Biomechanics of Human Spine

BIOMECHANICS II Lecture 1:
Anatomy of Human Spine
Presented by :
Sidra Tariq
Orthotist and Prosthetist
PIRS, Isra University
CONTENTS:
 Vertebral Column anatomy
 Intervertebral Discs and Biomechanics
 Vertebral Arch and Spinal Canal
 Facet Joints and Biomechanics
 Spinal Cord
 Spinal Curves
 Biomechanics Spine
Anatomy
BLOOD SUPPLY OF SPINAL CORD

Spinal cord receives its blood supply from 3

main arteries:

 Two posterior spinal arteries

 One anterior spinal artery
LIGAMENTS OF SPINE
MUSCLES OF SPINE
 Creates cover of soft tissue
 Permits movements and stability of spine
 It is knows as par spinal muscles
 Role of Para spinal muscles are:
 Stabilization of bones
 It Influence posture
 It Influence movements: Extension, flexion, Rotation
VERTEBRAL COLUMN

 Vertebrae are 33 individual, interlocking bones that form spinal

column.
 Divided structurally into 5 regions.
 7 cervical vertebrae,
 12 thoracic vertebrae,
 5 lumbar vertebrae
 5 fused sacral vertebrae,
 4 small, fused coccygeal vertebrae.
Each vertebra has three main functional components:

1. The vertebral body for load bearing.

2. The vertebral arch for load bearing
3. The transverse process for ligament attachments
 Motion segment

 Two adjacent vertebrae and the soft tissues between them is known as a
motion segment.

 Varying amounts of movements are permitted between adjacent vertebrae of

the.

 The motion segment is considered the functional unit of the spine

VERTEBRAE

 Vertebrae is plural of vertebra

 The vertebral bodies serve as the primary weight-bearing components of the

spine.

 The neural arches and posterior sides of the bodies and inter-vertebral discs

form a protective passageway for the spinal cord and associated blood vessels

known as the vertebral canal.

Cervical (neck):
 The main function of the cervical spine is to support the weight of the head (about 10 pounds.

 The neck has the greatest range of motion because of C1 and C2 vertebrae that connect to the skull.

 C1 to C7 are vertebrae in neck.

Thoracic (mid back):

 Thoracic spine has T1 to T12 vertebrae

 Their main function of is to hold the rib cage, protect the heart and lungs.

 The range of motion in the thoracic spine is limited.

Lumbar :
 Lubber spine has L1 to L5 vertebrae

 Their main function is to bear the weight of the body.

 These vertebrae are much larger in size than other vertebrae of the spine , to absorb the stress

of weight.

Sacrum:
 Sacrum has five vertebrae S1 to S5, all fused together.
 The sacrum connects the spine to the iliac bones of the pelvis girdle

Coccyx region :
These are 4 fused bones of the coccyx or tailbone provide attachment for ligaments and

muscles of the pelvic floor.

PARTS OF VERTEBRA:
 A vertebra has three parts: Body
(purple), Vertebral arch (green), and
Transverse Processes (tan).

 A drum-shaped body (Purple) is to

bear weight and compression

 An arch-shaped bone (green) that

protects the spinal cord,
 The first cervical vertebra, known as the atlas, provides a reciprocally shaped
receptacle for the condyles of the of the skull.

 The second vertebra is called Axis, and has tooth like structure that makes
rotatory joint (atlantoaxial joint) with atlas for rotation of head. . Motion at the
atlantoaxial joint averages around 75° of rotation, 14° of extension, and 24° of
lateral flexion

 The atlantooccipital joint ( between 1st cervical vertebra and skull) is extremely
stable, with flexion/extension of about 14–15° permitted, but with virtually no
motion occurring in any other plane.
 ANATOMY OF VERTEBRA
Spinous process
Lamina Transverse process
Body Facet that articulates
Pedicle with rib tubercle
Superior articulating
process
Vertebral foramen

Thoracic vertebra
Biomechanics
WHAT IS BIOMECHANICS?

 Biomechanics is the science of movement of a living body,

including how muscles, bones, tendons, and ligaments work
together to produce movement.

