Vertebral Column

Osteology and Arthrology

Osteology
 7 C, 12 T, 5 L, 5 S (Fused as Sacrum), 4
coccygeal
 Primary Curves
 Secondary Curves
 Anterior/Posterior alignment
Primary Curve
Vertebral Segments
A-P View
Secondary Curves Lateral
Vertebral Column
Osteology
 Typical Vertebrae
 Body
• Superior and inferior surfaces of body (plateaus)
• Thickened around the rim, location of epiphyseal plates
• Cartilaginous end-plates
 Vertebral Arch
• Pedicles, Laminae
• Transverse Processes
• Spinous Process
• Facets – superior articular and inferior articular
 Spinal Foramen
 Intervertebral Foramen
Typical Vertebrae
Typical Vertebrae
Typical Lumbar
Typical Thoracic
Typical C
Sacrum and Coccyx
Vertebral Relationships
Arthrology
 Intervertebral Discs
 Fibrocartilaginous joints
 Increase in size from C to L (3mm to 9
mm)
 Ratio remains the same
 Make up 20-30% of length of column
Intervertebal Discs
Discs
Discs
Arthrology
 Two Components
 Outer rim of fibrocartilage called the
anulus fibrosus (attaches to cartilaginous
end plate)
 Connects vertebral bodies in a
fibrocartilaginous joint (no capsule, little
motion)
Arthrology
 Anulus encloses a central mass called
the nucleus pulposus
 About 80-90% water, less with increased
age
 Contains a mucopolysaccharide matrix
 Changes shape, releases and absorbs
water. Thicker in AM than PM
 Neither blood vessels or nerves
penetrate nucleus
Arthrology
 Structure deforms when pressure is put on
vertebral column as in weight bearing
 Acts as a shock absorber
 Annulus totally encloses the nucleus and
keeps it under constant pressure
 As you get older, the H2O content decreases
and the nucleus becomes more
fibrocartilaginous, therefore less easily
deformable and more easily damaged
Arthrology
 Nucleus, when under extreme pressure, can
herniate or extrude from the disc in a posterior
or posterior-lateral direction
 Usually occurs in cervical or lumbar region
 Nucleus can put pressure on spinal nerve
causing refereed symptoms (motor and
sensory)
 Can cause pressure on cord itself if true
posterior
Vertebral Relationships
Facet Joints (C and T)
Arthrology
 Facet Joints (Typical)
 Superior articular facets of one vertebrae with
inferior facets of vertebrae above
 Synovial gliding joints
 Surrounded by joint capsule and small
capsular ligaments
 The type and amount of motion in any given
part of the spine is dictated by the orientation
of the articular facets as well as the fluidity,
elasticity and thickness of the intervertebral
discs
Facets L
Arthrology
 Typical movements in sections of the
spine
 Lumbar
 Thoracic
 Cervical
Major Ligaments of the Spine
 Anterior Longitudinal Ligament - ALL
 Dense band along anterior and lateral surface
of the vertebral bodies from C2 to sacrum
• Superficial - bridge several vertebrae
• Deep – short, run from V to V, blends with fibers of
anulus fibrosus
• Limits extension of V column
 From C1 to skull, called Atlanto-Occipital
Membrane
ALL
Atlanto-Occipital Membrane
A and P Longitudinal Ligament
Major Ligaments
 Posterior Longitudinal Ligament
• Runs along posterior surface of vertebral
bodies (anterior to spinal canal)
• C2 to Sacrum
• Short fibers attach ligament to posterior disc,
reinforce disc posteriorly
 Superiorly, continues to occiput, called
Tectorial Membrane
 Limits flexion
PLL
Tectorial Membrane
Ligaments
 Supraspinous
• Spinous process to spinous process – tip to
tip
• C7 to sacrum
 Limits flexion
 In cervical region, becomes much thicker
with a greater elastic content
 Called Ligamentum Nuchae
Supraspinous
Ligamentum Nuchae
Ligaments
 Interspinous
 Found between spinous processes
 Most well developed in lumbar region
 support
Interspinous
Interspinous
Ligaments
 Ligamentum Flavum
 Connects lamina of one to lamina of the
other
 Found from axis to sacrum
 Limit flexion
 Continuation to the skull is called
Posterior Atlanto-Occipital
membrane
Ligamentum Flavum
Atlanto-Occipital Membrane-
Posterior
Ligaments
 Intertransverse
 Only well-developed in Lumbar Region
 Between transverse processes
 Limit lateral flexion
Special Joints of Spine
 Lumbo-Sacral
• L5 and S1 (or sacrum)
• Drastic change from lordotic to kyphotic curve
• Strong “shearing forces”
• The sacral segment is inclined anteriorly and inferiorly
forms an angel with the horizontal called the lumbo-
sacral angle
 Angle can be increased significantly with an
increase in lumbar curve
 During flexion/extension the greatest mobility
of the spine occurs between L5 and S1
Lumbo-Sacral Jt.
