Biomechanics of

spine
By, Dr. Rama Ramdurgkar(MPT, COMT)
Assistant professor
DYP college of physiotherapy
 VERTEBRAL COLUMN
• Need of vertebral column- Demands of mobility and stability of the
trunk and the extremities and of providing protection for the spinal
cord.
• Structures in vertebral column- Cervical, Thoracic, Lumbar Sacrum
and coccygeal
Introduction-
• The vertebral column resembles a curved rod, composed of 33
vertebrae and 23 intervertebral disks. The vertebral column is divided
into the following five regions: cervical, thoracic, lumbar, sacral, and
coccygeal
• The vertebrae increase in size from the cervical to the lumbar regions
and then decrease in size from the sacral to coccygeal regions
• Twenty-four of the vertebrae in the adult are distinct entities. Seven
vertebrae are located in the cervical region, 12 in the thoracic region,
and 5 in the lumbar region. Five of the remaining nine vertebrae are
fused to form the sacrum, and the remaining four constitute the
coccygeal vertebrae.
 DEVLOPMENT OF CURVE
• The curve of the vertebral column of a baby in fetal life exhibits one long
curve that is convex posteriorly, whereas secondary curves develop in
infancy. However, in the column of an adult, four distinct anteroposterior
curves are evident.
• The two curves (thoracic and sacral) that retain the original posterior
convexity throughout life are called primary curves, whereas the two
curves (cervical and lumbar) that show a reversal of the original posterior
convexity are called secondary curves.
• Curves that have a posterior convexity (anterior concavity) are referred to
as kyphotic curves; curves that have an anterior convexity (posterior
concavity) are called lordotic curves. The secondary or lordotic curves
develop as a result of the accommodation of the skeleton to the upright
posture
WHY DO WE HAVE CURVED SPINE ???
• A curved vertebral column provides significant advantage over a
straight rod in that it is able to resist much higher compressive loads.
• a spinal column with the normal lumbar, thoracic, and cervical curves
has a 10-fold ability to resist axial compression in comparison with a
straight rod
• What is Mobile segment ?
A TYPICAL VERTEBRA
 A TYPICAL VERTEBRA
• The structure of a typical vertebra consists of two major parts: an
anterior, cylindrically shaped vertebral body and a posterior, irregularly
shaped vertebral or neural arch.
• The vertebral body - is designed to be the weight-bearing structure of
the spinal column. It is suitably designed for this task, given its
blocklike shape with generally flat superior and inferior surfaces. In
order to minimize the weight of the vertebrae and allow dynamic load-
bearing, the vertebral body is not a solid block of bone but a shell of
cortical bone surrounding a cancellous cavity.
• The cortical shell is reinforced by trabeculae in the cancellous bone,
which provide resistance to compressive forces.
 A TYPICAL VERTEBRA
• The neural arch- can be further divided into the pedicles and the
posterior elements.
• The pedicles are the portion of the neural arch that lie anterior to the
articular processes on either side and serve as the connection between
the posterior elements and the vertebral bodies.
• Their function is to transmit tension and bending forces from the
posterior elements to the vertebral bodies. They are well designed for
this function, inasmuch as they are short, stout pillars with thick walls.
• In general, the pedicles increase in size from the cervical to lumbar
regions, which makes sense inasmuch as greater forces are transmitted
through the pedicles in the lumbar region.
 A TYPICAL VERTEBRA
• The laminae- are thin, vertically oriented pieces of bone that serve as the
“roof” to the neural arch, which protects the spinal cord.
• In addition, the laminae transmit forces from the posterior elements to the
pedicles and, through them, onto the vertebral body. This force transfer
occurs through a region of the laminae called the pars interarticularis.
• The pars interarticularis, as its name suggests, is the portion of the
laminae that is between the superior and inferior articular processes. The
pars interarticularis is subjected to bending forces as forces are
transmitted from the vertically oriented lamina to the more horizontally
oriented pedicles. The pars interarticularis is most developed in the
lumbar spine, where the forces are the greatest in magnitude.
