VERTEBRAL COLUMN

The vertebral column consists

of 33 vertebrae:
• 7 cervical,
• 12 thoracic,
• 5 lumbar,
• 5 fused sacral,
• 4 fused coccygeal vertebrae
It protects the spinal cord,
supports the weight of the head
and the trunk, and allows the
movement of the rib cage for
respiration by articulating with
the ribs.
TYPICAL VERTEBRA
 Typical cervical vertebrae (C3 – C5)
1. The body is small and broader from
side to side than from before
backwards.
2. Vertebral foramen is
larger than the body. It is
triangular in shape.
3. Each cervical vertebra has the oval
foramen transversarium in the
transverse process. The vertebral
arteries and their accompanying
veins pass through the transverse
foramina.
4. The transverse processes of cervical
vertebrae end laterally in two
projections: an anterior tubercle and
a posterior tubercle.
5. The spine is short and bifid. The
notch is filled up by the ligamentum
nuchae.
 FIRST CERVICAL VERTEBRA ( С 1, Atlas)
that Atlas of Greek mythology bore the weight of the world on his shoulders

1. It has neither a body nor a spine process.

2. This ring-shaped body has paired lateral masses.
3. The kidney-shaped, concave superior articular surfaces articulate with
occipital condyles.
4. Anterior and posterior arches, each of which bears a tubercle in the center
of its external aspect.
5. Anterior arche on posterior surface bears an oval facet which articulates with
the dens.
6. The posterior arch has a wide groove for the vertebral artery on its superior
surface.
 SECOND CERVICAL VERTEBRA (С2, axis)

• It is identified by the presence of the dens or odontoid process.

 SIXTH CERVICAL VERTEBRAES (С6)
• The anterior tubercles of vertebra C6 are
called carotid tubercles because the
common carotid arteries may be
compressed here, in the groove between
the tubercle and body, to control bleeding
from these vessels.
SEVENTH CERVICAL VERTEBRAES (C7)
• is also known as the vertebra prominens because of its long spinous process. Run
your finger along the midline of the posterior aspect of your neck until you feel the
prominent C7 spinous process.
• The spinal process is not bifid on the end.
• The foramina transversaria are smaller in C7 than those in other cervical vertebrae,
and occasionally they are absent (because it transmit only small accessory veins).
 The typical thoracic vertebrae (Th2-Th8) are:
• identified by the presence of costal facets (superior and inferior demifacets) on
the sides of the vertebral bodies;
• the articular processes of thoracic vertebrae extend vertically with paired,
nearly coronally oriented articular facets;
• the anterior surface of each transverse process bears a facet near its tip, for
articulation with the tubercle of the corresponding rib;
• the spine is long, and is directed downwards and backwards
 Atypical thoracic vertebrae:
Th 1 - The superior costal facet
on the body is complete. It
articulates with the head of the
first rib. The inferior costal facet
is a demifacet for the second rib.
Th 9 - the body has a single
superior costal demifacet on
each side.
Th 10 - the body has a single large
costal facet on each side.
Th 11 - The body has a single large
costal facet on each side. The
transverse process is small, and
doesn’t have articular facet.
Th 12 - The transverse processes and
spine are similar to those of a lumbar
vertebra. The body has a single costal
facet on each side. The transverse
process is small, and doesn’t have
articular facet.
 Typical lumbar Vertebrae
• Because the weight they support
increases toward the inferior end of the
vertebral column, lumbar vertebrae
have massive bodies;
• their articular processes extend
vertically;
• the transverse processes are thin and
tapering, has a small, rough elevation,
the accessory process;
• the superior articular processes has a
rough elevation, the mammillary
process.
• the vertebral foramen is triangular in
shape, and is larger than in the thoracic
region;
• the spine is thickened along its
posterior and inferior borders.
 THE SACRUM
• is usually composed of five fused sacral vertebrae in adults;
• provides strength and stability to the pelvis and transmits the
weight of the body to the pelvic girdle;
• the anterior (pelvic) sacral foramina are larger than the
posterior (dorsal) ones;
• the sacrum supports the vertebral column and forms the
posterior part of the bony pelvis;
• the median sacral crest, represents the fused rudimentary
spinous processes;
• the intermediate sacral crests represent the fused articular
processes;
• the lateral sacral crests represent the fused transvers
processes.
 Coccyx
• the coccyx (tail bone) is a small triangular
bone that is usually formed by fusion of the
four rudimentary coccygeal vertebrae;
• the coccyx is the remnant of the skeleton of
the embryonic tail-like caudal eminence,
which is present in human embryos from the
end of the 4th week until the beginning of the
8th week;
• Co1 is the largest and broadest of all the
coccygeal vertebrae.
 Development of the vertebral
column
In a frontal section of a 4-week
embryo, the sclerotomes appear as
paired condensations of
mesenchymal cells around the
notochord. Each sclerotome consists
of loosely arranged cells cranially
and densely packed cells caudally.
Cartilaginous Stage of Vertebral Development
During the sixth week, chondrification centers appear in each
mesenchymal vertebra.
The two centers in each centrum fuse at the end of the embryonic
period to form a cartilaginous centrum. Concomitantly, the centers in
the neural arches fuse with each other and the centrum. The spinous
and transverse processes develop from extensions of chondrification
centers in the neural arch. Chondrification spreads until a cartilaginous
vertebral column is formed.
Bony Stage of Vertebral Development
Ossification of typical vertebrae begins during the embryonic period and
usually ends by the 25th year. There are two primary ossification centers,
ventral and dorsal, for the centrum.
These primary ossification centers soon fuse to form one center. Three
primary centers are present by the end of the embryonic period:
• one in the centrum
• one in each half of the neural arch.
Ossification becomes evident in the neural arches during the eighth week.
At birth, each vertebra consists of three bony
parts connected by cartilage.
The bony halves of the vertebral arch usually
fuse during the first 3 to 5 years. The arches first
unite in the lumbar region, and union progresses
cranially.
Five secondary ossification centers appear in the
vertebrae after puberty:
One for the tip of the spinous process
One for the tip of each transverse process
Two anular epiphyses, one on the superior and one on
the inferior rim of the vertebral body.

