ANATOMY OF COLUMNA

VERTEBRALIS
DAN VERTEBRAE

DR. INDRI SETA SEPTADINA, M. KES

BAGIAN ANATOMI FAKULTAS KEDOKTERAN
UNIVERSITAS SRIWIJAYA PALEMBANG
COLUMNA VERTEBRALIS
• Composed of 33
vertebrae
• 7 cervical
• 12 thoracic
• 5 lumbar
• 5 sacral + 4
coccyx (fused)
• Act to support the trunk
and transfer muscular
load 2
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THE SPINE - VERTEBRAE

• Vertebrae
• Irregular bone
• Anterior elements - Vertebral body
Thin cortical shell (<1mm) surrounding trabecular
centrum
• Posterior elements
- Cortical and lamellar bone
- Superior and inferior articular processes
- Spinosus process
- Transverse processes
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TYPICAL VERTEBRAE

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REGIONAL CHARACTERISTICS OF VERTEBRAE
CERVICAL
• Body
Small, wide side to side
• Spinous process
Short, bifid, projects posteriorly
• Vertebral foramina
Triangular
• Transverse processes
Contain foramina
• Superior & inferior articulating processes
Superior facets directed superoposteriorly
Inferior facets directed inferoanteriorly
• Movement allowed
Flexion, extension, lateral flexion, rotation
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REGIONAL CHARACTERISTICS OF VERTEBRAE
THORACIC
• Body
Larger than cervical,heart shaped,bears two
costal demifacets
• Spinous process
Long, sharp, projects inferiorly
• Vertebral foramen
Circular
• Transverse processes
Bear facets for ribs (Except T11&T12)
• Superior & inferior articulating processes
Superior facets directed posteriorly
Inferior facets directed anteriorly
• Movement allowed
Rotation, lateral flexion possible but limited
by ribs, flexion & extension prevented
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REGIONAL CHARACTERISTICS OF VERTEBRAE
LUMBAR
• Body
Massive, kidney shaped
• Spinous process
Short, blunt, projects posteriorly
• Vertebral foramen
Triangular
• Transverse processes
Thin & tapered
• Superior & inferior articulating processes
Superior facets directed posteromedially (or
medially)
Inferior facets directed anterolaterally (or
laterally)
• Movement allowed
Flexion & extension ; some lateral flexion,
rotation prevented
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REGIONAL CHARACTERISTICS OF VERTEBRAE
SACRUM

• Composed of five fused sacral vertebrae

• Inferior half of the sacrum is not weightbearing
• Provide strength & stability to the pelvis and
transmits the weight of the body to the pelvic
girdle
• Sacral canal contains nerve root of the cauda
equina
• The sacrum is tilted so that articulates with L5
vertebrae at the lumbosacral angle which varies
from 130-160o
• Pelvic surface is smooth & concave
• Dorsal surface is rough & convex
• Sacral hiatus results from the absence of the
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laminae & spinous process of S5 vertebrae
REGIONAL CHARACTERISTICS OF VERTEBRAE
COCCYX

• Formed by four rudimentary

vertebrae
• Remnant of the sceleton of
the tail
• Pelvic surface is concave &
smooth
• Dorsal surface is convex &
rough

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ABNORMAL FUSION OF VERTEBRAE

• Approximately 5% of people, L5 vertebrae partly or

completely incorporated into the sacrum
(hemisacralization & sacralization of L5 vertebrae)
• In other people, S1 vertebrae separated from the
sacrum & partly or completely fused with L5 vertebrae
(lumbarization of S1 vertebrae)
• When L5 is sacralized, the L5/S1 level is strong & the
L4//L5 level degenerates producing painful symptoms

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JOINTS OF THE SPINE

• Atlanto-occipital joints
• Atlantoaxial joints
• Costovertebral joints
• Joints of the vertebral bodies (intervertebral [IV] discs)
• Joints of the vertebral arches (zygapophysial joints/facet joints)
• Sacroiliac joints

