GENERAL SPINE

SEGMENTS OF SPINE
 CURVES

 Kyphotic curves
 Curves that have a posterior convexity (anterior concavity)

 Lordotic curves
 Curves that have an anterior convexity (posterior concavity)
 CURVES

 Primary curves
 Thoracic and sacral
 Retain the original posterior convexity
throughout life

 Secondary curves
 Cervical and lumbar
 Show a reversal of the original posterior
convexity .
 Secondary or lordotic curves develop as a
result of the accommodation of the
skeleton to the upright posture
 IMPORTANCE OF CURVE

 Primary and secondary curve is able to resist much higher compressive

loads.
 According to kapandji
 A spinal column with the normal lumbar, thoracic, and cervical curves
has a 10-fold ability to resist axial compression in comparison with a
straight rod.
 MOBILE SEGMENTS OF SPINE

 Smallest functional unit in the spine is the mobile segment that is :

 Any two adjacent vertebrae
 Intervening intervertebral disk
 All the soft tissues that secure them together
 TYPICAL VERTEBRA

 Consists of two major parts:

 Anterior
 Posterior
 TYPICAL VERTEBRA

 Anterior: (vertebral body)

 It is the weight-bearing structure of the spinal column

 Block like shape with generally flat surfaces
 Vertebral body is not a solid block of bone
 Consist of shell of cortical bone, surrounding a
cancellous cavity.
 TYPICAL VERTEBRA

 Posterior: (posterior elements )

 pedicles
 Laminae
 Articular processes
 Spinous process
 Transverse processes
 TYPICAL VERTEBRA

 Posterior : (pedicles )
 Serve as the connection between the posterior elements and the vertebral
bodies.
 Transmit tension and bending forces from the posterior elements to the
vertebral bodies.
 Short, stout pillars with thick walls
 Increase in size from the cervical to lumbar regions
 Greater forces are transmitted through the pedicles in the lumbar region
 TYPICAL VERTEBRA

Laminae
 Transmit forces from the posterior elements to the pedicles and, through
them, onto the vertebral body.
 This force transfer occurs through a region of the laminae called the pars
interarticularis.
 TYPICAL VERTEBRA

 Posterior :

 Spinous and transverse process

 Sites for muscle attachments
 Serve to increase the lever arm for the muscles of the
vertebral column

 Articular processes
 Consist of two superior and two inferior facets for
articulation with facets from the cranial and caudal
vertebrae, respectively.
 TRABECULAR SYSTEM

 It is a system of lines found within the spongy

bone
 Develops in response to the stresses placed on
the vertebral bodies and the neural arch
 The vertical systems within the body help to
sustain the body weight and resist compression
forces
 There are also fan-shaped trabeculae introduced
into the vertebral body at the area of the pedicle
in response to bending and shearing forces
transmitted through this region.
 INTERVERTEBRAL DISC

 It separate two vertebral bodies and transmit load from one

vertebral body to the next.
 increasing available motion,
 Size of the intervertebral disk is related to both
 Amount of motion
 Magnitude of the loads that must be transmitted.
 The intervertebral disks
 Make up about 20% to 33% (1/3) of the length of the vertebral
column
 Increase in size from the cervical to the lumbar regions.
 Disk thickness varies
 Approximately 3 mm in the cervical region,
▪ Where the weight-bearing loads are the lowest
 About 9 mm in the lumbar region,
▪ Where the weight-bearing loads are the greatest
 INTERVERTEBRAL DISC

 The greater the ratio, the greater the mobility

 Ratio is greatest in the cervical region and lumber region
 Ratio is smallest in the thoracic region.

 Greater functional needs for mobility found:

 Cervical and lumbar regions
 stability in the thoracic region.
 ARTICULATIONS

 Articulations found in the vertebral column:

 Cartilaginous joints of the symphysis:
 Between the vertebral bodies, with the
interposed disks,
 Diarthrodial, or synovial, joints:
 Between the zygophyseal joint

 The joints between the vertebral bodies are referred

to as the interbody joints.
 The joints between the zygapophyseal facets are
called the zygapophyseal (apophyseal or facet)
joints
 ARTICULATIONS

 The joints between the vertebral bodies are referred to as the interbody joints.
 Available movements at the interbody joints
 Gliding
 Distraction
 Compression
 Rotation (also called tilt or rocking in the spine)
 Gliding motions can occur in the following directions:
 Anterior to posterior
 Medial to lateral
 Torsional.
 Tilt motions can occur in
 Anterior to posterior and in lateral directions.
 INTERBODY JOINTS

