The Vertebral Column Joints

The Vertebral Column Joints

Vertebral Column Function

The spinal column (or vertebral column) extends from the skull to the pelvis and is comprised of 33 individual vertebrae. The vertebral column is the central axis of the body, acting as a support for the weight of the body above the pelvis, encloses and protects the spinal cord and has roles in both posture and movement.

The spinal column can be separated into five different regions, with each region characterized by a different vertebral structure, cervical, thoracic, lumbar, sacrum, and coccyx.

- 7 cervical vertebra with C1 and C2 designed to allow head movement

- 12 thoracic vertebra, medium size and increasing in size moving down the back. Main function is to articulate with ribs

- 5 lumbar vertebra, largest of the vertebra, support the weight of the upper body

- 5 sacrum (fused) vertebra articulates with the pelvis

- 4 coccyx (fused) vertebra, small bones which articulates with the apex of the sacrum. Does not contain the spinal cord

Adjacent vertebrae are connected by three intervertebral connections:

- Synovial joints formed between the joints

- Specialized cartilaginous joints known as intervertebral discs

- 3 ligaments

The spinal cord lies within the vertebral canal of the vertebra and is covered by three membranes.

Each vertebra consists of a centrum mounted upon a y-shaped neural arch which provides areas of attachment for muscles and ligaments. Together the centrum and neural arch surround the opening through which the spinal cord passes. The centrums are separated by cartilaginous intervertebral discs, which help cushion shock from movement.

Common Injuries of the Vertebral Column

Back Pain – can be acute (lasting days to weeks) or chronic (lasting more than 3 months). This can be due to muscular or ligament strains or due to herniated discs

Herniated Discs – soft tissue in the discs between the joints comes out causing pain by pressing on nerves

Bulging Discs – these protrude but not as much as a herniated disc. Continual symptoms are not experienced, only when the bulging disc pushes on a nerve root

Degenerative Disc Disease – the discs between the vertebra shrink or tear, which causes the bones to rub together

Wear/Inflammation of the sacroiliac joint – where your spine and pelvis meet, swelling and wearing away of the joint cartilage through injury or arthritis

Spinal Stenosis – narrowing of the spinal canal adding pressure to the spine and nerves causing numbness in the legs

Cervical Radiculopathy – a pinched nerve usually caused by a bone spur or a herniated disc

Spondylolisthesis – a bone in the spine slips forward and out of place. The degenerative form is arthritis, which weakens the joints and ligaments keeping the spine aligned

Osteoarthritis – degenerative joint disease which occurs when cartilage breaks down

Scoliosis – curvature of the spine, pain typically starts mid life

Sciatica – acute pain from the sciatic nerve radiating to the buttocks and sometimes the feet

Vertebral Column Treatments

Rest, Ice and Exercise – reduce pain and inflammation

Physical Therapy – may include massage, ultrasound, whirlpool baths, controlled applications of heat, and exercise programs to help regain full use of the back, strengthening both the abdominal and back muscles to help stabilize the spine

Chiropractor – realign spine

Inversion Therapy – reduce pressure on the discs

Pain medication – OTC and prescription medication

Epidural Steroid Injections – pain management and inflammation

Radiofrequency Neurotomy – pain management

Transcutaneous Electrical Nerve Stimulator (TENS) – mild electric current that helps relieve pain

Acupuncture – for chronic lower back pain

Surgical procedures – to correct disc problems, bone spurs and spinal canal narrowing

• Discectomy – removal of herniated portion of the disc

• Laminectomy – removal of bone to enlarge spinal canal

• Fusion – permanently connects two or more bones in the spine to add stability

• Artificial discs – implanted artificial disc to replace a degenerated disc