The role of the spine in human life article on the topic

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The human spine is the basis of the musculoskeletal system. At the same time, it not only performs a supporting function and provides the ability to walk upright, but also represents a fairly flexible axis of the body, which is achieved due to the mobility of the vast majority of its individual parts. In this case, the anterior part of the spine participates in the formation of the walls of the thoracic and abdominal cavities. But one of its most important functions is to ensure the safety of the spinal cord that runs inside it.

Spinal sections:

In medical terminology, for brevity, the Latin letter “C” - C1 - C7 is used to designate the cervical vertebrae, the Latin letter “Th” - Th1 - Th12 is used to designate the thoracic vertebrae, and the lumbar vertebrae are designated the letter “L” - L1 - L5.

• Cervical spine (7 vertebrae) This is the uppermost section of the spinal column. It is distinguished by its special mobility, which provides such variety and freedom of head movement. The two upper cervical vertebrae, with the beautiful names atlas and 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 turn and tilt his head. By the way, all mammals have 7 cervical vertebrae, even the giraffe.
• Thoracic region (12 vertebrae) 12 pairs of ribs are attached to this region. The thoracic spine is involved in the formation of the posterior wall of the chest, which is the container for vital organs. In this regard, the thoracic spine is inactive.
• Lumbar (5 vertebrae) This section consists of the most massive vertebrae, since they bear the heaviest load. Some people have a sixth lumbar vertebra. Doctors call this phenomenon lumbalization. But in most cases, such an anomaly has no clinical significance. 8-10 vertebrae fuse to form the sacrum and coccyx.
• Sacrum (5 vertebrae)
• Coccyx (4-5 vertebrae)

Age and gender characteristics of the spine

The length of the spinal column in newborns does not exceed 40% of the total height. But during the first 2 years of life, its length almost doubles. All this time, all parts of the spine are growing at a high speed, but mainly in width. From 1.5 to 3 years, the growth rate decreases, especially in the cervical and upper thoracic regions. At about 3 years of age, active growth of the lumbar and lower thoracic spine begins. From 5 to 10 years, a phase of smooth, uniform growth in all parameters begins, followed by a phase of active growth, lasting from 10 to 17 years. After this, the growth of the cervical and thoracic regions slows down, but the growth of the lumbar region accelerates. The entire process of development of the spinal column is completed at 23-25 ​​years of age.

Thus, in an adult man, the length of the spine is on average 60-75 cm, and in a woman - 60-65 cm. Over the years, degenerative changes occur in the intervertebral discs, they flatten and cease to fully cope with their functions, and physiological bends increase. As a result, not only various diseases arise, but also the length of the spinal column decreases in old age by about 5 cm or more.

Thoracic kyphosis and lumbar lordosis are more pronounced in women than in men.

Thus, the human spine has a complex structure, a dense network of nerves and blood vessels. This largely explains the difficulty of performing surgical interventions on it and the possible risks. Therefore, today all efforts are aimed at finding the least invasive methods of performing operations that involve minimal tissue trauma, which sharply reduces the likelihood of developing complications of varying severity.

Osteochondrosis?

Synonyms: radiculitis, salt deposits. Between the bodies of two adjacent vertebrae there is an intervertebral disc that performs 3 functions: shock absorption, holding adjacent vertebrae, ensuring mobility of the vertebral bodies. With osteochondrosis, the intervertebral disc loses its elasticity, becomes less durable, and therefore cannot perform its functions. Salts are deposited at the junctions of the vertebrae, bone growths appear, which, together with the discs, can shift and compress the nerve roots. This causes pain.

Manifestations of osteochondrosis are herniated intervertebral discs. A lumbar hernia causes pain in the back, buttocks, sacrum, and can spread to the legs. If you have any of these symptoms, it is necessary to undergo an examination, which includes not only x-rays, but also magnetic resonance imaging (MRI). When determining treatment tactics, we rely on MRI data. If an MRI reveals a disc herniation, the patient is most often frightened by this “terrible” diagnosis - not surgery! It must be said that for surgery for a herniated disc at the lumbar level, good reasons are needed. The patient makes the final decision after consultation with a neurosurgeon - vertebrologist.

A disc herniation causes severe pain, even with slight exertion, which interferes with life and work. If the patient wants to significantly improve the quality of his life, he will choose surgical treatment that will permanently rid him of this disease.