Ligaments
• Anterior and posterior longitudinal ligaments;
• The ligamentum flavum
• The interspinous,
• Supraspinous, and
• Intertransverse ligaments
Kinematics and kinetics

• Kinematics- Movements are kinematics like flx, extn, lat flex, rotation
or coupled movements
• Kinetics- are all about forces like axial compression, tension, bending,
torsion, and shear stress not only during normal functional activities
but also at rest.
CERVICAL VERTEBRAL COLUMN
• The cervical vertebral column consists of seven vertebrae
• The cervical column is divided into two distinct regions: the upper
cervical spine, or craniovertebral region, and the lower cervical spine
• The craniovertebral region includes the occipital condyles and the first
two cervical vertebrae, C1 and C2, or, respectively, the atlas and axis.
The lower cervical spine includes the vertebrae of C3 to C7(typical
cervical vertebrae)
• The atlas, axis, and C7 exhibit unique characteristics and are
considered the atypical cervical vertebrae. All of the cervical vertebrae
have the unique feature of a foramen (transverse foramen) on the
transverse process, which serves as passage for the vertebral artery
ATLAS
 ATLAS
• The functions of the atlas are to cradle the occiput and to transmit
forces from the occiput to the lower cervical vertebrae
• it has no vertebral body or spinous process and is shaped like a ring
• The lateral masses include four articulating facets: two superior and
two inferior. The superior zygapophyseal facets are large, typically
kidney-shaped, and deeply concave to accommodate the large, convex
articular surfaces of the occipital condyles.
 AXIS
• The primary functions of the axis are to transmit the combined load of
the head and atlas to the remainder of the cervical spine and to provide
motion into axial rotation of the head and atlas.
• The axis is atypical in that the anterior portion of the body extends
inferiorly and a vertical projection called the dens arises from the
superior surface of the body
• The arch of the axis has inferior and superior zygapophyseal facets for
articulation with the adjacent inferior vertebra and the atlas,
respectively. The spinous process of the axis is large and elongated
with a bifid (split into two portions) tip
AXIS
Articulations
• The two atlanto-occipital joints consist of the two concave superior
zygapophyseal facets of the atlas articulating with the two convex
occipital condyles of the skull.
• There are three synovial joints that compose the atlantoaxial joints: the
median atlantoaxial joint between the dens and the atlas and two
lateral joints between the superior zygapophyseal facets of the axis
and the inferior zygapophyseal facets of the atlas
Articulation of atlanto-occipital
joints and atlantoaxial joints.
 CRANIOVERTEBRAL LIGAMENTS
• Posterior atlanto-occipital and atlantoaxial membranes are the continuations
of the ligamentum flavum
• The anterior atlanto-occipital and atlantoaxial membranes are the
continuations of the anterior longitudinal ligament
• The tectorial membrane is the continuation of the PLL in the upper two
segments and is a broad, strong membrane that originates from the posterior
vertebral body of axis, covers the dens and its cruciate ligament, and inserts at
the anterior rim of the foramen magnum
• The thick ligamentum nuchae, which extends from the spinous process of C7
to the external occipital protuberance, is an evolution of the supraspinous
ligaments
• The ligamentum nuchae serves as a site for muscle attachment and likely
helps to resist the flexion moment of the head.
Transverse Ligament
• The transverse portion of the ligament holds the dens in close
approximation against the anterior ring of the atlas and serves as an
articular surface. Its primary role, however, is to prevent anterior
displacement of C1 on C2. This ligament is critical in maintaining
stability at the C1/C2 segment
Alar ligaments
• The two alar ligaments are also specific to the cervical region
• Arise from the axis on either side of the dens and extend laterally and
superiorly to attach to roughened areas on the medial sides of the occipital
condyles and to the lateral masses of the atlas.
• These ligaments are relaxed with the head in midposition and taut in flexion
• Axial rotation of the head and neck tightens both alar ligaments and prevent
distraction of C1 on C2
• The apical ligament of the dens connects the axis and the occipital bone of
the skull. It runs in a fan-shaped arrangement from the apex of the dens to
the anterior margin of the foramen magnum of the skull
The Lower Cervical Region
• Typical Cervical Vertebrae
• The body of the cervical vertebra is small, with a transverse diameter
greater than anteroposterior diameter and height. The upper and lower
end plates from C2 to C7 also have transverse diameters (widths) that
are greater than the corresponding anteroposterior diameters.
