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Shalu Thariwal
Biomechanics of
Lumbar spine
Anatomy of lumbar spine
 5 lumbar vertebrae
 Body(massive, transverse diameter is greater)
 Arches
 Pedicles(short, thick, project posterolaterally)
 Laminae(short and broad)
 Zygapophyseal articular process
 Transverse process(long, extends horizontally)
 Spinous process(broad, thick, horizontally)
 Vertebral foramina(triangular)
Lumbar
Lumbar vertebral joints
 The mobility of the vertebral column is provided by the symphyseal
joints between the vertebral bodies, formed by a layer of hyaline
cartilage on each vertebral body and an intervertebral disc between the
layers.
 The synovial joints between the superior and inferior articular processes
on adjacent vertebrae are termed the facet joints (also known as
zygapophyseal joints or Z-joints). They permit simple gliding
movements. The movement of the lumbar spine is largely confined to
flexion and extension with a minor degree of rotation. The region
between the superior articular process and the lamina is the pars
interarticularis. A spondylolysis occurs if ossification of the pars
interarticularis fails to occur.
 The 3-joint complex is formed between 2 lumbar vertebrae.
 Joint 1: Disc between 2 vertebral bodies;
 Joint 2: Left facet (zygapophyseal) joint;
 Joint 3: Right facet (zygapophyseal) joint.
 Lumbosacral articulation
Ligaments and fascia
 Ligamentum flavum
 Anterior longitudinal ligament
 Posterior longitudinal ligament
 Interspinous
 Supraspinous ligament(only in upper lumbar
region)
 Joint capsules
 Iliolumbar ligaments
 Thoracolumbar fascia
3 column stability
Iliolumbar ligaments
 Consists of series of band, extends from tip and
border of L5 transverse processes
 attach bilaterally on the iliac crest
 3 primary bands
a) Dorsal band
b) Ventral band
c) Sacral band
Function
 Strong and stabilize L5 vertebra
 Resist flex, ext, axial rotation, and lateral bending
of L5 on S1
 Maximally loaded at Lumbosacral
junction(absence of muscle protection against
flexion)
 Low back pain – when sitting in a relaxed or
slouched posture.
Thoracolumbar fascia
 Also known as lumbodorsal fascia
 3 layers
a) Anterior
b) Middle
c) Posterior
 Act as a stabilizing corset, increases spinal
stiffness, mechanical transmission of forces
between pelvis and trunk.
Kinematics
 Flexion – 52 degree(sagittal plane )
 Extension-19
 Lateral flexion-30(frontal plane)
 Rotation -30(transverse plane)
Lumbopelvic rhythm
Kinematics
 Flexion and extension sagittal plane
orientation of zygapophyseal facets
 Upper lumbar region(most free lateral flexion
and rotation)
largest at L2, L3 level
 Lower lumbar region –flex and ext
Motions
Flexion
 Anterior rotation/translation
 IAP up/forward, compression forces on anterior side of
disc tending to migrate nucleus pulposus posteriorly
 Motion limited by: – Ligament/capsule tension – Facet joint
 5°-7°
Extension
 Posterior rotation/translation IAP, Posterior tilting , gliding
of superior vertebra
 IAP moves down/back, nucleus pulposus displaces
anteriorly
 Motion limited by: – Interspinous ligament buckling –
Bony impaction
4°-7°
Motions
Rotation
 Closes ipsilateral facet
 Opens contralateral facet Motion limited by:
 Motion limited by: – Facet orientation – Annulus fibrosus
 1°-3°
 Coupled with sidebend
Sidebend(lateral flexion)
 Creates a “extension/flexion” of the facets on the same segment
 Ipsilateral- close
 Contralateral-open, Superior vertebra laterally tilts, rotates and
translates over vertebra below, Annulus fibrosus is compressed
on concavity of curve and stretched on convex side
 2°-5°
 Coupled with rotation
Coordinated and simultaneous activity of lumbar
flexion and anterior tilting of the pelvis in the sagittal
plane.
