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Download Basic Biomechanics, (5th edition) by Susan J. Hall, Ph.D.
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Chapter 9 The Biomechanics of the Human Spine Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. McGraw-Hill/Irwin © 2012 The McGraw-Hill Companies, Inc. All rights reserved. Structure of the Spine The spine is 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 Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-2 Thorax 12 pairs of ribs 7 pairs of true ribs (attach to sternum) 5 pairs of false ribs -3 pairs attach indirectly to sternum -2 floating ribs Manubrium Sternum Xiphoid process Ribs attach to vertebrae at the costal facets Vertebral joints: motion segment Atlanto-axial joint: pivot joint at C1 and C2. Atlanto-occipital joint: base of skull and C1 Vertebrae Landmarks: body, vertebral foramen, spinous process, transverse process, articular facets, costal facets. Structure of the Spine Transverse process Posterior Interspinous longitudinal ligament ligament Supraspinous ligament Vertebral body Intervertebral joint and facet Spinous process Ligamentum flavum Vertebral canal Posterior Anterior longitudinal ligament Cartilaginous end-plate Intervertebral disc Intervertebral foramen with nerve root Anterior The motion segment, consisting of two adjacent vertebrae and the associated tissues, is considered to be the functional unit of the spine. Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-6 Structure of the Spine What types of joints connect adjacent vertebrae? • intervertebral symphysis joints on the anterior side • two gliding diarthrodial facet joints on the posterior side Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-7 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 Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-8 Structure of the Spine The intervertebral discs are fibrocartilaginous structures that cushion the anterior spinal symphysis joints. The center region is the nucleus pulposus, a colloidal gel with a high fluid content. This is surrounded by the annulus fibrosus, a thick, fibrocartilaginous ring that forms the disk exterior. Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-9 Vertebrae Vertebrae increase in size from superior to inferior C1 and C2: atlas and axis Spinal curves: secondary: cervical and lumbar primary: thoracic and sacral Spinal curvature deformations: lordosis, kyphosis, and scoliosis Structure of the Spine What are the primary spinal curves? • the thoracic and sacral curves • (concave anteriorly) • are present at birth Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-11 Primary spinal curves (thoracic and sacral) are a result of body position during fetal development. 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 Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-13 Structure of the Spine Vertical alignment Lordosis Kyphosis Scoliosis Lordosis - exaggerated lumbar curve Kyphosis - exaggerated thoracic curve Scoliosis - lateral spinal curvature Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-14 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. Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-15 Movements of the trunk and spine • Spinal flexion (lumbar, trunk, cervical flexion): forward movement. • Spinal extension (lumbar, trunk, cervical extension): return movement posteriorly. • Lateral flexion (cervical or trunk) left or right side bending. • Spinal rotation (trunk or cervical): left or right rotation . • Reduction: return movement from lateral flexion. Movements of the Spine The cervical spinal flexor muscles include rectus capitus anterior, rectus capitis lateralis, longus capitis, longus colli, and eight pairs of hyoid muscles. Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-17 Movements of the Spine The abdominal spinal flexor muscles include rectus abdominis, the internal obliques, and the external obliques. Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-18 Movements of the Spine The cervical spinal extensor muscles include splenius capitis and splenius cervicis, assisted by rectus capitis posterior major and minor, and obliquus capitis superior and inferior. Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-19 Movements of the Spine The thoracic and lumbar spinal extensors are erector spinae (spinalis, longissimus, and iliocostalis), semispinalis - (capitis, cervicis, and thoracis), and the deep spinal muscles - (mulitifidi, rotatores, interspinales, intertransversarii, and levatores costarum). Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-20 Movements of the Spine The cervical lateral flexor muscles include sternocleidomastoid, levator scapulae, and scalenus anterior, posterior, & medius. When developing tension unilaterally, the cervical flexors and extensors also contribute. Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-21 Movements of the Spine The lumbar lateral flexor muscles are the quadratus lumborum and psoas major. The lumbar flexors and extensors also contribute when developing tension unilaterally. Basic Biomechanics, 6 edition th By Susan J. Hall, Ph.D. 9-22 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 Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-23 Loads on the Spine In normal standing position, body weight acts anterior to the spine, creating a forward bending load (moment) on the spine. Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-24 Loads on the Spine Fs Fc Because the spine is curved, body weight, acting vertically, has components of both compression (Fc) and shear (Fs) at most motion segments. wt Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-25 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 Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-26 Loads on the Spine tension compression Lumbar hyperextension can create a bending load (moment) in the posterior direction. Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-27 Loads on the Spine Lumbar hyperextension produces compressive loads at the facet joints. hyperextension Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-28 Loads on the Spine Superior view Lateral view Spinal rotation generates shear stress in the intervertebral discs. Basic Biomechanics, 6th edition By Susan J. Hall, Ph.D. 9-29 Vertebral disks: annulus fibrosus and nucleus pulposus. Herniated disks: protrusion of nucleus pulposus
