8/3/2019 Spine Anatomy

SPINE ANATOMY

The spine
The spine is divided into four segments:  

Cervical spine (C1 to C7) forms the neck

displaying the most exible section of the
spine;  

Thoracic spine (T 1 to 12) connects to the rib

cage thus having limited exibility; 

Lumbar spine (L1 to L5) including the largest

vertebrae suited to support most of the body
weight;  

Sacrum (S1 to S5) consisting of fused

vertebrae that attach laterally to the hip ring,
and joining underneath to the tailbone or
coccycx formed by ve fused bones.

The curvature of the spine  

Spinal curves are important to balance and
stand upright. If any one of the curves
becomes too large or small, it is di cult to
stand up straight and our posture appears
abnormal.  

Changes in the curvature of the spine are

referred to as spinal deformities. They
include:   kyphosis of the thoracic spine
("hunchback"), and lordosis of the lumbar
spine ("swayback"). Scoliosis is a sideways
curvature of the spine forming a shape like an
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"S" or a "C" rather than straight from the front

or back view.

Bones
Vertebrae
The vertebrae are the main constituents of
the spine. They are round-shaped bones piled
up to form the spinal column. The cavity in the
centre, or foramen, is only present in the
cervical, thoracic and lumbar vertebrae and is
occupied by the spinal cord and its nerves.
 The anatomy of the vertebrae includes a body
with a large oval shape made by the strongest
bone structure. The rim of the body is thicker
to provide a concave form.  

The pedicles are short lateral processes and

the laminae are at bones extending from the
pedicles and joining at the midline. The
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processes divided into articular, transverse

and spinous are thin bones required for
connecting the spine to ligaments and
tendons. Four articular processes connect
each vertebra with the next one to create the
facet joints, which facilitate the spine
movement.

The vertebrae of the upper cervical spine have

a di erent shape and function. Their
structures are the atlas (C1), the axis (C2) and
the dens (also C2). They connect the spine to
the cranium and allow the rotation, extension
and exion movements of the head.

Facet joints 
Facet joints are small hinges located in the
back of the vertebrae. They contribute to the
spine movement by allowing spinal rotation.
Similarly to other joints, they have a cartilage
surface that may degenerate into an arthritic
condition and become a source for low back
or neck pain.

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The ligaments of the spine

Ligaments are brous elastic tissues, which
connects bones with each other to stabilise
the joints. By limiting spine exibility, they
prevent damage caused by hyperextension
and exion.

The  anterior longitudinal ligament and

the  posterior longitudinal ligament confer the
principal spinal support. They extend through
the entire length of the spine (skull to sacrum)
in the anterior/ventral side and posterior/back
side, respectively. These ligaments attach
directly to the annulus brosis rings.

The  supraspinatus ligament  links the spinous

processes with one another.

The interspinous ligament  connects the rest of

the spinous process to each other.

The ligamentum avum is located in the deep

spine. This is the strongest ligament and runs
from the skull base to the pelvis on the
anterior side between the laminae and the
facet joint capsules.

Function of the ligament during

movement

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A. In upright position, the ligaments are at

normal length. However, when bending the
body forwards, the ligaments are stretched to
their maximal length to hold the vertebrae
together and support the body.

B. The facet joints prevent excessive extension

when the spine is bent backwards (full bridge
pose).

Muscles 
The muscular system of the spine is very
complex. All these muscles essentially
stabilise the spine by keeping the alignment of
the vertebrae. Strong back muscles support
the spine while keeping it in a good straight
position. If the muscles are not trained, the
spine can adopt a pathological posture which
over time can cause injury or deformity.  

Speci c muscles control movements of

speci c sections of the spine. For instance the
sternocleidomastoid muscle at the cervical
spine permits the movement of the head,
while the psoas major (sacral area) is
associated with the exion of the thighs.   If
well trained, the muscles of the spine can
reduce the load on the bones, facet joints,
disks, and ligaments. In contrast, when they
are weakened from the lack of use or injury,
they lose their size, strength, endurance, and
exibility.     

Table describing the main muscles of the spine

and their function:

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The spinal cord

The spinal cord is a bundle of nerves
originating from the brain reaching out to the
limbs and internal organs. It runs from the
skull, through the spinal canal up to the rst
lumbar vertebra. It has a length of 40-50 cm
and a diameter of approximately 1-1.5 cm.
  The spinal canal plays the important role to
direct and protect the spinal cord. Similar to
the brain, the spinal cord is enclosed by a
membrane, the meninges, and is embedded
in a liquid, the cerebrospinal uid. This uid is
produced in brain cavities (the ventricles) to
cushion both the brain and spinal cord.   The
gray matter, with a butter y shape located in
the center of the cord, contains the
interneurons and motor neurons. The lateral
projections of the gray matter are called
horns. Motor neurons of the ventral horn
project their axons to innervate skeletal and
smooth muscles that control voluntary and
involuntary re exes. It also contains neurons
projecting axons to mediating autonomic
control of the visceral functions. The white
matter is located outside the gray matter and
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is made of myelinated motor and sensory

axons. These axons transmit information
along the spinal cord.  Each level of the spinal
cord is associated with a pair of dorsal root
ganglia, located outside the cord. The ganglia
contain the sensory neurons whose axons
travel into the spinal cord via the dorsal roots.
 Ventral roots contain axons from motor brain
and spinal cord to the periphery. Dorsal and
ventral roots merge, exit the intervertebral
foramina to become spinal nerves.    

Nerves 
At each vertebral body the nerve roots branch
out laterally in a total of 31 pairs through the
intravertebral foramen and from there they
become peripheral nerves. Spinal nerves
connect the brain with other nerves of the
body. This complex network of nerves is part
of the central nervous system and transmits
signals between the brain and the rest of the
body. There are 8 pairs of cervical nerves, 12
pairs of thoracic nerves, 5 pairs of lumbar
nerves. A group of nerves at the conus
medullaris located in the cauda equina,
resemble  a horsetail.   The nerves control
movement and function of all organs but also
transmit signals from the external
environment back to the brain including
pressure, heat, cold, and pain.   Any
interruption of this bidirectional
communication severely a ects the nervous
system and the complex functions of the

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organism. The nerve roots exit from the

spaces between vertebrae to transmit signals
originating from the brain via the nerves
throughout the body. 

The cauda equina

The spinal cord ends around the rst and
second lumbar vertebra in the lower back and
continues as nerve roots. This bundle of nerve
roots is called the cauda equina. They exit the
spinal canal through openings in the
vertebrae (foramen), just like other nerve
roots.

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