ENT 214

Biomechanics

Biomechanics of Human Spine

Picture retrieved from
http://en.wikipedia.org/wiki/Image:Spinal_column_curvature.png
 Structure of the Spine

What is the vertebral column?

 a curved stack of 33 vertebrae
structurally divided into five regions:
 cervical region - 7 vertebrae
 thoracic region - 12 vertebrae
 lumbar region - 5 vertebrae
 sacrum - 5 fused vertebrae
 coccyx - 4 fused vertebrae
Picture retrieved from
http://www.becomehealthynow.com/images/organs/spine/ant_lat.jpg
 Structure of the Spine

What is a motion segment?

 two adjacent vertebrae and the
associated soft tissues
 considered the functional unit of the
spine
 Structure of the Spine
Transverse
process Posterior
Interspinous longitudinal
ligament Anterior
ligament
Supraspinous longitudinal
ligament ligament
Vertebral
Cartilaginous
body
Intervertebral end-plate
joint and facet Intervertebral
Spinous disc
process Intervertebral
Ligamentum foramen with
flavum Vertebral nerve root
canal
Posterior Anterior

Two adjacent vertebrae and the associated

tissues comprise the motion segment.
 Structure of the Spine

What are the joints between adjacent

vertebrae?
 intervertebral symphysis joints on the
anterior side
 two gliding diarthrodial facet joints on
the posterior side
 Structure of the Spine

What is the function of the facet joints?

 to channel and limit the range of
motion in the different regions of the
spine
 to assist in load bearing, sustaining
up to 30% of the compressive load on
the spine, particularly when the spine
is in hyperextension
 Structure of the Spine

What are the intervertebral discs?

 fibrocartilaginous discs that cushion the
anterior spinal symphysis joints

 composed of a nucleus pulposus (colloidal

gel with a high fluid content) surrounded by
the annulus fibrosus (a thick,
fibrocartilaginous ring that forms the disk
exterior)
 Picture retrieved from
http://upload.wikimedia.org/wikipedia/commons/e/e9/ACDF_oblique_annotated_english.png

Cervical
Vertebra
 Structure of the Spine

What are the primary spinal curves?

 the thoracic and sacral curves

 concave anteriorly
 are present at birth
Thoracic
Vertebra

Picture retrieved from

http://upload.wikimedia.org/wikipedia/commons/d/d2/Gray90.png
 Structure of the Spine

What are the secondary spinal curves?

 the lumbar and cervical curves
 concave posteriorly
 develop from supporting the body in
an upright position after young
children begin to sit and stand
 Picture retrieved from

Cervical http://en.wikipedia.org/wiki/Image:Cervical_vertebra_english.png

Vertebra

Picture retrieved from

http://en.wikipedia.org/
wiki/Image:Gray85.png
 Picture retrieved from
http://upload.wikimedia.org/wikipedia/commons/6/62/Gray94.png

Lumbar
Vertebra

Picture retrieved from

http://upload.wikimedia.org/wikipedia/commons/b/b2/Gray430.png
 Structure of the Spine

Vertical Lordosis Kyphosis Scoliosis

alignment

Lordosis - exaggerated lumbar curve

Kyphosis - exaggerated thoracic curve
Scoliosis - lateral spinal curvature
Picture retrieved from
http://www.childsdoc.org/spring2002/scoliosis2.jpg
 Movements of the Spine

What movements of the spine are allowed?

The movement capabilities of the spine are
those of a ball and socket joint, including
movement in all three planes and
circumduction.
Mechanically:
Annulus fibrous – acts like coiled spring
Nucleus pulposus – acts like ball bearing
 Movements of the Spine

What muscles contribute to flexion of

the spine in the cervical region?
 rectus capitus anterior
 rectus capitis lateralis
 longus capitis
 longus colli
 eight pairs of hyoid muscles
Picture retrieved from
http://
upload.wikimedia.org/
wikipedia/en/6/6f/
Rectus_capitis_anterior_mu
scle.PNG
 Movements of the Spine

What muscles contribute to flexion of

the spine in the abdominal region?
 rectus abdominis
 internal obliques
 external obliques
Picture retrieved from
http://upload.wikimedia.org/wikipedia/
commons/3/32/Illu_trunk_muscles.jpg
 Movements of the Spine

What muscles contribute to extension

of the spine in the cervical region?
 splenius capitis
 splenius cervicis
 assisted by:
rectus capitis posterior major and minor
obliquus capitis superior and inferior
Picture retrieved from
http://upload.wikimedia.org/wikipedia/
commons/5/51/Splenius.png
 Movements of the Spine

What muscles contribute to extension of the

spine in the thoracic and lumbar regions?
 erector spinae - spinalis,
longissimus, iliocostalis
 semispinalis - capitis, cervicis,
thoracis
 deep spinal muscles - mulitifidi,
rotatores, interspinales,
intertransversarii, levatores Picture retrieved from
http://upload.wikimedia.org/wikipedia/
commons/9/90/Gray389.png
 Movements of the Spine

What muscles contribute to lateral

flexion of the cervical spine?
 sternocleidomastoid
 levator scapulae
 scalenus anterion, posterior, & medius
 PLUS the cervical flexors and extensors
when developing tension unilaterally
Picture retrieved from
http://upload.wikimedia.org/wikipedia/
commons/1/1a/Sternocleidomastoideus.png
 Movements of the Spine

What muscles contribute to lateral

flexion of the lumbar spine?
 quadratus lumborum
 psoas major
 PLUS the lumbar flexors and extensors
when developing tension unilaterally
Picture retrieved from
http://upload.wikimedia.org/wikipedia/
commons/8/8d/Quadratuslumborum.png
 Loads on the Spine

What forces commonly act on the spine?

 body weight
 tension in the spinal ligaments
 tension in the spinal muscles
 any external loads carried in the hands
 Loads on the Spine

In normal standing position, body weight acts

anterior to the spine, creating a forward
bending load (moment) on the spine.
 Loads on the Spine

Because the spine is

curved, body weight,
acting vertically, has
components of both
compression (Fc) and
shear (Fs) at most
Fs
Fc motion segments.
wt
 Loads on the Spine
Muscle
tension
During lifting, both
Shear
compression and reaction
force
anterior shear act
Joint
on the spine. center

Tension in the
Compression
spinal ligaments reaction
force
and muscles
contributes to
compression.
Sample Problem 1

How much tension

must be developed by
the erector spinae
with a moment arm of
6cm from L5-S1 joint
center to maintain the
body in the position
shows on your right?
Given that
Head : 58 N Arms : 81 N
Trunk : 328 N Box : 111 N
 Loads on the Spine

compression tension

Lumbar hyperextension can create a bending

load (moment) in the posterior direction.
 Loads on the Spine

Lumbar hyperextension
produces compressive
loads at the facet joints.

hyperextension
 Loads on the Spine

Superior view Lateral view

Spinal rotation generates shear stress in the intervertebral discs.
Human Posture When Lifting
Common Injuries

 Low back pain

 Soft tissue Injuries
 Acute fractures
 Stress Fracture – spondylolysis (fracture in
vertebral neural arch)
 Disc herniation