Biomechanics

of
the Spine
 Vertebral Column
• Complex structure
• Base of support
• Link between upper and lower
extremities
• Transfer load from head trunk to the
pelvis
• Protects spinal cord
• Stability vs. mobility
 General Motion Segment
• Functional Spinal Unit
– 2 adjacent vertebrae & intervening soft tissue
– Divided into 2 aspects
• Anterior aspect
• Posterior aspect
 General Motion Segment

Transverse Process
Vertebra
Spinous Process

Cortical Shell Pedicle

Facet Joint
Endplate
Disc
Cancellous or
Trabecular Bone

Nucleus Pulposus Annulus Fibrosus

Anterior Aspect of Spinal Column
• Vertebral body
• Primary load-transmitting element, 80-
90%
• Increasing size from C to L spine
• Compressive load> pressure higher in
center of end plates than periphery
• In vivo, filled with blood> greater
strength, hydraulic shock absorber
• Weaker anterior trabeculae, Wolff’s law
Posterior Aspect of Spinal Column

• Pedicles, lamina, facet joints, spinous &

transverse processes
• Bony processes
– Lengthen moment arms of muscles
• Forces on processes
– Transmitted to Lamina
• Forces on posterior aspects
– Transmitted to vertebral bodies from Pedicles
Posterior Aspect of Spinal Column
• Pars Interarticularis
– Large bending forces; excessive extension
– Thicker than rest of lamina
• Facet Joints
– Major role in controlling motion
– Resist torsion & shear, role in compression
– Load sharing varies with flexion & extension
– Capsules lax, allow gliding
 Facet Joint
• Articulation
between the
superior and
inferior facets
• Guide
intervertebral
motion through
their orientation in
the transverse and
frontal planes
 Facet Joint Capsule
• Limit motions
• Strongest in thoracolumbar and
cervicothoracic regions where the
curvatures change
• Resist flexion and undertake tensile
loading in the superior portion with axial
loading or extension.
• Resists rotation in lumbar region
 Function of the Facet Joints

• Limit the range of motion in the different

regions of the spine
• To assist in load bearing, sustaining up to
30% of the compressive load on the spine,
particularly when the spine is in
hyperextension
 Facets
• Change orientation
– From Cervical to
Lumbar regions
• Articular joints
– Allow smooth
articulations between
vertebrae
• Resist motion
– Through bony
interactions
– Aided by ligaments
 Intervebral Foramina
• Exit for nerve root.
• The size is dictated by
the disc heights and
the pedicle shape.
• Decreases by 20%
with extension and
increases 24% with
flexion
Spinal Ligaments
• Anterior Longitudinal
• Posterior Longitudinal
• Ligamentum Flavum
• Interspinous
Ligaments
• Supraspinous
Ligaments
• Intertransverse
Ligaments
 Spinal Ligaments
• Limit motion, provide stability/equilibrium
• Anterior longitudinal ligament
– Interlinked to disks
– Resists extension
– 2X tensile strength of Posterior longitudinal
ligament
• Posterior longitudinal ligament
– Narrow over vertebral bodies
– Resists flexion
 Spinal Ligaments
• Ligamentum Flavum
– Elastic & strong
– “shingled” configuration with laminae
– Lengthen w/ flexion, shorten w/ extension
• Interspinous & Supraspinous
– Resist flexion
– Long moment arms
• Intertransverse Ligaments
– Resist lateral flexion
 Motion Segment Studies
• 6 degrees of freedom
– Translation & Rotation
– 3 orthogonal planes
– Motion usually coupled
• Center of gravity
– In front of 2nd sacral segment
 Intervertebral Disc
• Make up 20-30% of
the height of the
column
• thickness varies from
– 3mm in cervical region
– 5mm in thoracic region
– 9 mm in the lumbar
region
• Total – 23 discs
• ¼ th of the spinal
column's length
 Intervertebral Disc
• Ratio between the vertebral body height
and the disk height will dictate the
mobility between the vertebra
– Highest ratio in cervical region allows for
motion
– Lowest ratio in thoracic region limits motion
• Avascular
• Nutrients diffuse through end plates
 Intervertebral Disc
• Spongy center
– Nucleus pulposus
• Surrounded by a
tougher outer fibrous
ring
– Anulus fibrosus
 Nucleus Pulposus
• Is located in the center
– Except in lumbar lies slightly posterior
• 80-90% is H2O
– decreases with age
• Disc volume will reduce 20% daily
(reversible)
– Causes a loss of 15-25 mm of height in the
spinal column
 Annulus Fibrosus
• Mostly avascular
• Thickest anteriorly
• Outermost 1/3 connects to vertebral body
• Outer 2/3 connect to the end plate
• Collagen arranged in sheets called
lamellae (outer layers).
– arranged in concentric rings -10-12 layers that
lessen in number with age and thicken
Intervertebral 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
 Theory of weight bearing
• 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
 Types of Loading
• Axial Compression
– Caused by gravity,
ground reaction
forces, muscle
contraction and
ligaments reaction to
tensile forces
 Types of Loading
• Axial Compression
– Causes tension at the annulus, changing the
angle of the fibers and increasing the stability
– Most load in anterior segment
– Posterior segment can load from 0-30%
depending upon segments position
 Types of Loading
• Bending
– Combination of
compression, shear
and tensile forces on
the segment from
translation
 Types of Loading
• Torsion
– Caused by axial
rotation and coupled
motions
– Annulus fibrosus
resists, 1/2 fibers CW
other 1/2 CCW in a
tensile manner
– facets resist depending
upon the orientation
 Types of Loading
• Shear
– Annulus will undergo
some tensile forces
depending upon
direction and the fiber
orientation or angle
 Intradiscal Pressure
• Disk pressure is usually uniform
• Pressure lowest in supine position
• Compressive loads in vivo: 500N standing,
700N sitting
• Increased to 3000 to 6000N during lifting
of moderate weights, decreases with load
closer to body
Mechanical Characteristics

