ANATOMY OF LUMBAR

SPINE

DR. ABDUL RASHAD

SENIOR LECTURER
DPT,MPHILL(OPT) ,MPPTA, MMTC (NZ),
MSTC(AUS), IASTM(GREECE)
UNITED COLLEGE OF PHYSICAL THERAPY
• Osteology
• Articulations
• Ligaments
• Muscles
• Blood supply
• Nerve supply

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 • 33 vertebrae
• 23 intervertebral disks

• Primary curves
• Secondary curves

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• Body
– Massive
– Transverse diameter > anterior diameter & height
– Supports compressive loads

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• Pedicles : short and thick and project posterolaterally
• Laminae : short and broad
• Transverse Process : long, slender; extends
horizontally

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• Accessory processes : small, irregular bony
prominences, located on posterior surface of
transverse process near its attachment to the pedicle

• Attachment sites for multifidus

• Spinous process : broad, thick, extends horizontally

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• Mamillary processes : located on posterior edge of
each superior zygapophyseal facet
• Attachment sites for multifidus

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• Zygapophyseal Articular Processes (facets):
superior and inferior; vary in shape and orientation

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• Vertebral foramen : triangular, larger than
thoracic vertebral foramen but smaller than
cervical vertebral foramen

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• Fifth lumbar vertebra is a transitional vertebra:
wedge- shaped body
• Superior diskal surface area 5% greater
• Inferior diskal surface are a smaller
• Spinous process is smaller, transverse processes are
large and directed superiorly and posteriorly.

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Intervertebral Disks
• Largest
• Collagen fibers of anulus fibrosus are arranged in
sheets: lamellae
• Concentric rings surrounding nucleus

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• Resist tensile forces in nearly all directions

• Shape of each disk is not purely elliptical but

concave posteriorly

• Provides greater cross-sectional area of anulus

fibrosus posteriorly and hence increased ability to
resist tension that occurs with forward bending

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ARTICULATIONS
1. Interbody Joints
• Capable of translations and tilts in all
directions
2. Zygapophyseal articulation
• True synovial joints
• Fibroadipose meniscoid structures

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 • Facet joint capsule restrains axial rotation
• Resistance to anterior shear

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3. Lumbosacral articulation
• 5th lumbar vertebra and 1st sacral segment.
• 1st sacral segment is inclined slightly anteriorly and
inferiorly, forms an angle with horizontal:
lumbosacral angle

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• Increase in angle : increase in lumbar lordosis
• Increase shearing stress at lumbosacral joint

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LIGAMENTS

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 Supraspinous ligament
• Well developed only in upper lumbar region
• Most common termination site - L4
• May terminate at L3
 Intertransverse ligaments are not true ligaments
in lumbar area and are replaced by the iliolumbar
ligament at L4
 Interspinous ligament has least overall stiffness and
joint capsules the highest

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Anterior longitudinal ligament
is strong and well developed in
this region
Posterior Longitudinal
Ligament
is only a thin ribbon in lumbar
region, whereas ligamentum flavum
is thickened here

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 Iliolumbar Ligaments
• Series of bands extend from tips and borders of transverse
processes of L4 and L5 to attach bilaterally on iliac crests
of pelvis
• 3 bands: ventral / anterior
dorsal/posterior
sacral

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 Ligaments Function
Anterior longitudinal lig Limits extension

Posterior longitudinal lig Limits forward flexion

Ligamentum flavum Limits forward flexion

Supraspinous ligament Limits forward

Interspinous ligaments flexion

Intertransverse ligaments Limit forward flexion

Limit contralateral lateral

Iliolumbar ligament
flexion
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Muscles of lower spine region serve roles of :
• Producing and controlling movement of trunk
• Stabilizing trunk for motion of lower extremities
• Assist in attenuating extensive forces that affect this
area
POSTERIOR MUSCLES
3 layers: superficial
Intermediate
Deep

1. Thoracolumbar fascia
• Most superficial structure
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3 layers: posterior, middle, and anterior
• Posterior layer : large, thick arises from spinous
processes and supraspinous ligaments of the
thoracic, lumbar, and sacral spines.

• Gives rise to latissimus dorsi cranially, travels caudally

to sacrum and ilium, and blends with fascia of
contralateral gluteus maximus

• Also gives rise to internal and external

abdominal oblique, and transversus
abdominis
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• Anterior layer : passive part - transmits tension
produced by contraction of hip extensors to
spinous processes

• Posterior layer : active part - activated by a

contraction of transversus abdominis muscle

• Tension on TLF will produce a force that exerts

compression of abdominal contents – external corset

• Compress lumbosacral region and impart stability

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 2. Erector spinae
• Iliocostalis,
longissimus
spinalis

• Each
having
lumbar
portion
(pars
lumborum)
and
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thoracic
3. Multifidus
• Not truly transverso spinales in lumbar region
• Run from dorsal sacrum and ilium in region of PSIS
to spinous processes of lumbar vertebrae
• Line of pull in lumbar region is more vertical
• Greater cross sectional area
• Produce lumbar extension
• Add compressive loads
to posterior aspect of
inter body joints.

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LATERAL MUSCLES

1. Quadratus lumborum
• Deep to erector spinae and multifidus
• Acting bilaterally:frontal plane stabilizer
• Also stabilization in horizontal plane
• Acting unilaterally, laterally flex
spine and control rotational motion

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• If lateral flexion occurs from erect standing,
force of gravity will continue motion, and
contralateral quadratus lumborum will control
movement by contracting eccentrically.

• If the pelvis is free to move, quadratus

lumborum will “hike the hip” or laterally tilt
pelvis in frontal plane

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ANTERIOR MUSCLES
1. Rectus abdominis
• Prime flexor of trunk
• Contained within abdominal fascia;
separates rectus abdominis into sections and
attaches it to aponeurosis of abdominal wall.
• Abdominal fascia also has attachment to
aponeurosis of pectoralis major.
• These fascial connections transmit forces
across midline and around trunk.
• Provide stability in a corset type of manner
around trunk. 31
2. Abdominal wall
• External oblique, internal oblique, transversus
abdominis muscles
• Forms “hoop” with TLF posteriorly
• Stability to lumbo-pelvic region

3. Psoas major
• Runs from lumbar transverse processes, ant erolateral
vertebral bodies of T12 to L4, lumbar intervertebral disks
to lesser trochanter of femur
• Distal tendon merges with that of iliacus.

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• Spinal cord ends at approximately L1–L2
• Bundle of spinal nerves extends downward:
cauda equina
The Lumbar Plexus
• Formed by T12–L5nerve roots
• Supplies anterior and medial muscles of
thigh region
• Posterior branches of L2–L4nerve roots
form femoral nerve - Quadriceps
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• Anterior branches form obturator nerve,
innervating adductor muscle group

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• Four paired lumbar arteries that
arise directly from posterior aspect of aorta
• Venous system is valve less, draining internal and
external venous systems into the inferior
venacava

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• Sinu vertebral nerve - major
sensory nerve.
• Innervates : posterior longitudinal
ligament, superficial layer of
annulus fibrosus, blood vessels of
epidural space, anterior but not
posterior dural space(posterior
dura is devoid of nerve endings),
dural sleeves surrounding spinal
nerve roots,and posterior vertebral
periosteum.
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Lumbar Range of Motion

Flexion: 50
Extension: 15
Axial rotation: 5
Lateral flexion:
20

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