Articulating Processes And Spinal Movement

The orientation of the vertebral articulating processes determines the movements that are permitted in each

Infant Intervertebral Disc Irm
Fig. 3. T2-weighted sagittal MRI showing normal vertebral body signal and normal intervertebral discs.

region of the spine (2). The articulating processes in the cervical region are oriented in nearly a coronal plane, and permit flexion/extension, rotation, and lateral bending. The articulating processes in the thoracic region are arranged on an arc that has its center in the vertebral body. Rotation and lateral bending are permitted. Flexion is prohibited both by the orientation of articulating processes and by attachment of the thoracic vertebrae to the rib cage. Articulating processes in the lumbar region are oriented in the sagittal plane, permitting flexion/extension and prohibiting rotation.

The anterior view of the articulated spine shows the consistent increase in size of the vertebral bodies from superior to inferior. The space between adjacent vertebrae is occupied by the intervertebral discs that collectively contribute approximately one fourth to the height of the spine. The uncovertebral joints are lateral and posterolat-eral between the C3-C7 vertebral bodies.

The posterior view of the spine demonstrates how the short transverse processes of the cervical vertebrae change dramatically at the C7-T1 junction to the large transverse processes of the thoracic type. The thoracic transverse processes gradually diminish in size from T1 to T12. The lumbar transverse processes are long and surprisingly

Spinal Process Image

Fig. 4. (A) Posterior view of spine. SAP, Superior articular process; IAP, inferior articular process; TP, transverse process; SP, spinous process; ILS, interlaminar space. (B) Axial CT through a lumbar vertebral body. VB, Vertebral body; P, pedicle; T, transverse process; L, lamina; S, spinous process. (C) Axial T2 MRI through a lumbar vertebral body. VB, Vertebral body; P, pedicle; T, transverse process; FJ, facet joint; SC, spinal canal.

Fig. 4. (A) Posterior view of spine. SAP, Superior articular process; IAP, inferior articular process; TP, transverse process; SP, spinous process; ILS, interlaminar space. (B) Axial CT through a lumbar vertebral body. VB, Vertebral body; P, pedicle; T, transverse process; L, lamina; S, spinous process. (C) Axial T2 MRI through a lumbar vertebral body. VB, Vertebral body; P, pedicle; T, transverse process; FJ, facet joint; SC, spinal canal.

slender and provide attachment points for both flexor and extensor muscle groups. The change is appearance of the spinous processes is dramatic. The bifid spines of cervical vertebrae evolve to the long and sloping spines of thoracic vertebrae. The lumbar spinous processes are flat and blunt. The change in the interlaminal space is also dramatic. The cervical vertebrae are closely packed and have a small interlaminal space. The short intervertebral discs and the downward sloping spines in the thoracic region make the interlaminal space here small. The interlaminal space in the lumbar region is wide and is the optimal site for obtaining spinal fluid and for delivering anesthetics. The termination of the vertebral canal at the sacral hiatus is seen posteriorly.

The fetal spine exhibits a primary kyphotic curvature that is retained in neonates and infants. Secondary lordo-tic curves develop in the cervical and lumbar regions to support the weight of the head and the erect position of the trunk, respectively. The lateral view of the adult spine

Posterior Trunk Bending Gait

demonstrates how the normal curvatures change between adjacent regions. The cervical and lumbar curvatures are concave posteriorly, and the thoracic and sacrococcygeal curvatures are concave anteriorly. Vollmer and Banister observe that the thoracic kyphosis is due to a slight wedging of the vertebrae, with the intervertebral discs being of relatively uniform thickness, and that the cervical and lumbar lordoses are due primarily to the discs having a slightly wedged configuration. One consequence of these arrangements is that pathological changes in thoracic curvature are more likely the result of changes in bone structure, while changes in cervical and lumbar curvatures are more likely due to degenerative changes in the discs (3). Posture has been defined as the position of the erect and static spine and is related to a vertical line of

Intervertebral Foramen Mri
Fig. 5. Sagittal T1 MRI showing the relationship of the nerve roots in the intervertebral foramen.

gravity. In good posture, the line of gravity passes through the odontoid process, posterior to the bodies of the upper cervical vertebrae, through the center of the C7 vertebra, anterior to the thoracic spine, and through the posterosu-perior aspect of the S1 endplate. Deviation of the spine from these relationships with the line of gravity indicates imbalance and can produce pain, muscle fatigue, and gait disturbance (3).

A central concept governing diagnosis and treatment of spinal pathology is that the vertebral canal and the intervertebral foramen are inexpansible. Any encroachment on these spaces, by arthritis, tumor, misalignment, or infection can exert pressure on nervous elements with different degrees of consequence, from paresthesia to paralysis. Furthermore, the site of the symptoms can be far removed from the site of encroachment because of the arrangement of the nerve elements in these spaces and the peripheral distribution of the nerves (Fig. 7).

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Responses

  • jasmine lightfoot
    What Is Intervertebral Foramen?
    6 years ago
  • Milly
    Which number indicates Thoracic vertebrae inferior articulating process?
    6 years ago
  • Amaranth
    Does c spine have superior articulating process?
    28 days ago

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