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Biomechanics PDF
Biomechanics PDF
spine
• PROBLEMS IN SPINE/BACK
Introduction
• Spine or Vertebral Column or Backbone
is a complex structure meant for
support and a linking structure between
upper and lower extremities.
• It provides a base of support for the head
and internal organs, a stable base for the
attachment of ligaments, bones and
muscles of the extremities, rib cage and the
pelvis.
• It is a link between the upper and the
lower extremities and provide mobility for
the trunk.
• It protects the Spinal cord.
Structure
• The Spine comprises of 33 vertebral bones
and 23 Intervertebral disc.
• Cervical (7), Thoracic (12), Lumbar (5),
Sacral (5), Coccygeal (4)
• The vertebrae increase in size from the
cervical to lumbar region and decrease
in size from the sacral to coccygeal
region.
• Primary curve (Kyphotic curve)- Thoracic
and Sacral, they retain the original posterior
convexity throughout life.
• Secondary curve (Lordotic curve)- Cervical
and Lumbar, they develop as anterior
convexity as a result of the accommodation
of the skeleton to the upright posture.
Articulations
• Two main types of articulations
are found in the vertebral
column:
• The joints between the
vertebral bodies and disks are
referred to as the
Intervertebral joints.
• The joints between the
zygapophyseal facets are
called the Zygapophyseal
(apophyseal or facet) joints.
• All the zygapophyseal joints,
except for the joint between
the first two cervical
vertebrae, are plane synovial
joints.
• The vertebral column
articulates with the ribs, with
the skull and the pelvis at
the sacroiliac joints.
• The motion between any two vertebrae at the intervertebral
joints is extremely limited and consists of a small amount of
gliding (translation) and rotation.
• So Vertebrae has got 3 degree of freedom, permitting
flexion and extension, lateral flexion and rotation.
• However, motions in the vertebral column often are coupled
motions.
• Coupling- the consistent association of one motion about
an axis with another motion around a different axis. Eg. Axial
rotation is coupled with lateral flexion and forward flexion)
Vertebral column structure Functions
Structure Function
Body Resists compressive forces.
Transmits compressive forces to vertebral end plates.
Pedicles Transmit bending forces (exerted by muscles
attached to the spinous and transverse processes)
to the vertebral bodies
• The intervertebral disks make up about 20% to 33% of the length of the
Spine. (approx. 70 cm in male, 60 cm in female)
• The size increases from the cervical to the lumbar region and disk
thickness varies from approx. 3mm in the cervical to about 9 mm in lumbar
region.
• The ratio between disk thickness and vertebral body height is greatest in
the cervical and lumbar regions and least in the thoracic region. The
greater the ratio, the greater the mobility, hence the disks in the cervical
and lumbar regions contribute to the greater mobility in comparison with
the thoracic region.
• The disk is composed of two parts; a central portion called the nucleus
pulposus and a peripheral portion called the annulus fibrosis.
Ligaments and Joint Capsules.
• Interbody Joints
• Zygapophyseal Articulations
Kinematics
• Flexion
• Extension
• Lateral flexion
• Rotation.
Contin…
Coupled Motion
Kinetics
• Axial Compression
• Bending
• Torsion
• Shear
Contin…..
• Side-to-side translation (gliding)
occurs in the frontal plane.
• Superior and inferior translation (axial
distraction and compression) occur
vertically.
• Anteroposterior translation occurs in
the sagittal plane.
• Side-to-side rotation (tilting) in a
frontal plane occurs around an
anteroposterior axis.
• Rotation occurs in the transverse
plane around a vertical axis.
• Anteroposterior rotation (tilting)
occurs in the sagittal plane around a
frontal axis.
Functions of Spine
Stability:
• The stiffness of the vertebral column is the column’s
ability to resist an applied load. Stiffness can be
represented graphically by the slope of the stress-
strain curve. The steeper the slope of the curve, the
stiffer the structure.
• The neutral zone is the ROM through which the spine
can be displaced from a neutral position to the point at
which elastic deformation begins when a small load is
applied. In a stress-strain curve the neutral zone would
be represented by the toe region of the curve.
