Thoracic and Lumbar

Spine Anatomy

Dr .S.Nizamudeen
 Anatomy
 Vertebral Column:
 Cervical Spine:
 Lordotic curvature
 Greatest ROM
 Most vulnerable to injury
 Thoracic Spine:
 Greatest protection
 Least ROM
 Lumbar Spine:
 Balance between
protection/ROM
 Anatomy
 Vertebral Column:
 Extends from skull to
the pelvis
 33 total vertebrae:
 Superiorly: 24
individual vertebrae
(separated by
intervertebral discs)
 Inferiorly: 9 fuse to
form 2 composite bones
 Sacrum (5)
 Coccyx (4)
 Anatomy
 Vertebral Column:
 Functions:
 Transmits weight of
the trunk to the lower
limbs
 Surrounds/protects
spinal cord
 Attachment point for
the ribs and muscles
of neck and back
 Anatomy
 Vertebral Column: Major
Supporting Ligaments
 Anterior Longitudinal
Ligament – runs vertically
along anterior surface of
vertebral bodies
 Neck - Sacrum
 Attaches strongly to both
vertebrae and intervertebral
discs (very wide)
 Prevents back
hyperextension
 Anatomy
 Vertebral Column:
Major Supporting
Ligaments
 Posterior Longitudinal
Ligament - runs vertically
along posterior surfaces of
vertebral bodies
 Narrower, weaker
 Attaches to intervertebral
discs
 Prevents hyperflexion
 Anatomy
 Vertebral Column: Major
Supporting Ligaments
 Ligamentum Flavum - strong
ligament that connects the
laminae of the vertebrae
 Protects the neural elements
and the spinal cord
 Stabilizes the spine to prevent
excessive vertebral body motion
 Strongest of the spinal
ligaments
 Forms the posterior wall of the
spinal canal with the laminae
 Stretches with forward bending
/ recoils in erect position
 Anatomy
 Vertebral Column:
Supporting Ligaments
 Intertransverse
Ligament - located
between the transverse
processes
 Cervical region: consist of
a few irregular, scattered
fibers
 Thoracic region: rounded
cords connected with deep
muscles of the back
 Lumbar region: thin and
membranous
 Anatomy
 Vertebral Column:
Supporting Ligaments
 Interspinal Ligament -
connect spinous
processes (spans the
entire process)
 Meets the ligamentum
flavum in front and the
supraspinal ligament
behind
 Anatomy
 Vertebral Column:
Supporting Ligaments
 Supraspinal Ligament -
connects together the
apexes of the spinous
processes
 Extends from 7th cervical
vertebra to sacrum
 Strong fibrous cord
 At points of attachment
(tips of the spinous
processes) fibrocartilage is
developed in the ligament

Supraspinal
Ligament
 Anatomy
 Bony Anatomy:
 Body : Centrum
 Anterior part
 Weight-bearing segment
 Vertebral Arch: Neural
Arch
 Posterior part
 Formed by pedicle and
lamina on each side
 Anatomy
 Bony Anatomy:
 Vertebral Foramen:
 Opening
 Pedicles: (2)
 Sides of vertebral arch
 “Little feet” project
posteriorly from body
 Laminae: (2)
 Flat roof plates
 Complete arch
posteriorly

Thoracic Vertebrae
 Anatomy
 Bony Anatomy:
 Transverse Processes:
 Project laterally from each
pedicle-lamina junction
 Attachment site for intrinsic
ligaments and muscles
 Spinous Processes:
 Prominent posterior
projections
 Attachment site for intrinsic
ligaments and muscles
Thoracic Vertebrae
Thoracic Vertebrae
Lumbar Vertebrae
Lumbar Vertebrae
 Anatomy
 Facet Joints:
 Articulations between
superior articular facet
(bottom vertebrae) and
inferior articular facet
(above vertebrae)
 Contribute to ROM
 ↓ Weight-bearing stress
through vertebral body
and disc
 Synovial joints
 Anatomy
 Pars Interarticularis:
 Area between the
superior and inferior
facets
 Common site for stress
fractures (lumbar spine)
 Spondylolysis - refers to
the defect (black arrows)
present when the pars
interarticularis (green
arrow) is fractured
 Anatomy
 Intervertebral Foramen:
 Space where spinal nerve
roots exit the vertebral
column
 Size variable due to
placement, pathology,
spinal loading, and posture
 Can be occluded by arthritic
degenerative changes and
space-occupying lesions
(tumors, spinal disc
herniations)
Vertebral Anatomy
Level Vertebral Body Transverse Process Spinous Process