Another question arises: Where to have surgery? What to look for when choosing a medical institution?

To successfully perform an operation, in addition to the knowledge and skills of the surgeon, you need appropriate equipment in the operating room (Electro-optical converter (EOC) - a special X-ray unit, a powerful operating microscope, a special set of microsurgical instruments). The operating rooms in our clinic meet all these requirements and are fully equipped with everything necessary for spinal surgery.

A question that people leading an active lifestyle ask: How many days will the hospital stay take in case of surgery? Before surgery – from 2 to 5 days. After surgery – up to two weeks. The patient gets up on the second day and is discharged after the stitches are removed. He is offered a special rehabilitation program that will allow him to recover as soon as possible and return to an active lifestyle.

Spinal injuries

Spinal injuries are very common and extremely dangerous, as spinal injuries cause injury to the spinal cord, which can lead to paralysis. Injuries to the cervical spine are varied: damage to the ligamentous apparatus, subluxations and dislocations of the vertebrae, and their fractures. Many experts do not consider injuries to the ligamentous apparatus to be serious, since they do not detect pathology on X-rays. The patient only has neck pain. Therefore, they either put a soft collar on him or let him go with the parting words: in 2 weeks everything will pass! However, our experience shows that such damage must be taken seriously. Lack of treatment often leads to serious complications: pain increases significantly, and intervertebral disc herniation may occur.

Subluxations and dislocations of the vertebrae are a very serious problem. In this case, the spinal cord and its roots suffer to one degree or another. In this situation, active actions of the surgeon are required. The goal is to eliminate compression of the nerve structures (spinal cord and its roots) and restore the correct anatomical relationship in the cervical spine between bone and nerve structures (eliminate dislocation). To restore the supporting function of the spine, during the operation the dislocation is reduced, and then special plates are implanted to fix the unstable part.

The human spine (or "vertebral column") is the basis of the human skeleton. The spine consists of 32 - 34 vertebrae arranged in a row, which are connected to each other by ligaments, joints, intervertebral (intervertebral) discs, which in turn are cartilage, or vertebrae fused together.

STRUCTURE OF THE SPINE

The human spine and vertebrae are usually divided and classified into sections. Each part of the spine consists of a certain number of vertebrae. Vertebrae are designated by a Latin letter (the first letter of the Latin name of the spine department) and a number (the serial number of the vertebra in the department), for example, C3 is the third cervical vertebra. Vertebrae are numbered from top to bottom

.

There are 5 sections of the spine (from top to bottom):

• The cervical region (or cervical part; in Latin “Pars Cervicalis”) - consists of 7 vertebrae numbered C1 - C7
  .
  Note. The occipital bone of the skull is conventionally considered the “zero” cervical vertebra with numbering C0
  . The cervical vertebrae differ from the general type: C1 - Atlas (in Latin "Atlas"), C2 - Axial vertebra or Axis (in Latin "Axis") and C7 - Protruding vertebra (in Latin "Vertebra Prominens");
• The thoracic region (or thoracic part; in Latin “Pars Thoracalis”) - consists of 12 vertebrae numbered Th1 - Th12
  or
  T1 - T12
  (there is also
  an alternative numbering D1 - D12
  );
• Lumbar (or lumbar part; in Latin “Pars Lumbalis”) - consists of 5 vertebrae numbered L1 - L5
  ;
• The sacral section (or sacral part; in Latin “Os Sacrum”) - consists of 5 vertebrae numbered S1 - S5
  - in an adult they grow together into the sacral bone;
• The coccygeal region (or coccygeal part; in Latin “Os Coccygis”) - consists of 3 - 5 vertebrae numbered Co1 - Co5
  - in an adult they grow together into the coccygeal bone.

The vertebrae are connected to each other by two upper and two lower articular processes, intervertebral discs and very strong ligaments located on the sides of the vertebral bodies, on their anterior and posterior sides.

The mobility of the vertebrae is ensured by the discs, joints and ligaments located between them. The latter to some extent play the role of a limiter, preventing too much mobility. Strong muscles of the back, neck, shoulder, chest, as well as the abdomen and hips largely determine the mobility of the vertebrae and the entire spinal column. All these muscles interact harmoniously with each other, providing fine regulation of movements in the spine. If the strength or tension of any muscle changes, it can cause a change in the motor function of the spine, resulting in back pain or fatigue.

