Structure and diseases of the lumbosacral spine

The spinal column consists of vertebrae assembled into an S-shaped structure, which ensures the musculoskeletal function of the entire skeleton.

Spine (vertebral column)

The structure of a human vertebra is both simple and complex, so further we will consider what parts it consists of and what function it performs.

Structure of a human vertebra

Spine

The spine is the main part of the human skeleton, ideally adapted to perform a supporting function. Due to its unique structure and shock-absorbing capabilities, the spine is able to distribute the load not only along its entire length, but also to other parts of the skeleton.

The spine consists of 32-33 vertebrae, assembled into a movable structure, inside of which there is a spinal cord, as well as nerve endings. Between the vertebrae there are intervertebral discs, thanks to which the spine has flexibility and mobility, and its bone parts do not touch each other.

The main part of the skeleton of the body serves as an organ of support and movement, the receptacle of the spinal cord

Thanks to the structure of the spine ideally created by nature, it is able to ensure normal human life. He is responsible for:

• creating reliable support when moving;
• proper functioning of organs;
• combining muscle and bone tissue into one system;
• protection of the spinal cord and vertebral artery.

The spine provides support for the body, being the place of attachment of muscles, and takes part in body movements

The flexibility of the spine is developed individually for everyone, and depends, first of all, on genetic predisposition, as well as on the type of human activity.

The cervical and lumbar regions have the greatest mobility, the mid-thoracic spine has minimal mobility

The spinal column is a framework for attaching muscle tissue, which in turn serves as a protective layer for it, as it takes on external mechanical influences.

Supportive corset for the spine

Purpose of X-ray

• Essentially, x-rays of the lumbosacral spine are used to evaluate back injuries as well as low back pain.
• This method is also used to identify problems in the lower back if there is weakness and persistent numbness.
• X-rays of the lumbosacral spine are used to detect other back injuries such as bone spurs, spinal deformities, fractures, spinal dislocations, osteoporosis, and slipped discs.
• Another goal of the study is to identify the cause of low back pain and numbness.

Spinal sections

The spine is divided into five sections.

1. Cervical.
2. Chest.
3. Lumbar.
4. Sacral.
5. Coccygeal

Parts of the human spine and possible diseases

Table No. 1. Structure of the vertebrae. Characteristics and functions of departments.

Vertebral structure

A vertebra is the main component of the spinal column.

In the center of each vertebra there is a small opening called the spinal canal. It is reserved for the spinal cord and vertebral artery. They run through the entire spine. The connection between the spinal cord and the organs and limbs of the body is achieved through nerve endings.

Schematic representation of anatomical formations located in the spinal canal

View from above. Transverse section at the level of the intervertebral disc

Basically the structure of the vertebrae is the same. Only the fused areas and a pair of vertebrae, designed to perform certain functions, differ.

A vertebra consists of the following elements:

• body;
• legs (on both sides of the body);
• spinal canal;
• articular processes (two);
• transverse processes (two);
• spinous process.

Typical vertebra

The vertebral body is located anteriorly, and the processes are located posteriorly. The latter are the connecting link between the back and the muscles. The flexibility of the spine is developed individually for everyone, and it depends, first of all, on a person’s genetics, and only then on the level of development.

Due to its shape, the vertebra ideally protects both the spinal cord and the nerves extending from it.

The spine is protected by muscles. Due to their density and location, a layer like a shell is formed. The rib cage and organs protect the spine from the front.

Muscles of the back, neck and suboccipital muscles

This vertebral structure was not chosen by nature by chance. It helps maintain the health and safety of the spine. In addition, this shape helps the vertebrae remain strong over time.

“Anatomy is Destiny”...

Sigmund Freud

Which means...

Anatomy of your spine -

this is your Destiny!

Having understood the material in this article, you will know, and - most importantly - UNDERSTAND the anatomy of the human spine at the medical level. The article itself is designed in such a way as to teach knowledge of the anatomy of the spine from scratch.