Lumbosacral flexion +anterior tilting of pelvis
Kinetics
 Compression
 Shear
Compression
 Support the weight of upper part in static as well
as dynamics situations.
 Large lumbar vertebrae –support additional
weight
 Compressive load by muscular contraction
 Interbody joint 80%load,zp facet 20%load
 In ext ,more load on zpp joint
Shear
 Anterior shear forces (in upright position) caused
by:
 Lordotic position
 Body weight
 Ground reaction forces
 Superior facets lie in the frontal plane and face
posteriorly.
Shear and compression forces
Lumbosacral articulation (by 5th L and 1st
S) 1st sacral is inclines ant and inferiorly and forms
an angle horizontal called lumbosacral angle.
Muscles of lumbar spine
 Anterior group
 Posterior group
 Lateral group
Posterior muscles
 Thoracolumbar fascia
 Superficial erector spinae (logissimus thoracic pars
thoracic, iliocoastalis lumborum pars
thoracic)=extension and assist in ipsilateral side
flexion.
 Deep erector spinae (LTPL,ILPL)=ipsilateral side
flexion, posterior shear, rotation, assist in extension.
 Multifidus (from dorsal sacrum and ilium to the
spinous processes of L)vertically
oriented,extension,control segmental shear and
torsion by producing compression.
Lateral muscles
 Quadratus lumborum=act bilaterally ,frontal plane
stabilizer. Unilaterally , lateral flexion.
 Hike the hip
 Intertransversarii and rotators=rotation and lateral
flexion
Anterior muscles
 Prime flexor =rectus abdominis
 Abdominal wall=external oblique ,internal
oblique,transversus abdominis
 Psoas majorand ilacus= primary hip flexor
 Role of psoas major :anterior ilial rotation and
thus L extension,provide stability to L spine
during hip flexion by providing great amount of
Lumbar compression+ some anterior shear
forces.
Anatomy and biomechanics of lumbar spine
Anatomy and biomechanics of lumbar spine

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Anatomy and biomechanics of lumbar spine

  • 2. Anatomy of lumbar spine  5 lumbar vertebrae  Body(massive, transverse diameter is greater)  Arches  Pedicles(short, thick, project posterolaterally)  Laminae(short and broad)  Zygapophyseal articular process  Transverse process(long, extends horizontally)  Spinous process(broad, thick, horizontally)  Vertebral foramina(triangular)
  • 4.
  • 5.
  • 6. Lumbar vertebral joints  The mobility of the vertebral column is provided by the symphyseal joints between the vertebral bodies, formed by a layer of hyaline cartilage on each vertebral body and an intervertebral disc between the layers.  The synovial joints between the superior and inferior articular processes on adjacent vertebrae are termed the facet joints (also known as zygapophyseal joints or Z-joints). They permit simple gliding movements. The movement of the lumbar spine is largely confined to flexion and extension with a minor degree of rotation. The region between the superior articular process and the lamina is the pars interarticularis. A spondylolysis occurs if ossification of the pars interarticularis fails to occur.  The 3-joint complex is formed between 2 lumbar vertebrae.  Joint 1: Disc between 2 vertebral bodies;  Joint 2: Left facet (zygapophyseal) joint;  Joint 3: Right facet (zygapophyseal) joint.  Lumbosacral articulation
  • 7. Ligaments and fascia  Ligamentum flavum  Anterior longitudinal ligament  Posterior longitudinal ligament  Interspinous  Supraspinous ligament(only in upper lumbar region)  Joint capsules  Iliolumbar ligaments  Thoracolumbar fascia
  • 8.
  • 10.