BENDINGS OF THE HUMAN SPINE

If you look at the structure of the human spine from the side, you can see that the vertebrae are not directly one above the other, but form characteristic physiological curves of the spine

:

1. in the cervical spine, the spine bends forward, forming the so-called cervical lordosis
   ;
2. in the thoracic region the spine bends backward, forming the so-called thoracic kyphosis
   ;
3. in the lumbar region the spine bends forward, forming the so-called lumbar lordosis
   ;
4. in the sacral region, the spine bends backward, forming the so-called sacral kyphosis
   .

These curves constitute a spring-loaded shock-absorbing apparatus for the spine, softening shocks and thus protecting the brain from damage when walking, running and jumping.

STRUCTURE AND FUNCTIONS OF VERTEBRES

Each vertebra consists of a round or kidney-shaped body and an arch that closes the vertebral foramen. Articular processes extend from it, serving for articulation with the above and underlying vertebrae.

The vertebrae consist of an internal spongy substance and a compact external substance. Spongy substance in the form of bone bars provides strength to the vertebrae. The outer compact substance of the vertebra consists of lamellar bone tissue, which provides the hardness of the outer layer and the ability of the vertebral body to absorb loads, for example, compression when walking. Inside the vertebra, in addition to the bone crossbars, there is red bone marrow, which has the function of hematopoiesis.

Depending on what part of the spine the vertebrae belong to, the shapes of their bodies and processes have some differences. In general, we can say that the lumbar vertebrae are more massive than the cervical vertebrae, which have smaller bodies and less developed processes. This is due to the fact that the lumbar vertebrae bear a greater load than the cervical vertebrae, which only bear the weight of the head.

The thoracic vertebrae have a special function, forming the rib cage together with the ribs and sternum. The ribs attached to the anterior side of the transverse processes are not a continuation of them, but are separate bones connected to the processes by two small joints. The joints allow some movement between the ribs, and between the ribs and vertebrae relative to each other, allowing for inhalation and exhalation. The chest, formed from bones, has less mobility compared to the neck and torso. The degree of freedom between the thoracic vertebrae is also less than between the cervical and lumbar vertebrae.

Between the vertebrae of the cervical, thoracic and lumbar regions (except for the first two cervical vertebrae) there are intervertebral discs, which consist of fibrous rings and nucleus pulposus. The elastic consistency of the disc allows it to change shape. The disc's ability to absorb and distribute pressure between the vertebrae allows it to act as a shock absorber and allows the spine to bend.

From the spinal cord in the intervertebral (foraminal) foramina, openings between two adjacent vertebrae, the roots of the spinal nerves, veins and arteries pass. Fibers in the nerve root carry signals to the spinal cord from nerves located in the skin and fibrous layers of connective tissue. Other nerve fibers in turn carry signals from the spinal cord to the muscles so that they can contract on command from the brain and spinal cord. The nerve roots of the cervical segments of the spinal cord go mainly to the arms, the lumbar segments - to the legs, while the nerve roots of the thoracic segments - to the torso.

The human bone structure, including the structure of the spine, is constantly renewed: cells of one type are engaged in the decomposition of bone tissue, while others are engaged in its renewal. Mechanical forces and loads to which the vertebra is exposed stimulate the formation of new cells. Increased impact on the vertebra ensures accelerated formation of bone substance

with a large number of crossbars and a denser bone substance, and vice versa, a decrease in load causes its disintegration.

For example, immobility forced due to illness leads to the breakdown of bone matter with its possible consequence - softening of the skeletal bones.

To counteract such problems and for preventive purposes, we recommend periodically

undergo a course of therapeutic massage and physiotherapy (using an electromyostimulation device), for example, in our medical center.

SPINAL MOTOR SEGMENT (SPINAL MOTOR SEGMENT)

Under the term " spinal motion segment"

"(
PDS of the spine
) refers to the part of the spine consisting of two adjacent (adjacent) vertebrae.

The spinal motion segment includes all the structural units at this level of the spine: two adjacent vertebrae, their joints and the ligamentous apparatus of the articulation of these two adjacent vertebrae, the intervertebral disc, and also includes the paravertebral muscles. In each spinal motion segment there are two intervertebral (foraminal) openings in which the roots of the spinal nerves, arteries and veins are located.

