Joints Of The Vertebral Arch

The joints of the vertebral arch are the paired zygapophyseal joints between opposed superior and inferior articular processes (Greek zygon, yoke). They are sometimes referred to as apophyseal joints to indicate that they are outgrowths, or offshoots, of the arch (Greek apophysis, an offshoot). Clinically, they are the facet joints (Fig. 10). As synovial joints, they are subject to all of the degenerative changes associated with synovial joints, such as osteoarthritis. The fibrous capsules of the facet joints are sufficiently lax to allow movement of the spine, but they can be easily strained. The laxity of the capsule can allow its fibers to be pinched between the articular surfaces of the facet joint and produce pain. The joint capsules are innervated by twigs from the medial branches of the posterior primary rami of the spinal nerves (Fig. 11).

A series of accessory ligaments fill the gap posterior to the facet joints and between adjacent vertebral arches. The ligamenta flava are elastic ligaments attached to the anterior surface of the laminal arch above and to the posterior surface of the lamina below. The ligamentum flavum on each side meet in the midline posteriorly and are continuous with the interspinous ligament that connects adjacent spinous processes. The superspinous liga

Disc Bulge

Fig. 9. Sagittal T2 MRI of a large disc herniation at L5-S1. Also notice the disc bulge at L4-L5 (arrowhead).

Superior Process
Fig. 10. Spine model showing the formation of the facet joint by the superior articular process (SAP) and inferior articular process (IAP). The pars interarticularis (PARS) is indicated.

Fig. 9. Sagittal T2 MRI of a large disc herniation at L5-S1. Also notice the disc bulge at L4-L5 (arrowhead).

ments connect the tips of adjacent spinous processes, and in the cervical region are continuous with the ligamentum nuchae. Laterally, the intertransverse ligaments connect the adjacent transverse processes.

The joints of the vertebral arches form the posterior border of the intervertebral foramen (Fig. 12). Inflammation of the joints and osteophyte formation as a result of inflammation can narrow the foramen and impinge on the spinal nerve. Pain from an affected nerve can be felt locally or along the peripheral distribution of the nerve.

THE UNCOVERTEBRAL JOINTS (OF LUSCHKA)

The uncovertebral joints are unique to the cervical spine and lie at the lateral and posterolateral aspect on the superior surface of the vertebral bodies, C3-C7. The joints are formed by the hooklike uncinate process of the superior aspect of the body below and a corresponding beveled surface on the body above. The joint surfaces are lined with hyaline cartilage. Some consider these joints to be synovial joints, while others feel they develop after degeneration and subsequent fluid accumulation within the substance of intervertebral discs (7). The uncovertebral joints are frequently the sites of osteophyte formation and such bony spurs can encroach upon the anterior aspect of the intervertebral foramen.

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Responses

  • Helen
    What is the name of the joints of the vertebral arches?
    6 years ago
  • nancy
    What is zygopophyseal joint of vertebral arches?
    5 years ago
  • david
    What is considered a large lumbar disc extrusion?
    5 years ago

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