LUMBAR SPINE

INTRODUCTION:

There is totally five lumbar vertebras.

The first 4 lumbar vertebrae are similar in structure. 5th lumbar vertebrae has
structural adaptation for articulation with sacrum.
The human spine is a complex structure, main function is protect the spinal
cord and transfer weight load from head and trunk to the pelvis.
Intervertebral disc and ligaments give intrinsic stability and muscles give external
stability.
The vertebral bodies in lumbar region are thicker and wider than those in thoracic and
cervical region.

MOTION SEGMENT:

It consists of two vertebrae and their intervening soft tissues.

Anterior portion consists: vertebral body, IVD, longitudinal ligaments.
Posterior portion consists: Arches, transverse and spinous process, various ligaments.
Arches and vertebral bodies forms vertebral canal, which protects the spinal cord.

ANTERIOR PORTION OF MOTION SEGMENT:

DISC:
o It bears and distributes loads.
o It consists of inner nucleus pulposis and outer annulus fibrosis.
o Nucleus pulposis is gelatinous mass, which contains glycosaminoglycan (water-
binding) in the young adult.
o Glycosaminoglycon will decreases with aging.
o Nucleus pulposis lies center in all disc except lumbar, where it situated in slightly
posterior position.
o Annulus fibrosis is tough outer covering made of fibrocartilage.
o Criss-cross arrangement of fibers in annulus fibrosis.
o Vertebral endplate presents between disc and vertebral body.
o Flexion, extension and side flexion of spine will produce compressive stress and
rotation of spine will produces shear stress.
Body:
o Transverse diameter is greater than height. These structure is for weight bearing
force of body, ground reaction force and muscle forces.
o
POSTERIOR PORTION OF MOTION SEGMENT:

Motion depends on orientation of facets with transverse and frontal plane.

o C1 and C2: parallel to transverse plane.
o Other cervical: 45 to transverse plane and parallel to the frontal plane.
o Thoracic: 60 to transverse plane and 20 to the frontal plane.
o Lumbar: right angle to the transverse plane and 45 to the frontal plane.
Arches
o It consists:
Pedicles:
Short and thick
Projects posterolaterally
Lamina:
Short and broad.
Zygapophyseal articular process
Mammillary process present in superior facet. It gives attachments
for multifidus muscles.
Facet orientation: vertical and covex.
Superior- posteromedial
Inferior- anterior and laterally.
Transverse process
Spinous processes
Vertebral foramen
Triangular in shape.
Cervical>lumbar>thorax

5TH LUMBAR VERTEBRAE:

Wedge shaped body.

Posterior portion of body is more in height than anterior portion.
L5 andS1 disc also wedge shaped
Spinous process is smaller than other vertebras.

LUMBOSACRAL ARTICULATION:

It is formed by 5th lumbar vertebrae and 1st sacral vertebra.

The first sacral segment, which is inclined slightly anteriorly and inferiorly, forms an
angle with the horizontal called the lumbosacral angle.
Increase in angle will results in increase in lumbar lordosis.
And also increased shearing force.
 LUMBOSACRAL ANGLE

KINEMATICS:
Lumbar region capable of movement in flexion, extension, lateral flexion and rotation.
The zygapophyseal joints favor for flexion and extension, because of sagittal plane
orientation.
Flexion of lumbar spine is more limited than extension.
Most of flexion and extension takes place in lumbosacral region.
Most mobility and weight bearing occurs between l4 and s1.
Rotation is more limited in lumbar region.
More medial orientation limits more rotation.
Pure flexion and extension occurs. Coupled motions occurs with lateral flexion and
rotation.
 Lateral flexion flexion and slight ipsilateral rotation.
Axial rotation lateral flexion contralateral and slight flexion.
Lateral flexion and rotation is more free in upper lumbar region and progressively
diminishes in lower lumbar region.
L2 L3 great lateral flexion & rotation.
In flexed position rotation is more limited because of posterior annulus and posterior
longitudinal ligament.

LUMBAR PELVIC RHYTHM:

Bending forward lumbar flexion followed by anterior tilting of pelvis.

Flexion to extension initial pelvic motion of posterior tilt followed by extension of
lumbar spine.

KINETICS:

COMPRESSION:
o 1000N compressive load demonstrated on interbody joints 80% and apophyseal
20%.
o If increased extension or lordosis, more load occurs at apophyseal joints. And also
with degeneration of IVD leads to more compressive load on the apophyseal
joints.
SHEAR:
o Lumbar segments are subjected to anterior shear force because of lordosis.
o This anterior shear force is resisted by inferior facet on superior vertebra against
superior facet of below vertebra
o The effectiveness of the zygapophyseal joint in providing resistance to anterior translation
during flexion depends on the extent to which the inferior vertebras superior facets lie in
the frontal plane and face posteriorly. The more that the superior zygapophyseal facets of
an adjacent inferior vertebra face posteriorly,