VERTEBRAL COLUMN

Dr.D.Navajyothi,MBBS;MD
 Learning outcomes
List the bones of vertebral column.
Explain various curvatures of vertebral
column.
Discuss the parts, features and
attachments of vertebra: cervical, thoracic,
lumbar, sacrum and coccyx
 Vertebral column
Made up of 33 vertebrae,
forms the major part of axial
skeleton Vertebral
Extends from skull to the column
pelvis
Contains spinal cord
Functions:
Transmits weight to pelvis and
lower limbs
Protects spinal cord
Permits movements
Muscle attachments - muscles
of back, head and neck, upper
extremity and thorax
 Vertebrae are grouped into 5 types
depending on the region where they are
present
Cervical vertebrae (7)
Thoracic vertebrae (12)
Lumbar vertebrae (5)
Sacral vertebrae (5)
Coccygeal vertebrae (4)
 Curvatures
At birth the vertebral
column is arched with
concavity facing
anteriorly.
At approximately the third
month after birth, when
the infant begins to hold
its head erect, the cervical
curve with convexity
facing anteriorly develops.
Later, when the child sits
up, stands and walks, the
lumbar curve with
convexity facing anteriorly
develops.
 Cervical-secondary
(convex anterior)
Primary curvature -the
ventrally concave curve of
the fetal vertebral column, Thoracic-primary
retained in the thoracic and (concave anterior)
sacral regions : (the thoracic
and sacral kyphoses)
Secondary curvatures -
ventrally convex curves of
the vertebral column that
develop postnatally in the Lumbar-secondary
cervical and lumbar regions: (convex anterior)
(the cervical and lumbar
lordoses) Sacral-primary
(concave anterior)
Abnormal curvatures
 Vertebral column- Lordosis (hollow
back)

convexity anteriorly
concavity posteriorly
 Kyphosis
Kyphosis
hunchback
Scoliosis
Parts of typical vertebra
 Typical vertebra
Parts of typical vertebra:
Has mainly 2 parts Body
Superior
Body (anterior part) articular
Vertebral arch (posterior process
part)
Contains vertebral Pedicle
foramen Transverse
process
Parts of vertebral arch:
Pedicle
Lamina
Spine Lamina
Vertebral
Transverse processes foramen
Superior articular
processes Spine
Inferior articular
processes
 Superior Superior Superior vertebral notch
articular articular
process facet
Superior surface
of body
Transverse
process
Inferior Inferior vertebral notch
Body vertebral
notch

Anterior Spine
surface
of body
Inferior surface
of body
Inferior Inferior Intervertebral
articular articular disc
facet process

Intervertebral foramen
 Body:
Cylindrical part which lies
anterior to vertebral foramen
Has 4 surfaces superior,
inferior, anterior and posterior
Superior and inferior surfaces
are related to inter-vertebral
discs
Posterior surface is related to
the posterior longitudinal
ligament and has basivertebral
foramen for nutrient artery and
basivertebral vein
Anterior surface related to
anterior longitudinal ligament
 Vertebral arch:
Situated on the lateral aspect and
posterior aspect of vertebral foramen
Pedicle:
Lies lateral to vertebral foramen
Upper margin presents superior
vertebral notch
Lower margin presents inferior
vertebral notch
These notches get converted into
inter-vertebral foramen when the
vertebrae articulate with each other
Inter-vertebral foramen transmits
spinal nerve
Lamina:
Lies behind the vertebral foramen
Joins the lamina of opposite side in
the midline and continue as spine
Give attachment to ligamentum
flavum
 Spine:
Situated on the posterior aspect
Formed by the union of laminae
Gives attachment to
supraspinous and interspinous
ligaments
Transverse processes: one on
each side
Directed laterally from the junction
of pedicle and lamina
Superior articular process: one
on each side
Extend upwards from the junction
of lamina and pedicle
Has a smooth area called
superior articular facet which
articulates with inferior articular
facet of upper vertebra
 Inferior articular
process: one on each Superior Superior
side articular articular
process facet
Extend downwards from
Superior surface
the junction of lamina and of body
pedicle Transverse
process
Has a smooth area called
Inferior
inferior articular facet
Body vertebral
which articulates with notch
superior articular facet of
Anterior Spine
lower vertebra surface
Vertebral foramen: of body
Inferior surface
Is surrounded by body, of body
Inferior Inferior
lamina and pedicle articular articular
Contains spinal cord, facet process
spinal meninges, vertebral
venous plexus
Cervical vertebrae
Cervical vertebrae
 Cervical vertebrae
7 in number
1st, 2nd and 7th vertebrae are
atypical cervical vertebrae
3rd, 4th, 5th and 6th vertebrae are
typical cervical vertebrae
Typical cervical vertebrae:
Body:
Small and broader from side to
side than before backwards
Vertebral foramen:
Larger than body and triangular
in shape
 Typical cervical vertebra
Anterior root
Body