All secondary centers unite with the rest of the vertebra

at approximately 25 years of age.
 Clinical anatomy:
Cervical ribs
• The costal element of seventh
cervical vertebra may get
enlarged to form a cervical
rib.
• The extra rib may elevate and
place pressure on structures
that emerge from the
superior thoracic aperture,
notably the subclavian artery
or inferior trunk of the
brachial plexus, and may
cause thoracic outlet
syndrome.
Variation in the Number of Vertebrae
A few have one or two additional vertebrae or
one fewer. To determine the number of
vertebrae, it is necessary to examine the entire
vertebral column because an apparent extra (or
absent) vertebra in one segment of the column
may be compensated for by an absent (or extra)
vertebra in an adjacent segment; for example,
11 thoracic-type vertebrae with 6 lumbar-type
vertebrae.
 Abnormal Fusion of Vertebrae
• In approximately 5% of
people, L5 is partly or
completely incorporated into
the sacrum—conditions
known as hemisacralization
and sacralization of the L5
vertebra.
• S1 is more or less separated
from the sacrum and is partly
or completely fused with L5
vertebra, which is called
lumbarization of the S1
vertebra.
Often producing painful
symptoms.
• Atlas may fuse with the
occipital bone. This is called
occipitalization of atlas.
 Caudal Epidural Anesthesia
Is a local anesthetic agent is injected into the fat of the sacral
canal that surrounds the proximal portions of the sacral nerves.
Anesthetic agents can also be injected through the posterior
sacral foramina into the sacral canal around the spinal nerve
roots (transsacral epidural anesthesia).
 Laminectomy
The surgical excision of one or
more spinous processes and
the adjacent supporting
vertebral laminae in a
particular region of the
vertebral column is called a
laminectomy.
Surgical laminectomy is often
performed to relieve pressure
on the spinal cord or nerve
roots caused by a tumor.
 Lumbar Spinal Stenosis
narrow vertebral foramen in one or more lumbar
vertebrae. Narrowing is usually maximal at the level of
the IV discs. Stenosis of a lumbar vertebral foramen
alone may cause compression of one or more of the
spinal nerve roots occupying the inferior vertebral
canal.
• Spina bifida occulta, in which the
neural arches of L5 and/or S1 fail to
develop normally and fuse
posterior to the vertebral canal. The
defect is concealed by the overlying
skin, but its location is often
indicated by a tuft of hair. Most
people with spina bifida occulta
have no back problems.
• Spina bifida cystica, one or
more vertebral arches may fail
to develop completely. Spina
bifida cystica is associated with
herniation of the meninges
(meningocele) and/or the spinal
cord (meningomyelocele).
Neurological symptoms are
usually present in severe cases
of meningomyelocele (e.g.,
paralysis of the limbs and
disturbances in bladder and
bowel control). Severe forms of
spina bifida result from neural
tube defects, such as the
defective closure of the neural
tube during the 4th week of
embryonic development.