L5/S1
L5/S1
 Spondylolysis – a developmental
anomaly of the lamina wherin a bony
defect separates the sup. and inf.
Articular processes thus separating the
post. Part of the neural arch from the
ant. Arch and the vertebral body
 Usually asymptomatic, very common in
males
S and S
L5/S1
 Spondylolistheses – an anterior
movement of the L5 vertebral body and
can cause compression of the cauda
equina which rests posteriorly
Sacralization
 Where 5th lumbar vertebrae takes on
characteristics of the sacrum and may
be partially or completely fused with
sacrum
Lumbarization
 Superior aspect of the sacrum assumes
characteristics of the 5th lumbar
vertebrae
S-I Joint
 Review Hip Bone AKA Innominate AKA
Os Coxae
 Ilium, Ischium and Pubis
 Fuse at Puberty
 Acetabulum
 Pelvis = 2 coxal bones the sacrum and
coccyx
Innominate Bone AKA Hip
Sacrum
Pelvis
Female Pelvis
S-I
 Auricular surface of ilium with auricular
surface of sacrum-Little movement
 Joint under relatively constant pressure
to rotate anteriorly based on anatomical
design
 Upper part of joint is not synovial, is
fibrous held in place by tough
Interrosseous S-I ligaments – helps limit
anterior motion
S-I Joint
S-I Joint
S-I Joint
S-I – Synovial Aspect of Joint
 Major Ligaments – mostly designed to prevent ant.
motion
 Posterior S-I – runs down and medially from ilium to
sacrum
 Iliolumbar – L4 and 5 transverse processes to
posterior iliac crest
 Anterior S-I – ilium to sacrum
 Sacrotuberous – iliac tuberosity and post. Surface
of lower sacrum to ischial tuberosity
 Sacrospinous – lateral borders of lower sacrum and
coccyx to attach to the spine of ischium
S-I Joint
S-I Joint
Pubic Symphysis
 Anterior connection of pelvis
 Fibrocartilaginous joint
 Limited motion
 Motion increase dramatically during
pregnancy, especially at the time of birth
 Similar increase in SI joint mobility at this
time
 Superior and Inferior Pubic Ligaments
Pubic Symphysis
Atlanto-Axial Joint
 Atlas and Axis
 Pivot
 Two convex superior facets of axis with two
concave inferior facets of the atlas
 Atlas also posses a facet on the internal
surface of the anterior arch which articulates
with the dens of the axis
 Major ligaments from spine support – Ant.
Atlanto-Occipital, Tectorial Membrane,
Post. A-O
C1/C2
C1/C2
C1/C2
A-A Joint
 Alar – from dens to occiput
 Transverse - around dens
 Cruciate
• Sup. Longitudinal Band
• Inferior Longitudinal Band
• Transverse
Atlanto-Occipital Joint
 Two concave superior facets of atlas
articulate with two convex surfaces of
occipital condyles of the skull
 Supported by major ligaments
 Small saddle joint
 Very limited motion – nodding type
motions in all directions.
Atlanto-Occipital
Atlanto-Occipital