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INTERVERTEBRAL DISC
• Notochord & mesenchym derivates
• Intervertebral disc - comprised of three parts :
• nucleus pulposus
• annulus fibrosus
• hyaline cartilage end plates
( Williams,1989 ; White III & Pamjabi, 1990 ; Holm,1990 ; Willis & Burton,1992)

• Acts as a thick-walled cylinder to distribute load, support stability &

flexibility of the spine
• A pair of vertebral bodies with the intervening disc is called
• Motion segmen
• Functional unit

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INTERVERTEBRAL DISCS

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ANNULUS FIBROSUS

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NUCLEUS PULPOSUS

• More cartilagineous than fibrous and normally highly elastic

• 30-50% of IV Disc volume
• Located more posteriorly than centrally because the lamellae of AF are
thinner and less numerous posteriorly than anteriorly or laterally
• Has a high content of water (70-90%) that is maximal at birth and
decreases wiith advancing age
• Acts like a shock absorber for axial forces and like semifluid ball bearing
during flexion, extension, rotation and lateral flexion of the spine
• NP is avascular and receives nourishment by diffusion from blood vessels
at the periphery of AF and vertebral body
• NP having no nerves, so it is insensitive

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DISC PROBLEMS

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DISC PROBLEMS

Disc degeneration

Disc herniation

Different Entity : - Disc Herniation 18

- Disc Degeneration
DISC DEGENERATION

• Initial degeneration in the human spinal column

occurs in the NP

• Characterized by a gradual loss of chondroitin sulfate

and water content loss of turgor and resilience

• With increasing age AF gradually loses some of its

elasticity, particularly posteriorly where it is relatively
thin more easilly separated or even torn NP
protude or herniate - site of weakness in the AF

• Second site of weakness is the thin cartilage end

plate through which nuclear material may protrude
into the underlying cancellous bone of the vertebral
body and thereby form a Schmorl’s node

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FACET JOINTS

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 LIGAMENTS OF THE SPINE

• Connected between adjacent

vertebrae along length of spine
• Act to limit excessive motion
• Anterior and posterior
longitudinal ligaments
• Ligamentum flavum
• Inter- and supraspinosus
ligaments
• Intertransverse ligaments
• Facet joint capsules
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LIGAMENTS OF THE SPINE
Anterior longitudinale ligaments
• covers and connects the anterolateral aspects of
the vertebral bodies and IV discs
• ultimate load of 340 N
• strongly attached to the the vertebral bodies
but loosely attached to AF
• maintains stability of the joints between the
vertebral bodies and help prevent hyperextension
of the spine
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LIGAMENTS OF THE SPINE

Posterior longitudinale ligaments

• runs within the vertebra canal along the posterior
aspects of the vertebral bodies
• ultimate load of 180 N
• strongly attached to the AF and the posterior
edges of the vertebral bodies
• helps prevent hyperflexion of the spine and
posterior protrusion of the discs
• provided with nociceptive (pain) nerve endings
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SPINE MUSCULATURE
• Muscle of the spine are part of
the trunk musculature
• Three groups of muscles in the
back : superficial, intermediate,
and deep group
• Deep / intrinsic back muscles are
grouped according to their
relationship to the surface :
superficial, intermediate, and
deep layer
• Muscle injury generally occurs
during forcible lengthening
while the muscle is activated
(contracting)
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SPRAINS AND STRAINS

• Result from excessive physical demands on the back

• Lifting something too heavy, sudden fall, car crash or sport injury can
cause soft tissues (ligaments, muscles and tendons) to stretch too much
• The ligaments, muscles and tendon work together to handle the external
forces the spine encounters during movement (bending, forward and
lifting)
• Sprains and strains are similar disorders affecting different soft tissues in
the spine
• Sprains are limited to the ligaments
• Strains affects muscles, tendons and muscle-tendon combinations

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