 Biomechanics is part of the larger field of kinesiology,

specifically focusing on the mechanics of the movement.
INTERVERTEBRAL DISCS

 It is a Fibro-cartilagenous structure
 Contributes 25% of height of spinal cord
 Function of shock absorption, transmitting compressive load between
adjacent vertebral bodies
 Composed of nucleus pulposus, peripheral annulus fibrosis and the end plate
 The end plate is a bilayer cartilage that separate the IVD from vertebral body
and serves as a growth plate for the vertebral body
Intervertebral Disc has two
components:

• Central: Nucleus pulposus

• Peripheral: Annulus fibrosus

Annulus Fibrosus:
 Annulus fibrosus means ring of fibers.
 Composed of concentric rings of type I collagen.
 High collagen and low proteoglycians ratio.
 Annulus Fibrosus functions to surround and
protect nucleus pulposus.
Nucleus pulposus:
Highly hydrated structure ( More water content)
 Colloidal gel with high water content
 Hydrophilic matrix: composed of proteoglycians inter-
spread type II collagen and elastin mesh
 Low collagen and high Prostaglycans ratio
 Characterised by compressibility
 The extremely high fluid content of the nucleus makes it
resistant to compression.
BIOMECHANICS OF DISC

 When a disc is loaded in compression, it tends to simultaneously lose water and

absorb sodium and potassium until its internal electrolyte concentration is
sufficient to prevent further water loss.

 When this chemical equilibrium is achieved, internal disc pressure is equal to the
external pressure.

 Continued loading over a period of several hours results in a further slight

decrease in disc hydration.

 The spine undergoes a decrease of height up to nearly 2 cm over the course of a

day, with approximately 54% of this loss occurring during the first 30 minutes
after an individual gets up in the morning.
 During flexion and extension, the vertebral bodies roll over the
nucleus while the facet joints guide the movements.

 Spinal flexion, extension, and lateral flexion produce

compressive stress on one side of the discs and tensile stress
on the other, whereas spinal rotation creates shear stress in the
discs.

 Once pressure on the discs is relieved, the discs quickly

reabsorb water, and disc volumes and heights are increased.
 In space without gravity, height of spine increases 5 cm.

 On earth gravity, disc height and volume are typically greatest when a person
first arises in the morning.

 Because increased disc volume also translates to increased spinal stiffness,

there appears to be a heightened risk of disc injury early in the morning.

 Measurements of spinal shrinkage following activities performed for one hour

immediately after rising in the morning yielded average values of 7.4 mm for
standing, 5.0 mm for sitting, 7.9 mm for walking, 3.7 mm for cycling, and 0.4
mm for lying down.

 Body positions that allow rehydration and height increase in the discs are
spinal hyperextension in the prone position and trunk flexion in the supine
position
DISC BIOMECHANICS

When the spine bends, a tensile load is

created on one side of the discs, and a
Mechanically, the annulus fibrosus compressive load is created onthe other.
behaves as a coiled spring, holding the
vertebral bodies together, whereas the
nucleus pulposus actslike a ball bearing
that the vertebrae roll over during
flexion/extension and lateralbending.

Spinal rotation creates shear stress within the

discs, with the greatest shear around the periphery
of the annulus.
 VERTEBRAL ARCH & SPINAL CANAL:

 Posteriorly, each vertebra make bony projections that form the

vertebral arch.
 The arch is made of two supporting pedicles and two laminae.
 The hollow spinal canal contains the spinal cord, fat, ligaments,
and blood vessels.
 Under each pedicle, a pair of spinal nerves exits the spinal cord
and pass through the intervertebral foramen.
The vertebral arch (green) forms the spinal canal (blue) through which the spinal
cord runs. Seven bony processes arise from the vertebral arch to form the facet joints
and processes for muscle attachment.
FACET JOINTS

 The superior and inferior vertebrae

articulates through facet joints.

 The facet joints of the spine allow

little spine motion.

 Each vertebra has four facet joints,

one pair that connects to the
vertebra above (superior facets)
and one pair that connects to the
vertebra below (inferior facets).
BIOMECHANICS OF FACET JOINT

 There are two facet joints in each spinal motion segment.