Foramen Anterior tubercle

transversarium
Costotransverse bar

Posterior tubercle
Transverse
process
Posterior root

Vertebral
foramen Spine - bifid
 Transverse process:
Contains a foramen foramen
transversarium which transmits the
vertebral artery and veins
Has anterior and posterior roots which
ends in anterior and posterior tubercles
The 2 roots are connected by
costotransverse bar
Anterior tubercle of 6th cervical
vertebra is large and called carotid
tubercle because common carotid artery
can be compressed against it
Anterior tubercles give attachment to
scalenus anterior muscle
Posterior tubercles give attachment to
scalenus medius and posterior muscles
Spine:
Short and bifid, the notch is filled with
ligamentum nuchae
Atlas vertebra
 Atlas vertebra
Anterior tubercle
Anterior Lateral mass
arch
Transverse process
Superior
view
Foramen transversarium
Groove on superior
surface of posterior arch Superior articular facet

Posterior Posterior Anterior arch

arch tubercle

Inferior
view
Inferior
Dens of axis Transverse
Vertebral foramen articular
vertebra ligament of atlas
facet
 Atlas (1st cervical) vertebra:
Ring shaped, has no body and no
spine
Has - short anterior arch and long
posterior arch, right and left
lateral masses, transverse
processes
Anterior arch:
Has anterior tubercle on its
anterior surface which gives
attachment to anterior longitudinal
ligament
Has facet for dens of 2nd cervical
vertebra on the posterior surface
Upper margin gives attachment to
anterior atlanto-occipital
membrane
Lower margin gives attachment to
anterior longitudinal ligament
 Posterior arch:
Has posterior tubercle on
its posterior surface which
Anterior arch
gives attachment to rectus Dens of
axis vertebra
capitis posterior minor
muscle and ligamentum
nuchae
Has a groove on the upper
aspect for vertebral artery Groove
and first cervical spinal
nerve Posterior
Upper margin gives tubercle
attachment to posterior
atlanto-occipital membrane
Posterior arch
Lower margin gives
attachment to ligamentum
flavum
 Lateral mass:
Upper surface presents kidney
shaped superior articular facet
which articulate with occipital
condyles of skull to form atlanto-
occipital joint
Inferior surface presents round,
inferior articular facet which
articulate with superior surface
of body of 2nd cervical vertebra
and form atlanto-axial joint
Has a tubercle on the medial
aspect which gives attachment
to transverse ligament of atlas
Transverse process:
Long and projects laterally from
lateral mass
Has foramen transversarium
which transmits vertebral artery
and vein
Tubercle
Axis vertebra
Axis vertebra
 Axis (2nd cervical) vertebra:
Superior surface of body presents a
projection in the midline called dens
or odontoid process
Dens on its anterior surface present a
facet which articulates with anterior
arch of atlas to form median atlanto-
axial joint
Dens on its posterior aspect related to
transverse ligament of atlas
Dens gives attachment to apical and
2 alar ligaments
Superior articular facet is on the
superior surfaces of body and pedicle
which articulates with atlas vertebra
to form lateral atlanto-axial joint
Inferior articular facet articulates
with superior articular facet of 3rd
cervical vertebra
Transverse process is very small
and contains foramen transversarium
which transmits vertebral artery and
vein
Spine is large, thick and bifid
Atlas
Dens of axis
vertebra

