Digitally signed by Dr Adel Bondok

DN: cn=Dr Adel Bondok gn=Dr Adel Bondok c=Egypt l=EG o=Mansoura University

Dr Adel Bondok ou=Faculty of Medicine e=adelbondok@mans.edu.eg

Reason: I am the author of this document
Location: Faculty of Medicine, Mansoura University, Egypt
Date: 2020-02-15 20:36+02:00

Dr Adel Bondok 1 VERTEBRAL CANAL

m

VERTEBRAL COLUMN: 33 vertebrae.

CURVES OF THE VERTEBRAL COLUMN:
2 main curves
1. Primary Curves:
 They are present during fetal life and at birth.
 They persist as the thoracic and pelvic curves.
 Are convex posteriorly
2. Secondary Curves:
 they are compensatory curves and are
developed after birth.
 They form the cervical and lumbar curves.
 Are convex anteriorly

Therefore, there are 4 curves: 2 primary and 2 secondary. From above downward:
1. The Cervical Curve:
 Is a secondary curve that appears after birth.
 Is convex forward and is the least marked of all the curves.
 It appears at the 3rd month when the child raises his head.
2. The Thoracic Curve:
 Is a primary curve (kyphotic curve) that appears at birth.
 Is concave forward.
3. The Lumbar Curve:
 Is a secondary curve (lordotic curve ) that appears after birth.
 Is convex forward and is more marked in the female than in the male.
 It appears at the 9th-18th month when the child sits upright and begins to walk.
4. The Pelvic (Sacral) Curve:
 Is a primary curve that appears at birth.
 Is concave forward (follows the concavity of the sacrum).

VERTEBRAL (SPINAL) CANAL

 Is the space between the bodies and the

vertebral arches of the vertebrae.
 Contents: it contains:
1. The spinal cord till L1/L2.
2. Cauda equina below L1/L2.
3. The meninges.
4. Internal vertebral venous plexus.
5. Epidural fat.
Dr Adel Bondok 2 VERTEBRAL CANAL

Protection: the canal is protected by the:

1. Ligamentum flavum posteriorly
2. Posterior longitudinal ligament anteriorly.
Meningeal Spaces in the Canal:
The dura, arachnoid & pia mater divide the spinal canal into 3 spaces:
1. The epidural space: outside the dura. It contains:
a. Epidural fat
b. Internal vertebral venous plexus.
2. The subdural space: potential space between the dura and arachnoid.
3. The subarachnoid space: between the arachnoid and pia mater. It contains:
a. Cerebrospinal fluid.
b. Spinal arteries: the anterior spinal artery and the 2 posterior spinal arteries.
c. Corresponding spinal veins.
d. Nerve roots.

ABNORMALITIES OF THE VERTEBRAL CANAL

1. Spina bifida:
 Is defect in the vertebral arches of the vertebrae (absent spine).
 Protrusion of the spinal meninges through the defect forms meningocele
 Protrusion of the spinal cord and the meninges forms meningomyelocele.
 Spina bifida is most common in the lumbosacral region, but it may occur in
the thoracic or cervical region.
2. Vertebral canal stenosis (narrowing): causing spinal cord compression.
3. Abnormal curvatures:
a. Kyphosis:
 Is an exaggerated kyphotic (posterior) curvature in the thoracic region.
 It is commonly observed in osteoporosis.
b. Lordosis:
 Is an exaggerated lordotic (anterior) curvature of the lumbar region.
 Temporary lordosis is common in pregnant women.
c. Scoliosis:
 Is lateral curvature of the vertebral column.
 Is the most common abnormal curvature (in 0.5% of the population).
 It is more common among females
 May result from unequal growth of the two sides of 1 or more vertebrae.
Dr Adel Bondok 3 VERTEBRAL CANAL
Blood Supply of the Vertebral Column & Spinal Cord
Arteries Supplying the Vertebral Column and Spinal Cord:
1. One anterior spinal artery: by union of 2 branches from the vertebral arteries.
2. 2 Posterior spinal arteries: each arises from the vertebral artery or the PICA.
3. Radicular arteries:
a. In the neck: from the Vertebral artery and Ascending cervical artery
b. In the thorax: from the posterior intercostal arteries (thoracic aorta).
c. Lumbar region: from the lumbar arteries (abdominal aorta).
d. Sacrum and Coccyx: from the Median sacral & Lateral sacral arteries
Veins Draining the Vertebral Column and Spinal Cord:
Into the internal and external vertebral venous plexus which drain into the:
1. Vertebral vein: in the neck
2. Posterior intercostal veins and azygos vein: in the thorax.
3. Lumbar veins and sacral veins: Sacrum and Coccyx
INTERVERTEBRAL DISC
Position: between the vertebral bodies and are fused with them.
Structure: the intervertebral disc consists of 2 parts:
1. An outer fibrous ring: annulus fibrosus: formed of tight collagen fibers
connecting the adjacent vertebrae
2. Spongy center: nucleus pulposus: consists of 80% water. It is the remains
of the notochord.
.
Function: spongy center absorbs shocks and pressures exerted upon the vertebrae
Changes in the water content:
 Compression forces on the vertebrae during movements force the water to go
out of the intervertebral disc, making it thinner.
 When the pressure is relieved, for example during sleep, the disc takes up
water again and becomes thicker.
 This mechanism explains why a person’s height may vary by 1-2 cm in the
course of a day depending on load and strain on the spine.
Aging: aging process ( water content, thinner, less elastic, bone-on-bone friction):
1. Decrease in water content..
2. Disc becomes thinner: causes the adjacent vertebrae to move closer together.
3. The intervertebral disc becomes less elastic: liable to tear
4. Bone-on-bone frictions: lead to formation of osteophytes (new bone).
Blood Supply: Via diffusion
 The intervertebral disc doesn't contain blood vessels after the fourth year of
life, and is supplied with nutrients via diffusion.
 Diffusion takes place from the bone marrow of the vertebral bodies.