Cervical Small; Short; Processes Small and short, except

Vertebral body contain the for C7 (characteristics of
absent in C1; transverse foramen thoracic vertebrae)
remaining for passage of
bodies vertebral artery
progressively ↑
in size
Thoracic Diameter and Attachment of Long and slender;
thickness ↑ as muscles and downward projections –
spine costovertebral overlap of spinous
continues ligaments; processes of inferior
inferiorly Processes of T1- vertebrae; gradually
T12 have articular thicken in size as you
surfaces for the move ↓
ribs
Lumbar Very broad Long for leverage Superior borders are
posteriorly projected with
a large inferior flare
 Anatomy
 Thoracic Segment:
 Wider/thicker – help support
torso weight
 Spinous Processes:
 Downward projection
 Limit extension
 Attachment for thoracic
muscles/ligaments
 Transverse Processes:
 Costotransverse Joints:
 Articulation with ribs
 Ribs 1 – 10
 Ribs 11 and 12
 No articulation with
transverse processes
Anatomy

Costovertebral
Joint

Costotransverse
Joint
 Anatomy
 Thoracic Segment:
 Costovertebral Joint:
 Articulation between vertebral bodies and ribs
 Superior and Inferior Costal Facets

Superior Costal Facet

Inferior Costal Facet

 Anatomy
 Sacrum:
 Curved, triangular
shaped
 5 fused vertebrae
 Fixes the spinal
column to the pelvis
 Stabilizes the pelvic
girdle
 Anatomy
 Sacroiliac Joint (SI):
 Between the sacrum (base of the spine) and the ilium of the pelvis
 Strong, weight bearing synovial joints (2)
 Covered by 2 different kinds of cartilage
 Sacral surface (hyaline cartilage)
 Iliac surface (fibrocartilage)
 Functions:
 Shock absorption (spine)
 Allows the transverse rotations (lower extremity) to be transmitted up
the spine.
 Motions:
 Anterior innominate tilt
 Posterior innominate tilt
 Sacral flexion (or nutation)
 Sacral extension (or counter-nutation)
Anatomy
 Anatomy
 SI Ligaments:
 Anterior Sacroiliac
Ligament:
 Connects the anterior
surface of the lateral
part of the sacrum to
the ilium

Note: Black Arrow

 Anatomy
 SI Ligaments:
 Posterior Sacroiliac
Ligament:
 Forms the chief bond of
union between the bones
 Upper part: (short PSL)
 Nearly horizontal in
direction
 Ilium to upper sacrum
 Lower part: (long PSL)
 Oblique in direction
 Lower sacrum to PSIS

Short PSL Long PSL

 Anatomy
 SI Ligaments:
 Sacrotuberous
Ligament:
 Arises from ischial
tuberosity to blend in
with inferior fibers of
posterior SI ligaments

Sacrotuberous
Ligament
Ischial Tuberosity
 Anatomy
 SI Ligaments:
 Sacrospinous
Ligament:
 Originates from the
ischial spine and
attaches to the coccyx