Axis
 Ligaments
Posterior
Anterior Ligamentum nuchae
atlanto-occipital
atlanto-occipital
membrane
membrane
Occipital
bone

Anterior
arch of atlas

Ligamentum
flavum Posterior
Lamina arch of atlas
Anterior Vertebral
of axis artery
longitudinal
ligament
Vertebra prominens (7 th

cervical vertebra)
Vertebra prominens (7th cervical vertebra)
Foramen
Spine is long, thick, transversarium
Transverse
horizontal and not bifid process

Transverse process is
large and contains
foramen transversarium Posterior
tubercle
which transmits
accessory vertebral vein
Transverse process has Spine
only posterior tubercle
Thoracic vertebrae
Thoracic vertebrae
 Thoracic vertebrae
12 in number
Identified by the presence of costal
facets on the sides of bodies of vertebrae
1st, 9th, 10th, 11th and 12th vertebrae are
atypical thoracic vertebrae
2nd to 8th vertebrae are typical thoracic
vertebrae
Typical thoracic vertebra:
Body:
Heart shaped and size increased in the
lower vertebrae
On each side contains 2 costal facets for
the heads of ribs to articulate
Vertebral foramen:
Is small and circular
 Typical thoracic verterba
Transverse
process
Body with facet
Costal facet
Pedicle
Costal facet

Transverse
process
with facet

Body Costal facet

Lamina

Vertebral foramen Spine - oblique

 Transverse process:
Large and extend laterally
from the junction of the
pedicle and lamina
Anterior surface near the tip
presents a facet for
tubercle of rib to articulate
Gives attachment to lateral,
superior and inferior
costotransverse ligaments
Spine:
Long, oblique, directed
downwards and
backwards
 Atypical thoracic vertebrae

Costal facet (complete)

1st thoracic vertebra
Costal demi facet

9th thoracic vertebra

10th thoracic vertebra

11th thoracic vertebra

12th thoracic vertebra

 1st thoracic vertebra:
Body is not heart shaped and resembles the body of cervical vertebrae
Body on the lateral aspect presents 2 facets for the heads of the ribs
Upper facet is complete and lower facet is a demifacet
Spine is thick, long and horizontal
Transverse process on its anterior surface presents a facet for tubercle of
the rib
11th thoracic vertebra:
Body on the lateral aspect has one single complete costal facet which also
extends to the lateral aspect of pedicle
No facet on the anterior surface of transverse process
Spine is horizontal in position
 12th thoracic vertebra
Body on the lateral aspect
Superior
has single complete facet, tubercle
Body - thick
which is more on the
pedicle than on the body Lateral
tubercle
Shape of the body is
Inferior
similar to those of lumbar tubercle
vetebrae
Transverse process is
short, has no facet, has 3
tubercles superior, Costal facet
inferior and lateral Spine
tubercles
Spine is horizontal in
position
Lumbar vertebrae
Lumbar vertebrae
 Lumbar vertebrae
5 in number
These do not have
foramen transversarium at
the transverse process
costal facets on the body
1st to 4th vertebrae are typical
lumbar vertebrae
5th vertebra is an atypical
lumbar vertebra
Typical lumbar vertebra:
Body is large, wider from side Accessory
to side process on
Mamillary process the transverse
Vertebral foramen is on the superior process
triangular in shape, larger articular process
than in thoracic vertebrae,
smaller than in cervical
vertebrae
 Spine is horizontal, Superior articular process
thick and quadrangular
in shape
Transverse process
are thin, tapering and Mamillary Accessory
arise from the junction process process
between lamina and
pedicle
Transverse process
has an elevation called
accessory process Spine