Interbody joints
• Translations and rotations of one vertebra in relation to an adjacent vertebra.
A. Side-to-side translation (gliding) occurs in the frontal plane.
B. Superior and inferior translation (axial distraction and compression) occur vertically.
C. Anteroposterior translation occurs in the sagittal plane.
D. Side-to-side rotation (tilting) in a frontal plane occurs around an anteroposterior axis.
E. Rotation occurs in the transverse plane around a vertical axis.
F. Anteroposterior rotation (tilting) occurs in the sagittal plane around a frontal axis.
 ZYGOPHYSEAL JOINTS

Zygapophyseal articulations
 The zygapophyseal joints are composed of the articulations between the
 Right and left superior articulating facets of a vertebra and
 Right and left inferior facets of the adjacent cranial vertebra.
 The zygapophyseal joints are diarthrodial joints and have regional variations in
structure.
 Intra-articular accessory joint structures in the zygapophyseal joints
 Adipose tissue pads & fibroadipose meniscoids.
▪ Protect articular surfaces that are exposed during flexion and extension of
the vertebral column
LIGAMENTS AND JOINT CAPSULE
 LIGAMENTS

 The ligamentous system of the vertebral column is extensive and exhibits

considerable regional variability.
 Six main ligaments are associated with the intervertebral and zygapophyseal
joints.

1. Anterior longitudinal ligament

2. Posterior longitudinal ligament
3. Ligamentum flavum
4. Interspinous ligament
5. Supraspinous ligament
6. Intertransverse ligaments
 LIGAMENTS

 Anterior longitudinal ligaments

 Well developed in the (cervical and lumbar)
 Little substance in the (thoracic) region

 The tensile strength of the ligament is greatest at:

 The high cervical
 Lower thoracic
 greatest strength in the lumbar region.
 LIGAMENTS

 Anterior longitudinal ligaments

 It is compressed in flexion and stretched in extension
 It may become slack in the neutral position of the spine
 It is reported to be twice as strong as the PLL.
 LIGAMENTS

 Posterior longitudinal ligaments

 PLL’s resistance to axial tension in the lumbar area.
 It is stretched in flexion
 slack in extension
 LIGAMENTS

 Ligamentum flavum
 Thick, elastic ligament

 Strongest in the lower thoracic region

 Weakest in the midcervical region.
 Highest strain during flexion when the ligament is
stretched
 LIGAMENTS

 Interspinous ligaments
 The interspinous ligament, along with the supraspinous ligament, is the
first to be damaged with excessive flexion
 Contribute to lumbar spine stability
 Degenerate with aging
 LIGAMENTS

 Supraspinous ligament
 The supraspinous ligament, is stretched in flexion.
 During hyper flexion, this ligament is the first to fail
 LIGAMENT

 Intertransverse ligaments
 The ligaments are alternately stretched and
compressed during lateral bending.
 During lateral bending to the left
 The ligaments on the right side are stretched and
offer resistance
 The ligaments on the left side are slack and
compressed during this motion.
 During lateral bending to the right
 The ligaments on the left side are stretched and
offer resistance to this motion
 CAPSULE

 Zygapophyseal joint capsules

 Assist the ligaments in providing limitation to motion
 provide stability to the vertebral column.
 The capsules are strongest in the thoracolumbar region
and at the cervicothoracic region
KINETICS OF VERTEBRAL COLUMN

( COMPRESSION, BENDING ,
TORSION AND SHEAR)
 KINETICS

 Vertebral column is subjected to

 Axial compression
 Tension
 Bending
 Torsion
 Shear stress
 During normal functional activities & also at rest

 Vertebral column’s ability to resist these loads depends on:

▪ Type, duration, and rate of loading
▪ Person’s age and posture
▪ Condition and properties of the various structural elements
▪ Vertebral bodies, joints, disks, muscles, joint capsules & ligaments
▪ Integrity of the nervous system
 AXIAL COMPRESSION

 Force acting through the long axis of the spine

 Occurs as a result of the
 Force of gravity
 Ground reaction forces
 Forces produced by the ligaments and muscular
contractions

 The disks and vertebral bodies resist most of the

compressive force, but the neural arches and
zygapophyseal joints share some of the load in
certain postures and during specific motions.
 AXIAL COMPRESSION

 Compressive load is transmitted

 From the superior end plate to the inferior end plate
 Through the trabecular bone of the vertebral body & the cortical shell

 Before the age of 40 years

 Cancellous body contributes 25% to 55% of the strength of a lumbar
vertebra

 After age 40 years

 Cortical bone carries a greater proportion of the load
▪ Trabecular bone’s compressive strength and stiffness decrease with
decreasing bone density
▪ Zygapophyseal joints carry from 0% to 33% of the compression load.
 AXIAL COMPRESSION

 The end plates are able to undergo the least deformation and therefore will be
the first to fail (fracture)
 Under high compressive loading. The disks will be the last to fail (rupture).
 The intervertebral disks (like all viscoelastic materials) Exhibit creep.
 This phenomenon produces typical diurnal changes in disk composition and
function.
 BENDING

 Bending causes both compression and tension on the

structures of the spine.