If you really want to understand this issue, then you need to read this article several times. And in order for you to have a clear image of the spine, and for all the anatomical details to be drawn in this image, you need to look at it several times

Video: Anatomy of the spine 3D

The article and video complement each other, creating ideal conditions for a visual and sometimes fascinating study of the anatomy of the spine.

First, about the spinal column in general. In humans, it consists of 34 vertebrae (7 cervical, 12 thoracic, 5 lumbar, 5 sacral, 5 coccygeal vertebrae) and has 4 physiological curves. The forward bend is called lordosis (in the cervical and lumbar regions), the backward bend is called kyphosis (in the thoracic and sacral regions).

The S-shape of the spinal column is associated with upright posture and provides the spine with an additional shock-absorbing function. This is due to the fact that the wavy curved back has the properties of a spring, which protects various levels of the spine from overload, evenly distributing the weight of the body and the burdens carried by a person along its entire length. An interesting fact is that, thanks to kyphosis and lordosis, the spine is able to withstand loads 18 times greater than the support capacity of a concrete pillar of the same diameter.

Let's look at the structure of a vertebra

The structure of vertebrae belongs to spongy bones and consists of a dense outer cortical layer and an inner spongy layer. Indeed, the spongy layer resembles a bone sponge, as it consists of individual bone beams. Between the bone beams there are cells filled with red bone marrow.

The anterior part of the vertebra is cylindrical in shape and is called the vertebral body. The vertebral body bears the main supporting load, since our weight is mainly distributed on the front of the spine. At the back of the vertebral body, the pedicle is connected to a semi-ring called the vertebral arch. 7 processes extend from the arch. The unpaired process is the spinous process. It is located at the back, which is what we feel under our fingers when we run our hand along the spine. Please note that we can palpate not the entire vertebra, but only one of its spinous process. The paired processes include 2 transverse and 2 pairs of articular processes, upper and lower, respectively. It is through these processes that the vertebrae are connected to each other through the facet joints. These joints play a crucial role, since the so-called “blockades” of these joints, that is, a sharp limitation of their mobility, are the main cause of scoliosis, crunches, vertebral instability and back pain.

Each vertebra has a hole in the center called the vertebral foramen. These openings in the spinal column are located on top of each other, forming the spinal canal - the container for the spinal cord. The spinal cord is a section of the central nervous system in which there are numerous nerve pathways that transmit impulses from the organs of our body to the brain and from the brain to the organs. There are 31 pairs of nerve roots (spinal nerves) that arise from the spinal cord. Nerve roots exit the spinal canal through the intervertebral (foramin) foramina, which are formed by the pedicles and articular processes of adjacent vertebrae. Through the foramina, not only nerve roots, but also veins exit the spinal canal, and arteries enter the spinal canal to supply blood to the nerve structures. Between each pair of vertebrae there are two foramina, one on each side.

It is significant that, emerging from the foraminar opening, the spinal nerves connect certain segments of the spinal cord with certain areas of the human body. For example, segments of the cervical spinal cord innervate the neck and arms, the thoracic region innervates the chest and abdomen, the lumbar region innervates the legs, and the sacral region innervates the perineum and pelvic organs (bladder, rectum). By determining in which area of ​​the body sensory or motor function disorders have appeared, the doctor can guess at what level the spinal cord injury occurred.

Intervertebral discs are located between the vertebral bodies. The intervertebral disc has a heterogeneous structure. In the center is the nucleus pulposus, which has elastic properties and serves as a shock absorber of vertical load. The main function of the nucleus pulposus is to absorb various loads during compression, stretching, flexion, extension of the spine and uniformly distribute pressure between different parts of the fibrous ring and the cartilaginous plates of the vertebral bodies. It, like a mercury ball, is able to move inside the disc in order to distribute the load as evenly as possible between adjacent vertebrae.

Around the nucleus is a multi-layered fibrous ring that keeps the nucleus in the center and prevents the vertebrae from moving sideways relative to each other. In an adult, the intervertebral disc has no vessels, and its cartilage is nourished by the diffusion of nutrients and oxygen from the vessels of the neighboring vertebral bodies.

