Thoracic & Lumbar Spine (Back)

1. Pot B1
a. Secondary cartilaginous (symphysis)
Midline
Sandwich of hyaline cartilage bread with fibrocartilage filling
Annulus fibrosus & nucleus pulposus
Notochord
Apical ligament of dens
Anterior & posterior longitudinal ligaments
Lumbar
Higher forces
Thoracic is even, lumbar wedge shaped
Causes lumbar lordosis
Posterolaterally
Weakest point, poor coverage by PLL
Lumbosacral
Highest forces
Nucleus pulposus absorbs water lost during the day due to gravity

b. Pedicles & laminae

Spinous, transverse & articular processes
Intervertebral foramina
Anterior & posterior nerve roots (with ganglion), dural sleeve, recurrent meningeal nerve,
radicular vessels,
Oblique area of bone between base of superior & base of inferior articular processes
Potential weak point of arch; if bilateral, will allow spondylolisthesis
Fracture or congenital weakness

c. Synovial
Thoracic (curved) coronal & lumbar sagittal
Allows thoracic rotation & increased lumbar flexion
Ligamentum flavum, interspinous, intertransverse, supraspinous ligaments

d. Epidural space (fat, internal vertebral venous plexus, recurrent meningeal nerve branches),
dura, potential subdural space, arachnoid, subarachnoid space (CSF), pia
L1/2
Must do lumbar puncture well below this
L3/4
Line joining tops of iliac crests is L4
L4/5
Tapering of spinal cord at L1/2
The subarachnoid space below L1/2 that contains the cauda equina
S2
S2 (as filum terminale)
Anterior & posterior spinal arteries
Vertebral arteries (usually)
Posterior from posterior inferior cerebellar artery
By posterior intercostal & lumbar arteries
Artery of Adamkiewicz
T9-L2

2. Pot B2
a. To laminae
Anterior surface of lamina above, posterior surface of lamina below
Yellow elastic tissue

3. Pot T21
a. Extrinsic layer 1, Extrinsic layer 2, Extrinsic layer 3
Intrinsic layer 1 (long), Intrinsic layer 2 (oblique), Intrinsic layer 3 (short)
Or
Superficial – extrinsic 1, extrinsic 2
Intermediate – extrinsic 3
Deep – intrinsic 1 (long), intrinsic 2 (oblique), intrinsic 3 (short)
E1 – Trapezius, latissimus dorsi, E2 – rhomboids, levator scapulae, E3 – Serratus posterior, I1 –
Erector spinae (long), I2 – Tranversospinales (oblique), I3 – short
Thoracolumbar fascia
Dorsal rami
They migrated from the upper limb

4. Pot A13
a. Lordosis.
Cervical spine
Kyphosis
Thoracic & sacral spine
Scoliosis
No-where, it is always abnormal