Sacrospinous
Ligament
 Anatomy
 Coccyx: Tailbone
 Consists of 4 (in some
cases 3 or 5) vertebrae
fused together
 Attachment site for
muscles of pelvic floor
and sometimes
portions of gluteus
maximus
 Anatomy
 Intervertebral Discs:
 23 intervertebral discs
 No disc between skull and C1 or
between C1-C2
 Discs are thickest in the lumbar
vertebrae and cervical regions
(enhances flexibility)
 Functions:
 Shock absorbers
 walking, jumping, running
 Allow spine to bend
 At points of compression, the
discs flatten out and bulge out a
bit between the vertebrae
 Anatomy
 Nucleus Pulposus: Core
 Gelatinous, acts like a
rubber ball (enables spine to
absorb compressive forces)
 60-70% water
 Annulus Fibrosus: Outer
rings
 Multilayered fibers (cross
from opposite directions)
 Rings absorb compressive
forces themselves
 Anatomy
 Intervertebral Discs: Dehydration Process
 Collectively, the discs make up about 25% of the
height of the vertebral column
 Nucleus pulposus becomes dehydrated during
course of day
 Flattens out (height is 1-2 centimeters less at night
than when we awake in morning)
 Aging Process = Permanent dehydration (ages 40 –
60)
 Decreased ROM
 Narrowing intervertebral foramen
 Anatomy
 Lumbar and Sacral
Plexus:
 Lumbar:
 Formed by 12th thoracic nerve
and L1-L5 nerve roots
 Innervation:
 Anterior and medial
muscles of thigh
 Dermatomes of medial leg
and foot
 Femoral Nerve – formed by
branches of L2, L3, L4 nerve
roots
 Obturator Nerve – anterior
branches of L2, L3, L4
 Anatomy
 Lumbar and Sacral
Plexus:
 Sacral:
 Formed by L4, L5 and
lumbosacral trunk
 Innervation:
 Muscles of buttocks,
posterior femur, and
lower leg
 Sciatic Nerve – 3
sections
 Tibial nerve
 Common peroneal nerve
 Tibial nerve
Anatomy
 Anatomy
 Lumbarization:
 1st sacral vertebrae does
not unite with sacrum
 Becomes a 6th lumbar
vertebrae
 Sacralization:
 5th lumbar vertebrae
becomes fused to
sacrum
 Anatomy
 Extrinsic Muscles – primarily function to
provide respiration and movement associated
with the upper extremity and scapula
 Indirectly influence the spinal column
 Intrinsic Muscles – lie close to spinal column
 Directly influence the spinal column
 Anatomy
 Middle Trapezius:
 O: Lower portion of
ligamentun nuchae and
spinous processes of C7
and T1 – T5
 I: Acromion process,
scapular spine
 A: Scapular retraction
and fixation of thoracic
spine
 Anatomy
 Lower Trapezius:
 O: Spinous processes of
T8 – T12
 I: Scapular spine
(medial portion)
 A: Scapular depression
and retraction; fixation
of thoracic spine
 Anatomy
 Rhomboid Muscles:
 Rhomboid Major and
Minor
 O: Spinous processes of
C7 through T5
 I: Vertebral border of
scapula between the spine
and inferior angle
 A: Scapular retraction,
elevation, and downward
rotation; Fixation of
thoracic spine
 Anatomy
 Latissimus Dorsi:
 O: Spinous processes of
T6 through T12 and the
lumbar vertebrae via the
thoracodorsal fascia,
posterior iliac crest
 I: Intertubercular groove
of humerus
 A: Extension of spine,
anterior rotation of pelvis,
stabilization of lumbar
spine (depression of
shoulder girdle, humeral
extension)
 Anatomy
 Rectus Abdominis:
 O: Pubic crest and
symphysis
 I: Xiphoid process and
costal cartilages of 5th,
6th, and 7th ribs
 A: Trunk flexion;
compression of
abdomen
 Anatomy
 External Oblique:
 O: 5th through 12th
ribs
 I: Iliac crest and linea
alba
 A: Bilaterally: trunk
flexion; compression
of abdomen;
Unilaterally: lateral
bending; rotation to
opposite side
 Anatomy
 Internal Oblique:
 O: Inguinal ligament,
iliac crest,
thoracolumbar fascia
 I: Tenth, eleventh, and
twelfth ribs; linea alba,
crest of pubis
 A: Bilaterally: Trunk
flexion, compression of
abdomen; Unilaterally:
lateral bending and
rotation to same side
 Anatomy
 Erector Spinae: 3
muscle pairs
 Iliocostalis:
 Iliocostalis Lumborum
 Iliocostalis Thoracis
 Iliocostalis Cervicis
 Longissimus:
 Longissimus Thoracis
 Longissimus Cervicis
 Longissimus Capitis
 Spinalis:
 Spinalis Thoracis
 Spinalis Cervicis
 Spinalis Capitis
 Anatomy
 Transversospinal
Muscles:
 Deep intrinsic layer
 Fibers run from 1
transverse process to
the spinous process
superior to them
 Group formed by:
 Semispinalis
 Multifidus
 Rotators