The annulus fibrosus has many layers and fibers intersecting in three planes. Normally, the annulus fibrosus is formed by very strong fibers. However, as a result of degenerative disc disease (osteochondrosis), the fibers of the annulus fibrosus are replaced by scar tissue. Scar tissue fibers do not have the same strength and elasticity as the fibers of the annulus fibrosus, so when intradiscal pressure increases, ruptures of the annulus fibrosus may occur. The need for such a strong fixation of the nucleus pulposus is due to the fact that in a healthy disc the pressure inside it reaches 5-6 atmospheres, which makes it possible to absorb loads quite effectively. For comparison, the pressure in a car tire is 1.8-2 atmospheres. With increasing static load on the spine, the intervertebral disc—due to the permeability of the cartilaginous plates and the fibrous ring—loses micromolecular substances and water, which pass into the peridiscal space. At the same time, the ability to retain water decreases, the volume of the disk and its shock-absorbing properties decrease. On the contrary, when the load is removed, diffusion occurs in the opposite direction, the disc absorbs water, and the nucleus pulposus swells. Thanks to this self-regulating system, the intervertebral disc adapts well to the action of varying loads. Throughout the day, under the influence of loads on the spine, the height of the discs decreases and, along with it, the actual height of a person by 1-2 cm. During night sleep, when the load on the disc is minimal and the pressure inside it drops, the disc absorbs water and, as a result, restores its elastic properties and height. At the same time, the distance between the vertebrae and actual growth are restored. You can figuratively imagine the disk as a sponge: in order for metabolism to occur normally in the sponge, it must contract, removing metabolic products, and stretch, absorbing the necessary nutrients, oxygen and water.

This is why movement is so necessary for our spine. Moreover, the movement should be in full: maximum flexion-extension and bending, that is, movements that we practically do not do in ordinary life. They are the ones who are able to ensure full metabolism in the discs and intervertebral joints.

In size, intervertebral discs have a slightly larger diameter than the vertebral bodies. Also, the discs have different thicknesses in different parts of the spine - from 4 mm in the cervical to 10 mm in the lumbar. The thickness of the underlying vertebral bodies also increases to compensate for the increasing load.

In addition to discs, vertebrae are also connected by joints and ligaments. The joints of the spine are called facet or facet joints. The so-called “facets” are the same articular processes mentioned above. Their ends are covered with articular cartilage.

Articular cartilage has a very smooth and slippery surface, which significantly reduces friction between the bones that form the joint. The ends of the articular processes are enclosed in a sealed connective tissue sac called the articular capsule. The cells of the inner lining of the joint capsule (synovial membrane) produce synovial fluid (joint fluid). Synovial fluid is necessary to lubricate and nourish articular cartilage, as well as to facilitate the sliding of articular surfaces against each other. Due to the presence of facet joints, a variety of movements are possible between the vertebrae, and the spine is a flexible, movable structure.

Ligaments are structures that connect bones to each other (as opposed to tendons, which connect muscles to bones). The anterior longitudinal ligament runs along the anterior surface of the vertebral bodies, and the posterior longitudinal ligament runs along the posterior surface of the vertebral bodies (together with the spinal cord, it is located in the spinal canal). The anterior longitudinal ligament is tightly fused with the vertebral bodies and loosely with the intervertebral discs. The posterior longitudinal ligament, on the contrary, has a tight fusion with the discs and a loose fusion with the vertebral bodies. The arches of adjacent vertebrae are connected by the ligamentum flavum. The interspinous ligaments are located between the spinous processes of adjacent vertebrae. Between the transverse processes of adjacent vertebrae there are respectively intertransverse ligaments.

Transverse section of a lumbar vertebra showing the attachment of the dorsal ligaments.

