Summary
- Functions of the spine
- Anatomy of the spine
- Spinal vulnerability to trauma
Functions of the Spine
- Protection (particularly of the spinal cord)
- Mobility
- There is significant mobility at individual facet joints between vertebrae
- The cumulative effect of this adds up
- Mobility differs by region
- Movement is greatest in cervical/lumbar movements
- Haematopoesis
- The is significant cancellous bone within the vertebral bodies
- Venous plexus in vertebral body
- Communication
- IV foramen allow neurovascular passage
Anatomy of the Spine
- There are several anatomical features with their own functions
- IV discs – 25% of the length of the spine is made up by these
- These are strong and can withstand pressure
- ↓Size with age as ↓hydration => decreased height
- Spinous processes
- These restrict movement (specifically hyperlordosis)
- ↑SA for ligament attachment
Spinal Curvatures
- Primary curvature – thoracic + sacral (these are present before birth)
- Secondary curvatures – Lumbar + cervical
- Lumbar lordosis
- Inward curving
- Exaggerates during pregnancy to maintain balance through hip
- Thoracic kyphosis
- Outward curving
- Can be pathological – Hunchback
- Scoliosis
- Lateral curvature
- Often pathological
Spinal vulnerability
- Some aspects of the spine have compromised stability for mobility
- Particularly C- and L-spine
- L-spine is prone to injury from ↑load
- C-spine is prone to injury from hyperflexion/hyperextension
- The spine is particularly vulnerable at static-dynamic junctions
- e.g. Sacrum-lumbar junction and spinal-skull junction
- Spine is prone to:
- Fractures
- IVD herniation
- Weak posterolaterally
- Cauda equina syndrome (CES)
- Loss of cauda equina function
- Often iatrogenic – lumbar puncture
- Causes incontinence