• The transverse and anteroposterior diameters increase from C2 to C7
with a significant increase in both diameters in the upper end plate of
C7
The body of a typical cervical vertebra
• Pedicles- The pedicles project posterolaterally and are located halfway
between the superior and inferior surfaces of the vertebral body.
• Laminae- The laminae are thin and slightly curved. They project
posteromedially.
• Zygapophyseal Articular Processes (Superior and Inferior)- The
processes support paired superior facets that are flat and oval and face
superoposteriorly. The width and height of the superior zygapophyseal
facets gradually increase from C3 to C7.
• Transverse Processes. A foramen is located in the transverse processes
bilaterally for the vertebral artery, vein, and venous plexus. Also, there is
a groove for the spinal nerves.
• Spinous Processes- The cervical spinous processes are short, slender,
and extend horizontally. The tip of the spinous process is bifid. The
length of the spinous processes decreases slightly from C2 to C3,
remains constant from C3 to C5, and undergoes a significant increase
at C7.
• Vertebral Foramen- The vertebral foramen is relatively large and
triangular.
Function of the Cervical Region
• Kinematics- The cervical spine is designed for a relatively large amount of
mobility. Normally, the neck moves 600 times every hour whether we are
awake or asleep
• The motions of flexion and extension, lateral flexion, and rotation are
permitted in the cervical region. These motions are accompanied by
translations that increase in magnitude from C2 to C7
• The atlanto-occipital joints allow for only nodding movements between the
head and the atlas
• In flexion, the occipital condyles roll forward and slide backward. In
extension, the occipital condyles roll backward and slide forward.
• The combined ROM for flexion-extension reportedly ranges from 10 to 30
• Motions at the atlantoaxial joint include rotation, lateral flexion, flexion, and
extension. Approximately 55% to 58% of the total rotation of the cervical
• Lower cervical segments generally favor flexion and extension ROM;
however, there is great variability in reported ranges of motion in the
individual cervical segments. In general, the range for flexion and
extension increases from the C2/C3 segment to the C5/C6 segment, and
decreases again at the C6/C7 segment
• The height is large in comparison with the anteroposterior and transverse
diameters of the cervical disks. Therefore, a large amount of flexion,
extension, and lateral flexion may occur at each segment, especially in
young persons, when there is a large amount of water in the disks
• The disk at C5/C6 is subject to a greater amount of stress than other disks
because C5/C6 has the greatest range of flexion-extension and is the area
where the mechanical strain is greatest
• Kinetics- In the cervical region from C3 to C7 compressive forces
are transmitted by three parallel columns: a single anterocentral
column formed by the vertebral bodies and disks and two rodlike
posterolateral columns composed of the left and right zygapophyseal
joints. The compressive forces are transmitted mainly by the bodies
and disks, with a little over one third transmitted by the two
posterolateral columns.59,67,68 Compressive loads are relatively low
during erect stance and sitting postures and high during the end ranges
of flexion and extension
Structure of the Thoracic Region
• The 1st and 12th thoracic vertebrae are transitional vertebrae and therefore
possess characteristics of the cervical and lumbar vertebrae
BODY-
• The body of a typical thoracic vertebra has equal transverse and anteroposterior
diameters
• The vertebral bodies are wedge shaped with posterior height greater than anterior
height, which produces the normal kyphotic posture of the thoracic spine
• Demifacets (or half facets) for articulation with the heads of the ribs are located
on the posterolateral corners of the vertebral plateaus.
• Arches Pedicles. These generally face posteriorly with little to no lateral
projection, creating a small vertebral canal.
• Laminae. The laminae are short, thick, and broad.
• Spinous Processes- The spinous processes slope inferiorly and, from
T5 to T8, overlap the spinous process of the adjacent inferior vertebra.
• The spinous processes of T11 and T12 are triangular and project
horizontally. For most of the thoracic spine, the tip of the spinous
process lies at the level of the caudal vertebral body.
• Vertebral Foramen- The vertebral foramen is small and circular.