1. Supraspinous ligament
2. Interspinous ligament
3. Ligamentum flavum
4. Posterior longitudinal ligament
5. Anterior longitudinal ligament

Sagittal section through the second and third lumbar vertebrae, showing ligaments attached to adjacent arches and spinous processes

1. Supraspinous ligament
2. Interspinous ligament
3. Ligamentum flavum

When intervertebral discs and joints are destroyed, the ligaments strive to compensate for the increased pathological mobility of the vertebrae (instability), resulting in ligament hypertrophy. This process leads to a decrease in the lumen of the spinal canal; in this case, even small hernias or bone growths (osteophytes) can compress the spinal cord and roots. This condition is called spinal stenosis.

The movements of the vertebrae relative to each other are ensured by the paravertebral muscles. Various muscles are attached to the processes of the vertebrae. We will not list their names, we will distribute them only according to the vector of movement: flexion - flexion (like bending forward), extension - extension (like bending backward), rotation - rotation (like turning left, right) and the so-called lateroflexion (like type of tilt to the right and left). Back pain is often caused by damage (stretching) of the paravertebral muscles during heavy physical work, as well as reflex muscle spasm when the spine is damaged or diseased.

When a muscle spasm occurs, the muscle contracts and cannot relax. When many vertebral structures (discs, ligaments, joint capsules) are damaged, involuntary contraction of the paravertebral muscles occurs, aimed at stabilizing the damaged area. When muscles spasm, lactic acid accumulates in them, which is a product of glucose oxidation under conditions of lack of oxygen. A high concentration of lactic acid in the muscles causes pain. Lactic acid accumulates in the muscles due to the fact that spasmed muscle fibers press on blood vessels. When the muscle relaxes, the lumen of the blood vessels is restored, the blood washes out lactic acid from the muscles and the pain goes away.

All of the above anatomical formations are part of the structural and functional unit of the spine - the vertebral motion segment. It is formed by two vertebrae with facet joints and an intervertebral disc with surrounding muscles and ligaments. Moreover, the vertebral bodies, as well as the discs connecting them and the anterior and posterior longitudinal ligaments running along the entire spine, provide mainly a supporting function and are called the anterior supporting complex. The arches, transverse and spinous processes, and facet joints provide motor function and are called the posterior supporting complex.

The vertebral motion segment is a link in a complex kinematic chain. Normal spinal function is possible only with proper functioning of essentially all spinal segments. Dysfunction of the spinal segment manifests itself in the form of segmental instability or segmental blockade. In the first case, an excessive range of movements is possible between the vertebrae, which can contribute to the appearance of mechanical pain or even dynamic compression (that is, compression due to looseness) of the nerve structures. In the case of a segmental block, there is no movement between the two vertebrae. In this case, movements of the spinal column are ensured due to excessive movements in adjacent segments (hypermobility), which can also contribute to the development of pain.

After describing the structure of the main anatomical formations that form the spinal column, let's get acquainted with the anatomy and physiology of different parts of the spine.

Cervical spine

The cervical spine is the uppermost part of the spinal column. It consists of 7 vertebrae. The cervical spine has a physiological curve (physiological lordosis) in the form of the letter “C”, with the convex side facing forward.

The cervical region is the most mobile part of the spine. This mobility gives us the opportunity to perform various movements of the neck, as well as turns and tilts of the head.

In the transverse processes of the cervical vertebrae there are openings through which the vertebral arteries pass. These blood vessels are involved in the blood supply to the brain stem, cerebellum, and the occipital lobes of the cerebral hemispheres.

With the development of instability in the cervical spine, the formation of hernias that compress the vertebral artery, with painful spasms of the vertebral artery as a result of irritation of damaged cervical discs, insufficient blood supply to these parts of the brain appears. This is manifested by headaches, dizziness, spots before the eyes, unsteadiness of gait, and occasionally speech impairment. This condition is called vertebrobasilar insufficiency.

With pathology of the cervical spine, the venous outflow from the cranial cavity is also disrupted, which leads to a short-term increase in intracranial and intra-auricular pressure. As a result, a person may experience heaviness in the head, tinnitus, and poor coordination of movements.