In total, the spine has 24 spinal motion segments: 7 cervical, 12 thoracic and 5 lumbar. The last lumbar segment (lowest) is formed by the 5th lumbar vertebra (L5) and the first sacral vertebra (S1).

In medical protocols, a spinal motion segment is named according to the vertebrae above and below in that segment, for example, the L5-S1 segment.

Cervical vertebrae fractures

This is a common injury. Especially among athletes. In case of a fracture of the cervical vertebrae, surgery is always required. You need to act as quickly as possible, since the spinal cord is damaged, and this entails serious problems (loss of sensitivity and loss of motor function are possible).

Separately, it is necessary to highlight injuries to the upper cervical spine. These include damage to the first two vertebrae. They are different in structure from the others and require a special approach to treatment. In order for the fragments to heal correctly, a special device is used - a Halo-device, which allows you to fix the fragments in the desired position.

Structure and functions of the cervical vertebrae

The very first vertebra of this section, located at the top, is called “atlas” . It is axial and does not have a body or spinous process. In this area, it allows you to connect the spinal column with the occipital bone, as well as the brain and spinal cord with each other.

These tasks determine its structure : it consists of two arches that border the spinal canal. The anterior arch forms a small tubercle. Behind it there is a depression combined with the odontoid process of the second vertebra.

On the posterior arch there is a groove where the vertebral artery is located. The articular part of the “atlas”, located on top, has a convex shape, and the bottom is flat. This structural feature is due to the intermediate position of the vertebra between the spine and the head.

The second vertebra, called the "axis" , is also distinguished by its shape, which resembles a pointed "tooth". It functions as a “hinge” that ensures rotation of the first vertebra of the atlas along with the skull, as well as the ability to tilt the head in different directions.

There is no intervertebral disc in the space between the atlas and axis . Their connection is formed like a joint. It is this factor that causes a high risk of injury.

The structure of the atlas and axis

The cervical vertebrae from the third to the sixth are small . Each of them has a fairly large hole, similar in shape to a triangle. Their upper edges protrude slightly, which is why they are compared to “sides.” Their articular processes are short and located at a slight angle.

The vertebrae from the third to the fifth also have small transverse processes that are split at the edges. These processes contain openings through which blood vessels pass. This is where the main vertebral artery that supplies the brain is located.

In the next area, where the sixth and seventh vertebrae are located, the spinal column has a slight expansion . This is where salt deposition most often occurs. The sixth vertebra is called “carotid” because its tubercle, located in front, is located near the carotid artery. It is against this that the artery is pressed to stop the bleeding.

The largest in the last section of the cervical region here is the seventh vertebra . This is what you can feel with your hands if you tilt your head forward. For the same reason, he is also called a speaker. In addition, it serves as the main guideline when counting vertebrae. The lower part of this vertebra has a depression.

Here is where it connects with the first rib. A special feature of the seventh vertebra is the holes in the area of ​​the transverse processes, which can be very small in size or completely absent. It has the longest spinous process, without divisions into parts.

Each of the cervical vertebrae is responsible for a specific function.

When they are damaged, unpleasant phenomena occur that correspond to each specific vertebra, such as:

Trauma to the thoracic and lumbar spine

Unlike the cervical region, vertebral dislocations in their pure form do not occur in these regions.

There are fractures and fracture-dislocations.

There are stable and unstable fractures.

Bones and ligaments that provide mobility protect the spinal cord from injury. When, due to a fracture, these structures no longer protect the spinal cord or nerve roots from damage or irritation during stress, the fracture is considered unstable.

Unstable fractures are subject to mandatory surgical treatment, while stable ones can be treated conservatively.

Treatment tactics

After all the necessary examinations, treatment tactics are selected.

If conservative (non-surgical) treatment is possible, a corset is selected for the patient, and primary rehabilitation is carried out (the abdominal and back muscles need to be strengthened).

If a decision is made to undergo surgery, the doctor will determine the type of surgical treatment. You can read more about this in the section “For persons with medical education.”

Thanks to reliable and proven methods, the experience of surgeons, as well as modern technologies, patients recover quickly.