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Degenerative Disease of

the Spine
CODILLIA CHEONG
ZUHAIR YUSOFF
AZREEN

Disease of the spine

Anatomy of
spine
Vertebral column
consist of 33
vertebrae:
7 Cervical
12 Thoracic
5 Lumbar
5 Sacral (fused)
4 Coccygeal
(fused)

Appearance of Secondary
curvatures
1.year

New born
Only
Concavity

3-4.month
Cervical
curvature
develop as the
child able to
raise the head
(convexity)

Lumbar curvature
develop as the
child begin to

Adult

Function of spine
The spine is the central body pillar
that:
Enable us to stand upright
Gives our body structures and
support
Allow us to move freely and bend
with flexibility
Designed to protect the spinal cord &
roots of spinal nerves.

General characteristic

Cervical
vertebrae

Main function: To support


the weight of the head.
C1 (Atlas) & C2 (Axis):
Specialized to allow
greater range of motion
of the head.
Atlanto-occipital jt
(Synovial) allows
nodding of the head and
lateral tilting.
C1 & C2 forms atloaxoid
joint (pivot joint) allowing
sideways rotation of the
head.

C3-C7
vertebrae

Features of
cervical
vertebrae:
Presence of
transverse
foramen
Bifid spine
Triangular
vertebral
foramen
Superior
articular facet is
directed

Thoracic
vertebrae
Main function is to hold
the rib cage.
Features :
Presence of costal
facets on the side of
the body & transverse
processes
Small and circular
vertebral foramen
Long and tapering
spinous process
They increase in size
going downwards.

Lumbar Vertebrae
Numbered from L1-L5
Main function is to support the weight of
the body.
Largest segment of the vertebrae column.
Features:
Large, broad body.
Horizontal, Quadrangular
spinous process
Superior articular facet
directed medially

Sacral Vertebrae
Consists of 5 bones
fused together
Articulate with L5
and the ilium
Sacral promontory
-ant.& upper
margin of
1st.S.vtbra
Sacral hiatus
-lower opening of
Sacr.canal

Coccyx Vertebrae
Coccyx vertebrae
is made up of
four bones fused
together
Provides
attachment for
ligaments and
muscles of the
pelvic floor

Intervertebral Discs
Each vertebra is separated by an
intervertebral disc
Functions :
Act as a shock absorber between each
vertebra
Allow the spine to bend
23 intervertebral discs:
6 in the cervical region
12 in the thoracic region
5 in the lumbar region

The disks are made of


fibrocartilaginous material
The outside of the disk is
made up of a strong material
called the annulus fibrosus.
Inside this protective covering
is a jelly-like substance known
as mucoprotein gel, known as
the nucleus pulposus.
Vertebral endplate act as
growth plate for vertebral
body
Separates each of the
intervertebral disc superiorly and
inferiorly

Ligaments of the Spine


The ligaments are strong fibrous bands that hold the
vertebrae together.
It also helps to stabilize the spine, and protect the discs.
The three major ligaments of the spine are :
ligamentum flavum
anterior longitudinal ligament (ALL)
posterior longitudinal ligament (PLL)

The ALL and PLL are continuous bands that run from the
top to the bottom of the spinal column along the
vertebral bodies
They prevent excessive movement of the vertebral
bones.
ligamentum flavum attaches between the lamina of each
vertebra.

Spinal Cord

Runs through the vertebral


canal
Extends from foramen
magnum to second lumbar
vertebra
Regions
Cervical
Thoracic
Lumbar
Sacral
Coccygeal
Gives rise to 31 pairs of
spinal nerves
All are mixed nerves
Not uniform in diameter
Cervical enlargement:
supplies upper limbs
Lumbar enlargement:
supplies lower limbs

Conus medullaris- tapered


inferior end
Ends between L1 and L2
Cauda equina - origin of spinal
nerves extending inferiorly from
conus medullaris.
Filum terminale - Extension of the
pia mater from the conus
medullaris.
- Fx: Gives support by anchors
spinal
cord to coccyx

Cross
Spinal
Cord
Anterior
medianSection
fissure andof
posterior
median
sulcus
deep clefts partially separating left and right
halves
Gray matter: neuron cell bodies, dendrites, axons
Divided into horns
Posterior (dorsal) horn
Anterior (ventral) horn
Lateral horn
White matter
Myelinated axons
Divided into three columns
Ventral
Dorsal
lateral
Each of these divided into sensory or motor
tracts

Thirty-one pairs of
spinal nerves branch
off the spinal cord
Each spinal nerve
has two roots.
ventral (front) root
carries motor
impulsesfromthe
brain
dorsal (back) root
carries sensory
impulsestothe brain.
The ventral and
dorsal roots fuse
together to form a
spinal nerve

Spinal nerve travels down the spinal


canal, alongside the cord, until it
reaches its exit hole
intervertebral foramen

Once the nerve passes through the


intervertebral foramen, it branches.
Anterior primary ramus
Posterior primary ramus

Each branch has both motor and


sensory fibers.
Posterior primary ramus turns
posteriorly to supply the skin and
muscles of the back of the body.
Anterior primary ramus turns anteriorly
to supply the skin and muscles of the
front of the body and forms most of the
major nerves.

The spinal nerves are numbered according to the


vertebrae above which it exits the spinal canal.
8 cervical spinal nerves are C1 through C8
12 thoracic spinal nerves are T1 through T12
5 lumbar spinal nerves are L1 through L5
5 sacral spinal nerves are S1 through S5
1 coccygeal nerve.

Covering of the Spinal Cord


There are 3 meningeal layers:
dura mater
arachnoid mater
pia mater
Dura mater is a outer, tough,
fibrous coat
Arachnoid mater is
translucent, collagenous
membrane
Innermost, pia mater is a
delicate, vascular membrane
firmly attached to the brain
and spinal cord

Blood supply of the spinal cord :

1 anterior spinal artery


2 posterior spinal artery
Radicular branches
Artery of adamkiewicz