The two upper cervical vertebrae, the atlas and the axis, have an anatomical structure that is different from the structure of all other vertebrae. Thanks to the presence of these vertebrae, a person can make various turns and tilts of the head.

ATLANTUS (1st cervical vertebra)

The first cervical vertebra, the atlas, does not have a vertebral body, but consists of an anterior and posterior arch. The arches are connected to each other by lateral bone thickenings (lateral masses).

AXIS (2nd cervical vertebra)

The second cervical vertebra, the axis, has a bony outgrowth in the front part, which is called the odontoid process. The odontoid process is fixed with the help of ligaments in the vertebral foramen of the atlas, representing the axis of rotation of the first cervical vertebra.

(connection of 1st and 2nd cervical vertebrae, rear view, from the back)

(connection of 1st and 2nd cervical vertebrae, rear view, from the side of the skull)

This anatomical structure allows us to perform high-amplitude rotational movements of the atlas and head relative to the axis.

The cervical spine is the most vulnerable part of the spine to traumatic injuries. This risk is due to a weak muscle corset in the neck, as well as the small size and low mechanical strength of the cervical vertebrae.

Damage to the spine can occur either as a result of a direct blow to the neck area or as a result of extreme flexion or extension movement of the head. The latter mechanism is called "whiplash" in car accidents or "diver's injury" when the head hits the bottom during a shallow dive. This type of traumatic injury is often accompanied by damage to the spinal cord and can be fatal.

The cervical spine, along with the vestibular and visual systems, plays an important role in maintaining human balance. Sensitive nerve endings - receptors - are located in the muscles of the cervical spine. They are activated during movements and carry information about the position of the head in space.

It is easy to feel the last - 7th cervical vertebra. It has the most prominent and noticeable spinous process, so the boundary between the cervical and thoracic regions is always quite easy to determine.

Thoracic spine

The thoracic spine consists of 12 vertebrae. Normally, it looks like the letter “C”, convexly facing backwards (physiological kyphosis).

The thoracic spine is involved in the formation of the posterior wall of the chest. The ribs are attached to the bodies and transverse processes of the thoracic vertebrae using joints. In the anterior sections, the ribs are connected into a single rigid frame with the help of the sternum, forming the chest.

The chest has two openings (apertures): upper and lower, which are covered by a muscular septum - the diaphragm. The ribs limiting the lower opening (inferior aperture) form a costal arch. There are 12 ribs on each side. All of them are connected with the bodies of the thoracic vertebrae by their posterior ends. The anterior ends of the 7 upper ribs connect directly to the sternum via cartilage. These are the so-called true ribs. The next three ribs (VIII, IX and X), which are attached with their cartilages not to the sternum, but to the cartilage of the previous rib, are called false ribs. Ribs XI and XII lie freely at their anterior ends, which is why they are called oscillating ribs.

The cartilaginous parts of the 7 true ribs are connected to the sternum through symphyses (that is, there is no cavity between the articulating surfaces, unlike joints, where there is always an articular cavity) or, more often, through flat joints. The cartilage of the first rib directly fuses with the sternum, forming synchondrosis Synchondrosis is essentially the same symphysis, that is, the connection of bones through cartilage. Each of the false ribs (VIII, IX and X) is connected by the anterior end of its cartilage to the lower edge of the overlying cartilage using a dense connective tissue fusion (syndesmosis). For simplicity, the most obvious example of connective tissue is scars.

The connection of the ribs with the vertebrae has its own characteristics. The thoracic vertebrae articulate with the ribs, so they are distinguished by the fact that they have costal fossae that connect to the heads of the ribs and are located on the body of each vertebra near the base of the arch. Since the ribs usually articulate with two adjacent vertebrae, most thoracic vertebral bodies have two incomplete costal fossae: one on the upper edge of the vertebra, and the other on the lower.

The exceptions are the first thoracic vertebra and the last thoracic vertebrae. The first thoracic vertebra has a full fossa above (the first rib is attached to it) and a half fossa below. The X vertebra has a semi-fossa on top (the X rib is attached to it), but has no fossa below. The XI and XII vertebrae each have one full fossa and the XI and XII ribs are attached to them, respectively.