 Each Facet joint is innervated by Recurrent spinal nerve.

 The facet joints and discs together provide 80% of the spine to resist rotational
torsion and shear forces

 The facet joints also sustain up to approximately 30% of the compressive loads
during hyperextension.
SPINAL CORD

 The spinal cord passes through spinal canal.

 It is about 18 inches long, runs from the brainstem to the L1 (1st

lumbar vertebra)
 Below L1, the spinal cord continues downward as a cauda equina (
horse tail like structure) before branching off to lower limbs.

 The spinal cord receives code messages of pain, temperature , and

movements from body and sends to brain. The brain after
analysing the coded messages, makes decisions and sends motor
messages to the limbs and body through the spinal cord allowing
for movement.
 These codes messges are transmitted through electrolytes changes
in nerves, called action potential changes through ganglions.
 Ganglions are connections of two or more nerves.
 Nerves, coming into the ganglion from body are called pre-
ganglionic nerves.
 Nerves leaving the ganglion into the spinal cord are called
post ganglion nerves.
 There are some special pathways from body to spine, and
spine can makes its own decisions, called spinal reflexes, are
designed to immediately protect our body from harm.
 There are some special pathways from body to spine, and spine can makes its
own decisions, called spinal reflexes, are designed to immediately protect our
body from harm e.g hand withdrawal after touching hot iron.

 Any damage to the spinal cord can result in a loss of sensory and motor
function below the level of injury.

 Paraplegia: An injury to the thoracic or lumbar area may cause motor and
sensory loss of the both legs.

 Tetraplegia An injury to the cervical spine may cause sensory and motor loss of
the both arms and both legs.
 Spinal cord Coverings and Spaces:
 The spinal cord is covered with the three membranes called meninges.
 The inner membrane is the Pia mater, a soft layer attached to the cord.
 The middle membrane is the Arachnoid mater.
 The outer membrane is the Dura mater which has hard layer.

 The subarachnoid space between the Pia and Arachnoid mater.

 It is the wide space filled with cerebrospinal fluid (CSF).
 CSF fluid is formed in brain ventricles choroid plexus and circulates
though subarachnoid space of spinal cord.
 CSF provides protection and nutrition to spinal cord.
The image shows CSF formation in plexus choroid and
circulation from brain to entire spinal cord.
EPIDURAL SPACE

 The epidural space, another potential is

the area between the Dura mater and the
vertebral wall, containing fat and small
blood vessels.

 The space is located just outside the Dural

sac which surrounds the nerve roots and is
filled with cerebrospinal fluid.

 Epidural space is used by anaesthetists to

use anaesthetic injections for different
lower limbs surgeries, gynaecological
procedures.
SPINAL CURVES
 When viewed from the side, an adult
spine has a natural S-shaped curve.

 The cervical and lumbar regions have

a slight concave curve, kyphosis, and
the thoracic and sacral regions have a
gentle convex curve, Lardosis.

 The curves work like a coiled spring

to absorb shock, maintain balance,
and allow range of motion throughout
the spinal column.
 An abnormal curve of the lumbar spine is lordosis, also called sway back.
 An abnormal curve of the thoracic spine is kyphosis, also called
hunchback.
 An abnormal curve from side-to-side is called scoliosis.
TYPES OF SPINAL CURVES
Primary Spinal Curves:
Curves that are present at birth. As viewed in the sagittal plane, the spine
contains four normal curves. The thoracic and sacral curves, which are
concave anteriorly, are present at birth and are referred to as primary curves.
Secondary Spinal Curves:
Curves that do not develop until the weight of the body begins to be supported
in sitting and standing positions. The lumbar and cervical curves, which are
concave posteriorly, develop from supporting the body in an upright position
after young children begin to sit up and stand
Abnormalities in Spinal Curvature
LORDOSIS

Lordosis is the normal inward lordotic curvature of the lumbar and cervical
regions of the human spine.
 Abnormal when Exaggeration of the lumbar curve, lordosis, and often
associated with weakness of abdominal muscles and anterior pelvic tilt
Causes:
 congenital spinal deformity
 weakness of the abdominal muscles,
 Poor postural habits
 overtraining in sports requiring repeated lumbar hyperextension, such as
gymnastics.
 Because lordosis places added compressive stress on the posterior elements of
the spine, some have hypothesized that excessive lordosis is a risk factor for
low back pain development.