Tensile stiffness of the disc annulus in different directions

Highest along – 150
Lowest along – the disc axis
Mechanical Characteristics

Highest – Along normal direction of annulus fibers

( 3 times stronger than that along horizontal direction)
Theory of weight bearing
 Spinal Discs under Various
Loads

Normal Additional Uneven Torsion

Load Load Load Load
 Spinal Movement
• Spinal movement is the combination of
– Intervertebral joints
– Facet joints
 Back Flexion
• Superior vertebra will anterior tilt and
forward gliding
– Widen the intervertebral foramina 24%.
– Add compressive forces on the anterior aspect
of the anterior segment
– Move the nucleus pulposus posteriorly
– Tensile forces will be placed on posterior
segment
– Central canal is widened
 Back Extension
• Superior vertebra will tilt and glide
posteriorly
– The intervertebral foramina narrowed up to
20%
– The central canal is narrowed
– Nucleus pulposus moves anteriorly
 Back Lateral Flexion
• Superior vertebra will
translate, tilt and rotate over
inferior in different direction
– 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 (in most
references)
 The Spinal Column
• A curved stack of 33
vertebrae
structurally divided
into five regions:
– Cervical region; 7
vertebrae
 The Spinal Column
• A curved stack of 33
vertebrae structurally
divided into five
regions:
– Thoracic region;
12 vertebrae
 The Spinal Column
• A curved stack of 33
vertebrae structurally
divided into five
regions:
– Lumbar region;
5 vertebrae
 The Spinal Column
• A curved stack of 33
vertebrae structurally
divided into five
regions:
– Sacrum; 5 fused
vertebrae
– Coccyx - 4 fused
vertebrae
 Spinal Curvatures
• Prior to birth “C-shaped”
• There are 4 distinct curves in an adult
– Primary spinal curves
– Secondary spinal curves
 Primary Spinal Curves

• The thoracic and sacral curves

• Concave anteriorly

• Are present at birth

 Secondary Spinal Curves

• The lumbar and cervical curves

• Concave posteriorly

• Develop from supporting the body in an

upright position after young children

begin to sit and stand

 Secondary Spinal Curves
• In the sagittal plane
– ‘S’ shape
• As a small child
– When starts to sit
– Cervical lordosis
• Toddler and adult
– When starts to stand
– Lumbar lordosis
– Allows spring-like action