In addition, on the transverse processes of the thoracic vertebrae there are also pits for connection with the tubercles of the corresponding ribs (again, except for the XI and XII thoracic vertebrae). In general, the connection of the ribs with the vertebrae and sternum looks like this:

The intervertebral discs in the thoracic region have a very small height, which significantly reduces the mobility of this part of the spine. In addition, the mobility of the thoracic region is limited by the long spinous processes of the vertebrae, arranged in the form of tiles, as well as a large number of costovertebral joints.

The spinal canal in the thoracic region is very narrow, so even small space-occupying formations (hernias, tumors, osteophytes) lead to the development of compression of the nerve roots and spinal cord.

Lumbar spine

The lumbar spine consists of the 5 largest vertebrae. Some people have 6 vertebrae in the lumbar region (lumbarization), but in most cases this developmental anomaly is not clinically significant. Normally, the lumbar spine has a slight smooth bend forward (physiological lordosis), just like the cervical spine.

The lumbar spine connects the sedentary thoracic region and the immobile sacrum. The structures of the lumbar region experience significant pressure from the upper half of the body. In addition, when lifting and carrying heavy objects, the pressure acting on the structures of the lumbar spine can increase many times, and the load on the lumbar intervertebral discs increases almost 10 times! Accordingly, the sizes of the vertebral bodies in the lumbar region are the largest.

All this is the reason for the most common wear of the intervertebral discs in the lumbar region. A significant increase in pressure inside the discs can lead to rupture of the annulus fibrosus and the release of part of the nucleus pulposus beyond the disc. This is how a disc herniation is formed, which can lead to compression of nerve structures, which leads to pain and other neurological disorders.

Sacral spine

In its lower part, the lumbar region is connected to the sacrum. The sacrum (simply the sacrum) is the support of the upper parts of the spine. In an adult, this is a single bone formation consisting of 5 fused vertebrae. The bodies of these vertebrae are more pronounced, and the processes less so. In the sacrum, there is a noticeable tendency for the power of the vertebrae to decrease (from the first to the fifth). Sometimes, the fifth lumbar vertebra can fuse with the sacrum. This is called sacralization . It is possible that the first sacral vertebra may be separated from the second sacral vertebra. This is the phenomenon of lumbarization . All these options are assessed by doctors as a type of “norm”. The sacrum connects the spine to the pelvic bones.

On the lateral part of the sacrum there is a tuberous surface through which it is connected to the right and left iliac bones. With their help, two sacroiliac joints are formed, strengthened by powerful ligaments.

Coccyx

The coccyx is a remnant of the tail that disappeared in humans; it consists of 3 to 5 underdeveloped vertebrae, which finally ossify at a late age. It has the shape of a curved pyramid, with the base facing upward and the apex facing down and forward.

The coccyx, connecting to the sacrum, forms the lower part, the base of the spine.

The tailbone plays an important role in distributing physical load on the pelvic floor (pelvic diaphragm). There are many nerve endings in the tissues surrounding the coccyx, so pain of a neurotic nature without anatomical causes is possible in the sacrococcygeal region.

In some people, the tailbone is bent far forward from birth and forms an almost right angle with the sacrum. The same thing happens after injuries (a fall on the tailbone and buttocks): even if the injury occurred in such distant childhood that a person does not remember, in adulthood he may experience various pain syndromes, forcing the patient to consult urologists and gynecologists, although the pain may be are absolutely not related to the pathology of these organs.

Spinal cord

The spinal cord is a part of the central nervous system and is a cord consisting of millions of nerve fibers and nerve cells. It is located in the spinal canal. The length of the spinal cord in an adult ranges from 40 to 45 cm, width - from 1.0 to 1.5 cm. As mentioned above, the spinal cord contains numerous nerve pathways that transmit impulses from the organs of our body to the brain and from the brain. brain to organs. There are 31 pairs of nerve roots (spinal nerves) that arise from the spinal cord. Nerve roots exit the spinal canal through the intervertebral (foramin) foramina, which are formed by the pedicles and articular processes of adjacent vertebrae.

