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ENT 214 Biomechanics Biomechanics of Human Spine Picture retrieved from http://en.wikipedia.org/wiki/Image:Spinal_column_curvature.png Structure of the Spine What is the vertebral column? a curved stack of 33 vertebrae structurally divided into five regions: cervical region - 7 vertebrae thoracic region - 12 vertebrae lumbar region - 5 vertebrae sacrum - 5 fused vertebrae coccyx - 4 fused vertebrae Picture retrieved from http://www.becomehealthynow.com/images/organs/spine/ant_lat.jpg Structure of the Spine What is a motion segment? two adjacent vertebrae and the associated soft tissues considered the functional unit of the spine Structure of the Spine Transverse process Posterior Interspinous longitudinal ligament ligament Supraspinous ligament Vertebral body Intervertebral joint and facet Spinous process Ligamentum Vertebral flavum canal Posterior Anterior Anterior longitudinal ligament Cartilaginous end-plate Intervertebral disc Intervertebral foramen with nerve root Two adjacent vertebrae and the associated tissues comprise the motion segment. Structure of the Spine What are the joints between adjacent vertebrae? intervertebral symphysis joints on the anterior side two gliding diarthrodial facet joints on the posterior side Structure of the Spine What is the function of the facet joints? to channel and limit the range of motion in the different regions of the spine to assist in load bearing, sustaining up to 30% of the compressive load on the spine, particularly when the spine is in hyperextension Structure of the Spine What are the intervertebral discs? fibrocartilaginous discs that cushion the anterior spinal symphysis joints composed of a nucleus pulposus (colloidal gel with a high fluid content) surrounded by the annulus fibrosus (a thick, fibrocartilaginous ring that forms the disk exterior) Picture retrieved from http://upload.wikimedia.org/wikipedia/commons/e/e9/ACDF_oblique_annotated_english.png Cervical Vertebra Structure of the Spine What are the primary spinal curves? the thoracic and sacral curves concave anteriorly are present at birth Thoracic Vertebra Picture retrieved from http://upload.wikimedia.org/wikipedia/commons/d/d2/Gray90.png Structure of the Spine What are the secondary spinal curves? the lumbar and cervical curves concave posteriorly develop from supporting the body in an upright position after young children begin to sit and stand Cervical Vertebra Picture retrieved from http://en.wikipedia.org/w iki/Image:Gray85.png Picture retrieved from http://en.wikipedia.org/wiki/Image:Cervical_vertebra_english.png Picture retrieved from http://upload.wikimedia.org/wikipedia/commons/6/62/Gray94.png Lumbar Vertebra Picture retrieved from http://upload.wikimedia.org/wikipedia/commons/b/b2/Gray430.png Structure of the Spine Vertical alignment Lordosis Kyphosis Scoliosis Lordosis - exaggerated lumbar curve Kyphosis - exaggerated thoracic curve Scoliosis - lateral spinal curvature Picture retrieved from http://www.childsdoc.org/spring2002/scoliosis2.jpg Movements of the Spine What movements of the spine are allowed? The movement capabilities of the spine are those of a ball and socket joint, including movement in all three planes and circumduction. Mechanically: Annulus fibrous – acts like coiled spring Nucleus pulposus – acts like ball bearing Movements of the Spine What muscles contribute to flexion of the spine in the cervical region? rectus capitus anterior rectus capitis lateralis longus capitis longus colli eight pairs of hyoid muscles Picture retrieved from http://upload.wikimedia.org/ wikipedia/en/6/6f/Rectus_c apitis_anterior_muscle.PN G Movements of the Spine What muscles contribute to flexion of the spine in the abdominal region? rectus abdominis internal obliques external obliques Picture retrieved from http://upload.wikimedia.org/wikipedia/common s/3/32/Illu_trunk_muscles.jpg Movements of the Spine What muscles contribute to extension of the spine in the cervical region? splenius capitis splenius cervicis assisted by: rectus capitis posterior major and minor obliquus capitis superior and inferior Picture retrieved from http://upload.wikimedia.org/wikipedia/common s/5/51/Splenius.png Movements of the Spine What muscles contribute to extension of the spine in the thoracic and lumbar regions? erector spinae - spinalis, longissimus, iliocostalis semispinalis - capitis, cervicis, thoracis deep spinal muscles - mulitifidi, rotatores, interspinales, intertransversarii, levatores costarum Picture retrieved from http://upload.wikimedia.org/wikipedia/common s/9/90/Gray389.png Movements of the Spine What muscles contribute to lateral flexion of the cervical spine? sternocleidomastoid levator scapulae scalenus anterion, posterior, & medius PLUS the cervical flexors and extensors when developing tension unilaterally Picture retrieved from http://upload.wikimedia.org/wikipedia/common s/1/1a/Sternocleidomastoideus.png Movements of the Spine What muscles contribute to lateral flexion of the lumbar spine? quadratus lumborum psoas major PLUS the lumbar flexors and extensors when developing tension unilaterally Picture retrieved from http://upload.wikimedia.org/wikipedia/common s/8/8d/Quadratuslumborum.png Loads on the Spine What forces commonly act on the spine? body weight tension in the spinal ligaments tension in the spinal muscles any external loads carried in the hands Loads on the Spine In normal standing position, body weight acts anterior to the spine, creating a forward bending load (moment) on the spine. Loads on the Spine Fs Fc wt Because the spine is curved, body weight, acting vertically, has components of both compression (Fc) and shear (Fs) at most motion segments. Loads on the Spine During lifting, both compression and anterior shear act on the spine. Tension in the spinal ligaments and muscles contributes to compression. Muscle tension Shear reaction force Joint center Compression reaction force Sample Problem 1 How much tension must be developed by the erector spinae with a moment arm of 6cm from L5-S1 joint center to maintain the body in the position shows on your right? Given that Head : 58 N Arms : 81 N Trunk : 328 N Box : 111 N Loads on the Spine compression tension Lumbar hyperextension can create a bending load (moment) in the posterior direction. Loads on the Spine Lumbar hyperextension produces compressive loads at the facet joints. hyperextension Loads on the Spine Superior view Lateral view Spinal rotation generates shear stress in the intervertebral discs. Human Posture When Lifting Common Injuries Low back pain Soft tissue Injuries Acute fractures Stress Fracture – spondylolysis (fracture in vertebral neural arch) Disc herniation