pulpous imbibes water
Develops internal pressure
Pressure exerted in all directions
Lateral forces
Against annulus
Superiorly and inferiorly directed forces
Against end plates
Increases stiffness
Of end plate and annulus fibrosus
Theory of weight bearing (contd)
Mechanical Characteristics
Tensile stiffness of the disc annulus in different directions
Highest along 15
0
Lowest along the disc axis
Strength
Highest Along normal direction of annulus fibers
( 3 times stronger than that along horizontal direction)
Shear & Tensile Characteristics
In direct shear tests
Shear stiffness in horizontal direction
260 N/mm
2
Spine rarely fails in pure shear
Similarly under normal physiologic activities
Pure tensile loading doesnt occur
But annulus undergoes tensile loading during
Bending
Axial rotation
Extension
Loads on the Spine

In normal standing position, body weight acts
anterior to the spine, creating a forward
bending load (moment) on the spine.
Loads on the Spine
Because the spine is
curved, body
weight, acting
vertically, has
components of both
compression (F
c
)
and shear (F
s
) at
most motion
segments.
F
c

F
s

wt
Loads on the Spine
During lifting, both
compression and
anterior shear act on
the spine. Tension in
the spinal ligaments
and muscles
contributes to
compression.
Muscle
tension
Shear
reaction
force
Compression
reaction force
Joint
center
Loads on the Spine
Lumbar hyperextension can create a bending
load (moment) in the posterior direction.
compression
tension
Loads on the Spine
hyperextension
Lumbar hyperextension
produces compressive
loads at the facet joints.
Loads on the Spine
Spinal rotation generates shear stress in the intervertebral discs.
Superior view Lateral view
Types of Segmental Loading
Axial Compression
Bending
Torsion
Shear
Axial Compression
Caused by gravity, ground reaction forces, muscle
contraction and ligaments reaction to tensile forces.
Intradiscal loads can range from 294N to 3332N
depending upon position.
Most load in anterior segment, posterior can load from 0-
30% depending upon segments position.
Compression at the disk causes tension at the annulus,
changing the angle of the fibers and increasing the
stability.
Creep will occur in the disc, will be larger with increased
force and aging.
5-11% of H
2
O is lost through creep.
Creep is rapid 1.5-2mm in 10 min.
Plateaus at 90 minutes.
Bending
Combination of compression, shear and
tensile forces on the segment from
translation.
Bending into flexion will be resisted by
posterior annulus, PLL and the facet capsule
and anterior compressive forces on the
anterior structures causing disc displacement.
For extension posterior compressive forces in
anterior segment and there is a tensile load in
facet capsule and ALL.
Torsion
Caused by axial rotation and coupled motions.
Stiffness may increase due to facet
compression with certain motions i.e., flexion
increases torsional stiffness at L
3-4
.
Annulus fibrosus resists, 1/2 fibers CW other
1/2 CCW facets may help depending upon the
orientation (resists in a tensile manner).
When combined with flexion the amount of
force required for tissue failure is decreased.
Shear
Facet joint resists especially in the lumbar
area.
Annulus will undergo some tensile forces
depending upon direction and the fiber
orientation or angle.
Discs also resist but if creep occurs - the facet
may undergo more loading.
Mobility
Amount and direct of motion in a segment is
determined by:
Vertebral body/disc size.
Facet orientation frontal vs. sagittal.
Flexion
Superior vertebra will anterior tilt and forward
gliding will occur:
Widening the intervertebral foramina 24%.
Adds compressive forces on the anterior aspect of
the anterior segment moving the nucleus pulposus
posteriorly.
Tensile forces placed on posterior annulus,
flavum, capsule and PLL.
Central canal is widened
Extension
Superior vertebra will tilt and glide
posteriorly and the intervertebral foramina
narrowed up to 20%.
The central canal is also narrowed.
Nucleus pulposus moves anteriorly
Lateral Flexion
Superior vertebra will translate, tilt and rotate
over inferior - direction will differ.
Concavity towards, convexity opposite
Tensile forces on convexity, compressive forces
on concavity
Extension in ipsilateral facet.
Flexion in contralateral facet.

Rotation
Accessory motions are like lateral flexion due
to same coupling in cervical and upper
thoracic spine.
Exception with lower T/S and L/S in neutral
coupling then opposite.
If the motion segment is flexed or extended
spine,the coupling will be the same.
Thank You