Transverse sections of the spinal cord show the location of the white and gray matter. The gray matter occupies the central part and is shaped like a butterfly with outstretched wings or the letter H. The white matter is located around the gray matter, on the periphery of the spinal cord. The gray matter of the spinal cord consists mainly of nerve cell bodies and their processes, which do not have a myelin sheath (the myelin sheath is a kind of “insulator” that is used to cover wires in order to avoid short circuits). Accordingly, white matter is the long processes of neurons (axons), covered with a myelin “insulator” in order to conduct nerve signals over long distances (from the brain to the spinal cord and vice versa).

In the middle sections of the gray matter there is a very narrow cavity - the central canal, which stretches throughout the entire spinal cord. In adults it is completely overgrown.

The spinal cord, like the brain, is surrounded by three membranes (soft, arachnoid and hard). The pia mater is the innermost. Its surface fits tightly to the surface of the brain and spinal cord, completely repeating their relief. The pia mater contains many tiny branching blood vessels that supply blood to the brain. Next comes the arachnoid membrane. Between the arachnoid and soft membranes there is a space called subarachnoid (subarachnoid), filled with cerebrospinal fluid. The outermost is the dura mater, which fuses with the vertebrae from the outside to form a sealed connective tissue dural sac. The space between the dura mater and the arachnoid membrane is called subdural; it is also filled with a small amount of fluid.

The spinal cord lies in the spinal canal from the upper edge of the first cervical vertebra to the first lumbar or upper edge of the second lumbar vertebra, ending there with a cone-shaped narrowing. Above the upper edge of the first vertebra, the spinal cord passes into the medulla oblongata without a sharp boundary.

The apex of the cone-shaped narrowing continues into the terminal filum, which has a diameter of up to 1 mm and is a reduced part of the lower part of the spinal cord. The filum terminale, with the exception of its upper sections where there are elements of nervous tissue, is a connective tissue formation. That is, it is impossible to injure the spinal cord below the second lumbar vertebra; only the spinal nerves can be injured.

Further from the spinal cord, the spinal nerve roots pass through the canal, which form the so-called “cauda equina.” The roots of the cauda equina are involved in the innervation of the lower half of the body, including the pelvic organs.

In humans, as well as in other vertebrates, the segmental innervation of the body is preserved. This means that each segment of the spinal cord innervates a specific area of ​​the body. For example, segments of the cervical spinal cord innervate the neck and arms, the thoracic region innervates the chest and abdomen, the lumbar region innervates the legs, and the sacral region innervates the perineum and pelvic organs (bladder, rectum). Through peripheral nerves, nerve impulses travel from the spinal cord to all organs of our body to regulate their function. Information from organs and tissues enters the central nervous system through sensory nerve fibers. Most of the nerves in our body contain sensory (that is, the nerve impulse is transmitted from receptors to the central nervous system), motor (that is, the nerve impulse is transmitted from the central nervous system to the muscles) and autonomic (nerves that regulate the functioning of internal organs) fibers.

The length of the spinal cord is approximately 1.5 times shorter than the length of the spinal column, therefore there is no anatomical correspondence between the segments of the spinal cord and the vertebrae. Although each spinal nerve emerges from the intervertebral foramen corresponding to the segment of the spinal cord from which this nerve emerged. The spinal cord has two thickenings: the cervical (which innervates the arms) and the lumbar (which innervates the legs). But the cervical thickening is located at the level of the cervical vertebrae, which means the spinal cord itself can be damaged by a herniated protrusion of the intervertebral disc. While the lumbar enlargement (which innervates the legs) is located at the level of the lower thoracic spine, in which hernias almost never occur. Therefore, intervertebral hernias of the cervical spine are more dangerous than those of the lumbar spine.