 Articulations
Interbody Joints- The interbody joints of the thoracic spine involve flat
vertebral surfaces that allow for all translations to occur. The
intervertebral disk allows for tipping of the vertebral bodies; however,
the relatively small size limits the available motion
Zygapophyseal Joints- The zygapophyseal joints are plane synovial
joints with fibroadipose meniscoids present. These joints lay
approximately 20º off the frontal plane, which allows greater ROM into
lateral flexion and rotation and less ROM into flexion and extension
LIGAMENTS
• Same as before
Function of the Thoracic Region
• The thoracic region is less flexible and more stable than the cervical
region because of the limitations imposed by structural elements such
as the rib cage, spinous processes, taut zygapophyseal joint capsules,
the ligamentum flavum, and the dimensions of the disks and the
vertebral bodies.
• Each thoracic vertebra articulates with a set of paired ribs by way of
two joints: the costovertebral and the costotransverse joints.
 Kinematics
• All motions are possible in the thoracic region, but the range of flexion and
extension is extremely limited in the upper thoracic region (T1 to T6),
because of the rigidity of the rib cage and because of the zygapophyseal facet
orientation in the frontal plane.
• In the lower part of the thoracic region (T9 to T12), the zygapophyseal facets
lie more in the sagittal plane, allowing an increased amount of flexion and
extension. Lateral flexion and rotation are free in the upper thoracic region
• In the upper part of the thoracic region, lateral flexion and rotation are
coupled in the same direction, whereas rotation in the lower region may be
accompanied by lateral flexion in the opposite direction.
• costovertebral and the costotransverse joints
Kinetics
• The thoracic region is subjected to increased compression forces in
comparison with the cervical region, because of the greater amount of
body weight that needs to be supported and the region’s kyphotic
shape
Structure of the Lumbar Region
• The first four lumbar vertebrae are similar in structure. The fifth
lumbar vertebra has structural adaptations for articulation with the
sacrum
• Body - The body of the typical lumbar vertebra is massive, with a
transverse diameter that is greater than the anterior diameter and
height. The size and shape reflect the need to support great
compressive loads caused by body weight, ground reaction forces, and
muscle contraction.
• Pedicles. The pedicles are short and thick and project posterolaterally.
• Laminae. The laminae are short and broad.
• Transverse Process. The transverse process is long and slender and
extends horizontally
• Spinous Process. The spinous process is broad and thick and extends
horizontally.
• Vertebral Foramen. The vertebral foramen is triangular and larger than the
thoracic vertebral foramen but smaller than the cervical vertebral foramen.
• L5 vertebra where in the anterior portion of the body is of greater height
than the posterior portion
• Additional to the previous ligaments there are 2 more ligaments that help
for the stability 1. thoracolumbar fascia and 2. iliolumbar ligament.
Function of the Lumbar Region
• Kinematics- The lumbar region is capable of movement in flexion,
extension, lateral flexion, and rotation
• during flexion and extension, the greatest mobility of the spine occurs
between L4, L5 and S1, which is also the area that must support the
most weight
• Rotation in this region, however, is more limited because of the shape
of the zygapophyseal joints
• Lumbar-Pelvic Rhythm
Lumbar-Pelvic Rhythm
Kinetics
• Kinetics- Compression
• primary functions of the lumbar region is to provide support for the
weight of the upper part of the body in static as well as in dynamic
situations.
• The lumbar region must also withstand the tremendous compressive
loads produced by muscle contraction
• Shear In the upright standing position, the lumbar segments are
subjected to anterior shear forces cause by the lordotic position, the
body weight, and ground reaction forces
 Structure of the Sacral Region
• Five sacral vertebrae are fused to form the triangular or wedge-shaped
structure that is called the sacrum.
• Sacroiliac Articulations- The two SIJs consist of the articulations
between the left and right articular surfaces on the sacrum (which are
formed by fused portions of the first, second, and third sacral
segments) and the left and right iliac bones
Sacral Region
 Function of the Sacral Region
• Kinematics- The SIJs permit a small amount of motion that varies
among individuals
• Nutation is the term commonly used to refer to movement of the sacral
promontory of the sacrum anteriorly and inferiorly while the coccyx
moves posteriorly in relation to the ilium.
• Counternutation refers to the opposite movement, in which the
anterior tip of the sacral promontory moves posteriorly and superiorly
while the coccyx moves anteriorly in relation to the ilium
Nutation and Counternutation
THANK YOU