 Limited range of motion in hip joint extension is associated with exaggerated

acquired lumbar lordosis.

 Obesity causes reduced range of motion of the entire spine and pelvis,
increased anterior pelvic tilt and increased lumbar lordosis.

 Similarly, increased anterior pelvic tilt and increased lordosis are greater during
running than during walking.
KYPHOSIS

 Kyphosis is a spinal disorder in which an excessive outward curve of the

spine results in an abnormal rounding of the upper back, known as
"roundback" or—in the case of a severe curve—as "hunchback.“

 Kyphosis can occur at any age, but is common during adolescence.

 The incidence of kyphosis is 8% in the general population, with equal

distribution across genders
Causes:
 A congenital abnormality
 A pathology such as osteoporosis, or Scheuermann’s disease
Look at the difference
between scoliosis and
kyphosis
SCHEUERMANN’S KYPHOSIS

 A regid thoracis hyperkyphosis defined by curve more than 45 degrees.

 It is caused by anterior wedging of > 5 degree across three consecutives
vertebrae, and narrowed disc space

Causes:
 Osteonecrosis of anterior apophyseal ring

 Herniation of disc material

 Altered biomechanics leading to anterior wedging and subsequent

growth arrest
Scheuermann’s kyphosis
showing curve more than 45
degree
SCOLIOSIS

 Lateral spinal curvature or deviations in spinal curvature are

referred to as scoliosis.
 Scoliosis may appear as either a C- or an S-curve involving the
thoracic spine, the lumbar spine, or both.
 A distinction is made between structural and non-structural scoliosis.
 Structural scoliosis involves inflexible curvature that persists even with
bending of the spine.
 Non-structural scoliotic curves are flexible and are corrected with bending of
spine
 This picture shows “S” shape
lateral deviation of spine
Called scoliosis
TYPES OF SCOLIOSIS

 Adolescent Idiopathic scoliosis

 Infantile idiopathic scoliosis
 Juvenile idiopathic scoliosis
 Congenital idiopathic scoliosis
 Neuromuscular scoliosis
 Pathological scoliosis
Causes of scoliosis
 Congenital abnormalities
 Spinal tumours, benign or malignant or metastatic
 Non-structural scoliosis may occur secondary to a leg length discrepancy
or local inflammation.
 Small lateral deviations in spinal curvature are relatively common and may
result from a habit such as carrying books or a heavy purse on one side of
the body every day.
 Idiopathic scoliosis is most commonly diagnosed in children between the ages

of 10 and 13 years, but can be seen at any age.

 It is present in 2–4% of children between 10 and 16 years of age and is more

common in females.

 Low bone mineral density is typically associated with idiopathic scoliosis and

may play a causative role in its development

 Treatment:
 Mild cases may be asymptomatic and may self-correct with time
maybe treated with brace for stop of progression or surgery if
braces in effective or scoliotic curve progression

 Severe cases, which is characterized by extreme lateral deviation

and localized rotation of the spine, can be painful and deforming,
and is treated with bracing and/or surgery or both.
BIOMECHANICS OF SPINE

Cardinal movements are:

 Flexion- Extension

 Compression
 Axial Rotation
 Lateral Flexion
FLEXION-EXTENSION

Two components:
 Sagittal rotation
 6-10 degree
 Resisted by annulus, Facet joints, Ligaments, back
muscles
 Translation
 2mm
 Resisted by facets and annulus
COMPRESSION

Compression is always
underestimated

Produced by:
 Weight lifting
 Back muscles
LATERAL FLEXION
 It is more limited than
extension.

 Maximum motion at Lumbo-

sacral spine.

 Anterior tilting and gliding

of superior vertebra occurs.

 Increases the diameter of

inter-vertebral foramina.
THANKYOU!