Author of the article – Igor Atroshchenko

To book a therapeutic massage session, please call in Samara:

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Features of the structure of certain vertebrae

The atlas consists of anterior and posterior arches connected together by lateral masses. It turns out that the Atlas has a ring instead of a body. There are no shoots. Atlas connects the spine and the skull thanks to the occipital bone. The lateral thickenings have two articular surfaces. The upper surface is oval, attached to the occipital bone. The lower circular surface connects to the second cervical vertebra.

First cervical vertebra (atlas)

The second cervical vertebra (axis or epistropheus) has a large process that is shaped like a tooth. This shoot is part of Atlas. This tooth is an axis. Atlas and the head rotate around her. That is why epistrophy is called axial.

Second cervical vertebra (axis)

Due to the joint functioning of the first two vertebrae, a person is able to move his head in different directions without experiencing problems.

The sixth cervical vertebra is distinguished by costal processes that are considered vestigial. It is called protruding because it has a longer spinous process than other vertebrae.

Sixth (VI) cervical vertebra, vertebra cervicalis VI; view from above

If you want to find out in more detail how many bends the human spine has, and also consider the functions of the bends, you can read an article about this on our portal.

Diet

Proper nutrition for a herniated disc is an element of complex treatment. The diet therapy method is aimed at maintaining the patient’s well-being and optimal weight.

It is important to choose a diet rich in vitamins and microelements. Food should be varied, you should eat more fresh fruits and vegetables, nuts, fish, and whole grains. A sufficient amount of protein must also be supplied to the body. Glycosaminoglycans, which are part of cartilage tissue and prevent its destruction, are found in products of animal origin: beef, poultry, and sea fish. Therefore, vegetarianism is not recommended for intervertebral hernia.

However, you shouldn’t get carried away with meat dishes, especially fatty, fried and spicy ones. Every person should remember that obesity is one of the factors that provokes the onset and progression of the disease.

So, we talked about how to cure a herniated disc and what the danger is if you ignore this disease. If you experience back pain, you should not rely on painkillers and put off seeing a doctor for a long time, because the key to the success of treatment is its timely start.

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Treatment

Physiotherapeutic devices

There are many options for spinal treatment that are performed in an inpatient setting. However, besides them, there is a simple and affordable way to improve your health - this is oriental massage. Anyone can master it and do it at home.

Oriental massage

According to Chinese tradition, bioactive points in humans are located near the above vertebrae (see table No. 2). The distance is two fingers.

At a distance of four fingers there are points where, according to Chinese doctors, destructive emotions accumulate. By walking along the entire length of the spine with just your fingertips, the massage therapist improves the functioning of the entire body.

Movements are made gently along the spine. You need to move from the highest point down.

The main rule of massage. The person receiving the massage should enjoy the process and not experience pain. If pain occurs when you press on any point, then you need to ease the pressure.

A simple massage, when performed correctly, can improve the condition of the human body. But the main thing is to get rid of the reasons that cause negative emotions. After all, they are usually the root cause of all problems.

How is the procedure done?

X-rays of the lumbosacral spine may be performed on an outpatient basis or as part of a hospital stay. Procedures may vary depending on the patient's condition.

Typically, X-ray examinations of the spine follow the following process:

• The person will be asked to remove any clothing, jewelry, hair clips, glasses, hearing aids, or other metal objects that may interfere with the procedure.
• The patient is positioned on an x-ray table, which carefully positions the part of the spine to be x-rayed between the x-ray machine and an x-ray film cassette or digital media. Your doctor may also require that x-rays be taken from a standing position.
• Parts of the body that do not need to be examined may be covered with a lead apron (screen) to avoid exposure to X-rays.
• The radiologic technologist will ask the patient to remain still in a certain position for several minutes during the X-ray exposure.
• If x-rays are used to determine injury, special attention will be given to preventing further injury.
• The X-ray beam will be focused on the area to be photographed.
• An x-ray technician stands behind a protective window during an examination.

Although the X-ray procedure itself does not cause pain, manipulation of the body part being examined may cause some discomfort or pain. This is especially true if there has been a recent injury or an invasive procedure such as surgery.