  • 11. Iliolumbar ligaments  Consists of series of band, extends from tip and border of L5 transverse processes  attach bilaterally on the iliac crest  3 primary bands a) Dorsal band b) Ventral band c) Sacral band
  • 12. Function  Strong and stabilize L5 vertebra  Resist flex, ext, axial rotation, and lateral bending of L5 on S1  Maximally loaded at Lumbosacral junction(absence of muscle protection against flexion)  Low back pain – when sitting in a relaxed or slouched posture.
  • 13. Thoracolumbar fascia  Also known as lumbodorsal fascia  3 layers a) Anterior b) Middle c) Posterior  Act as a stabilizing corset, increases spinal stiffness, mechanical transmission of forces between pelvis and trunk.
  • 14. Kinematics  Flexion – 52 degree(sagittal plane )  Extension-19  Lateral flexion-30(frontal plane)  Rotation -30(transverse plane) Lumbopelvic rhythm
  • 15. Kinematics  Flexion and extension sagittal plane orientation of zygapophyseal facets  Upper lumbar region(most free lateral flexion and rotation) largest at L2, L3 level  Lower lumbar region –flex and ext
  • 16. Motions Flexion  Anterior rotation/translation  IAP up/forward, compression forces on anterior side of disc tending to migrate nucleus pulposus posteriorly  Motion limited by: – Ligament/capsule tension – Facet joint  5°-7° Extension  Posterior rotation/translation IAP, Posterior tilting , gliding of superior vertebra  IAP moves down/back, nucleus pulposus displaces anteriorly  Motion limited by: – Interspinous ligament buckling – Bony impaction 4°-7°
  • 17.
  • 18. Motions Rotation  Closes ipsilateral facet  Opens contralateral facet Motion limited by:  Motion limited by: – Facet orientation – Annulus fibrosus  1°-3°  Coupled with sidebend Sidebend(lateral flexion)  Creates a “extension/flexion” of the facets on the same segment  Ipsilateral- close  Contralateral-open, Superior vertebra laterally tilts, rotates and translates over vertebra below, Annulus fibrosus is compressed on concavity of curve and stretched on convex side  2°-5°  Coupled with rotation
  • 19. Coordinated and simultaneous activity of lumbar flexion and anterior tilting of the pelvis in the sagittal plane. Lumbosacral flexion +anterior tilting of pelvis
  • 21. Compression  Support the weight of upper part in static as well as dynamics situations.  Large lumbar vertebrae –support additional weight  Compressive load by muscular contraction  Interbody joint 80%load,zp facet 20%load  In ext ,more load on zpp joint
  • 22. Shear  Anterior shear forces (in upright position) caused by:  Lordotic position  Body weight  Ground reaction forces  Superior facets lie in the frontal plane and face posteriorly.
  • 24. Lumbosacral articulation (by 5th L and 1st S) 1st sacral is inclines ant and inferiorly and forms an angle horizontal called lumbosacral angle.
  • 25. Muscles of lumbar spine  Anterior group  Posterior group  Lateral group
  • 26. Posterior muscles  Thoracolumbar fascia  Superficial erector spinae (logissimus thoracic pars thoracic, iliocoastalis lumborum pars thoracic)=extension and assist in ipsilateral side flexion.  Deep erector spinae (LTPL,ILPL)=ipsilateral side flexion, posterior shear, rotation, assist in extension.  Multifidus (from dorsal sacrum and ilium to the spinous processes of L)vertically oriented,extension,control segmental shear and torsion by producing compression.
  • 27. Lateral muscles  Quadratus lumborum=act bilaterally ,frontal plane stabilizer. Unilaterally , lateral flexion.  Hike the hip  Intertransversarii and rotators=rotation and lateral flexion
  • 28. Anterior muscles  Prime flexor =rectus abdominis  Abdominal wall=external oblique ,internal oblique,transversus abdominis  Psoas majorand ilacus= primary hip flexor  Role of psoas major :anterior ilial rotation and thus L extension,provide stability to L spine during hip flexion by providing great amount of Lumbar compression+ some anterior shear forces.