Superior articular
processes are placed
away from the midline,
present a rough
elevation called
mamillary process
 5th lumbar vertebra
Body is largest among
all the lumbar vertebrae
Spine
Transverse process is Mamillary process
thick, short and
pyramidal in shape Transverse
process
Transverse process is
attached to body and
pedicle
Spine is short and
rounded at the tip
Superior
articular
process
Sacrum
Sacrum
 Sacrum
Large, flattened, triangular bone formed
by the fusion of 5 sacral vertebrae
Forms the posterior part of bony pelvis
Articulates on either side with ilium of
hip bone to form sacroiliac joint
Has sacral canal which contains sacral
and cocygeal spinal nerves, meninges
of spinal cord and filum terminale
Has a base, apex, pelvic surface,
dorsal surface and 2 lateral surfaces
The lateral part of sacrum is called
lateral mass
Base:
Is the upper part, formed by superior
surface of 1st sacral vertebra
Presents body of S1 vertebra, ala on
either side of body, superior articular
processes
 Sacrum and coccyx
Superior articular
process of Body of S1 vertebra
S1 vertebra Sacral
Ala canal

Sacral
promontory
Lateral
surface
Lateral mass

Pelvic Apex of sacrum

sacral
foramen
Coccyx

Pelvic surface
 Sacrum and coccyx (dorsal surface)
Sacral canal

Auricular surface
Lateral sacral crest

Median sacral crest

Intermediate sacral crest

Dorsal sacral foramen

Sacral cornu
Sacral hiatus

Coccyx
 Body of S1 vertebra:
Articulates with L5 vertebra
In males, width of the body of S1
vertebra is more than width of ala
In females, width of the body of S1
vertebra is almost equal to the width of
ala
Anterior margin of body is prominent
sacral promontory
Ala:
Has a smooth medial part and rough
lateral part
Medial part is related to sympathetic
chain, lumbosacral trunk, iliolumbar
artery and obturator nerve
Lateral part gives attachment to iliacus
muscle
Superior articular process:
Presents superior articular facet which
articulates with inferior articular facet of
L5 vertebra
 Apex:
Is the lower end of sacrum, formed by
inferior surface of body S5 vertebra
Articulates with the coccyx
Pelvic surface:
Concave, presents 4 pelvic sacral
formaina on each side which transmit
ventral rami of upper 4 sacral spinal
nerves and lateral sacral arteries
Gives attachment to piriformis
muscle
Dorsal surface:
Is rough, irregular and convex
Presents
Median sacral crest situated at the
midline
4 dorsal sacral foramina on either
side which transmit dorsal rami of
upper 4 sacral spinal nerves
 Sacral hiatus near the apex which
transmits 5th sacral spinal nerve, 1st
coccyngeal spinal nerve and filum
terminale
Sacral cornu situated lateral to sacral
hiatus, represents the inferior articular
process of S5 vertebra
Intermediate sacral crest situated
medial to dorsal sacral foramina
Lateral sacral crest situated lateral to
dorsal sacral foramina
Lateral surface:
Upper part is wide and lower part is
narrow
Upper part presents L-shaped auricular
surface which articulates with ilium of hip
bone to form sacroiliac joint
Lower part gives attachment to gluteus
maximus and coccygeus muscles,
sacrotuberous and sacrospinous
ligaments
Coccyx
Coccyx
 Coccyx
Small triangular bone
fromed by the fusion of 4
rudimentary coccygeal
vertebrae
Has a base and apex
Base is formed by 1st
coccygeal vertebra and
articulates with apex of
sacrum
Apex lies free gives
attachment to
anococcygeal ligament
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