 In forward flexion,
 The anterior structures (anterior portion of the disk,
anterior ligaments, and muscles) are subjected to
compression;
 The posterior structures are subjected to tension.
 BENDING

 when the vertebral column is subjected to sustained loading, such

as occur in
 Fully flexed postures (gardening)
 Fully extended postures (painting the ceiling)

 The resulting deformation (elongation or compression) of

supporting structures
▪ Such as ligaments, joint capsules, and intervertebral disks
 Leads to an increase in the ROM beyond normal limits, and
places the vertebral structures at risk of injury.
 BENDING

 In extension,
 The posterior structures are unloaded or
subjected to compression,
 The anterior structures are subjected to tension.
 BENDING

 In lateral bending
 The ipsilateral side of the disk is
compressed;
 In right lateral bending
 The right side of the disk is compressed
 The outer fibers of the left side of the disk
are stretched.

 Contralateral fibers of the outer anulus

fibrosus and the contralateral
intertransverse ligament
 Help to provide stability during lateral
bending by resisting extremes of motion.
 TORSION

 Torsional forces are created during axial

rotation that occurs as a part of the coupled
motions that take place in the spine.

 The torsional stiffness

 In flexion and lateral bending of the upper
thoracic region from T1 to T6 are similar,
 increases from T7/T8 to L3/L4.
 is provided by the outer layers of both the
vertebral bodies and intervertebral disks

 The outer shell of cortical bone reinforces the

trabecular bone and provides resistance to
torsion.
 TORSION

 When the disk is subjected to torsion

 half of the anulus fibrosus fibers resist clockwise
rotations,
whereas fibers oriented in the opposite direction
resist counterclockwise rotations.

 It has been suggested that the anulus fibrosus may be

the most effective structure in the lumbar region for
resisting torsion

 The risk of rupture of the disk fibers is increased

when torsion, heavy axial compression, and bending
are combined.
 SHEAR

 Shear forces act on the midplane of the disk and

tend to cause each vertebra to undergo translation
 Move anteriorly, posteriorly, or from side to side
in relation to the inferior vertebra
 In the lumbar spine,
 Zygapophyseal joints resist some of the shear
force, and the
 Disks resist the remainder.
 When the load is sustained,
 Disks exhibit creep
 Zygapophyseal joints may have to resist all of
the shear force.
KINEMATICS OF VERTEBRAL COLUMN
 KINEMATICS

 The motions available to the column as a whole are:

 Flexion and extension
 Lateral flexion
 Rotation.

 These motions appear to occur independently of each other

 At the level of the individual motion segment,
 These motions are often coupled motions.
 KINEMATICS

 Coupling motion:
 Is defined as the consistent association of one motion about an axis with
another motion around a different axis.
 The most predominant motions that exhibit coupled behaviors are
 Lateral flexion and rotation.
 Pure lateral flexion and pure rotation do not occur in any region of the
spine.
 KINEMATICS

 Coupling patterns, as well as the types and amounts of

motion that are available are:
 Complex,
 Differ from region to region
 Depend on the
▪ Spinal posture, curves,
▪ Orientation of the articulating facets,
▪ Fluidity, elasticity, and thickness of the intervertebral
disks
▪ Extensibility of the muscles, ligaments, and joint
capsules
MUSCLE ACTIVITY
 ROLE OF GLOBAL AND CORE MUSCLE
ACTIVITY

 superficial (global) muscle

 Deep (core) muscles
 Function to maintain the upright posture.
 GLOBAL MUSCLE

 Global muscles
 Being multisegmental, are the large guy wires
that respond to external loads imposed on the
trunk that shift the center of mass (fig. A).
 Unable to stabilize individual spinal segments
except through compressive loading because
they have little or no direct attachment to the
vertebrae.
 If an individual segment is unstable,
compressive loading from the global guy
wires may lead to place stress on the inert
tissues at the end of the range of that segment
(fig's).
 Core muscle
 Core muscles
 Have segmental attachments, respond
regardless of direction of motion.
 Provide dynamic support to individual
segments in the spine and help maintain each
segment in a stable position so the inert tissues
are not stressed at the limits of motion.
 Both the global and core musculature play critical
roles in providing stability to the multisegmental
spine.
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