• The spine is subjected to axial compression, tension,
bending, torsion and shear stress not only during
normal functional activities, at rest also it depends
upon the type, duration and rate of loading; the
person’s age and posture; the condition and properties
of the various elements.
Stress-Strain Curve
Axial Compression
• Axial compression (force acting through the long axis at an 90*
degree) occurs due to the force of gravity, ground reaction forces
and forces produced by the ligaments and muscular contractions.
• Most compressive force is resisted by the disks and vertebral bodies,
but the arches and zygapophyseal joints share some of the load in
certain postures and during specific motions.
• Compressive load> pressure higher in center of end plates than
periphery.
Bending
• Bending causes both compression and tension on the structures of
the spine.
• In forward flexion the anterior structures are subjected to
compression; the posterior structures are subjected to tension. The
resistance offered to the tensile forces by collagen fibers in the
posterior outer annulus fibrosus, zygapophyseal joint capsules, and
posterior ligaments help to limit extremes of motion and hence
provide stability in flexion.
• The nucleus pulposus acts like a pivot but unlike a ball is able to
undergo greater distortion because it behaves as a fluid.
• Cervical Region
Structure
Two distinct regions:
• The upper cervical , or
craniovertebral region and
• The lower cervical region
Cervical Region
Craniovertebral Region
ATLAS
LIGAMENTS
• Atlantal cruciform ligament
• Alar ligaments
Kinematics
Nodding motions of the
atlanto-occipital joints.
Kinetics
• The thoracic region is subjected to
increased compression forces in
comparison with the cervical region,
because of the greater amount of body
weight that needs to be supported and
the region’s kyphotic shape.
Lumbral region
Lumbar Anatomy
• 5 vertebraes- L1-L5
• 5 intervertebral discs
• 5 pair of exiting nerve roots
• Lumbar lordosis L1-S1 ranges
from 30°–80°.
• The apex of lumbar lordosis is
L3-L4.
Types of motion
Lumbo sacral angle
Ferguson’s angle
•Stage 2: “Lumbar instability” at the effected level(s) develops due to laxity of the
facet capsules, cartilage degeneration and grade 2-3 degenerative disc disease.
Segmental Instability: may be defined as loss of motion and segmental stiffness
such that force application to that motion segment will produce greater
displacements than would occur in a normal structure. Mechanical testing suggests
the intervertebral disc is most susceptible to herniation at this stage.
•Stage 3: “Fixed deformity” results from repair processes such as facet and
peridiscal osteophytes effectively stabilising the motion segment. There is advanced
facet joint degeneration (or “facet joint syndrome”) and grade 3-4 disc degeneration
of clinical importance is altered spinal canal dimensions due to fixed deformity and
osteophyte formation
Sacral region
Five sacral vertebrae are fused to form
the triangular or wedge-shaped structure
that is called the sacrum.
• The base of the triangle, which is formed
by the first sacral vertebra, supports two
articular facets that face posteriorly for
articulation with the inferior facets of the
fifth lumbar vertebra.
• The apex of the triangle, formed by the
fifth sacral vertebra, articulates with the
coccyx.
SACROILIAC JOINT
• A joint that connects the spinal
column with the pelvis. The V-
shaped sacrum near the base of
the spine fits like a wedge
between the wide wings of the
ilium (hipbone).
Disorders Of The Back/Spine
● Back Strain/Sprain
● Ankylosing Spondylitis
● Cauda Equina
● Herniated Nucleus Pulposus
(HNP)
● Spinal Stenosis
● Kyphosis/Scoliosis
● Low Back Pain (LBP):
Spondylolysis
Back Strain/Sprain
● LBP is the most frequentcause of lost
work time and disability in adults
<45 years
● Most symptoms of limited
duration
● 85% of patients improve
and returning to work
within 1month
Ankylosing Spondylitis
● Progressive spinal flexion
deformities (mayprogress to a chin-
on-chest deformity)
Cauda Equina symdrome
Herniated Nucleus Pulposus (HNP) of the Lumbar Spine
Kyphosis
● Defined: abnormally
increased convexity in the
curvature of the thoracic
spine asviewed from side
● Scheuermann’s Disease
● Hyperkyphosis that
does not reverse on
attempts at
hyperextension
Scoliosis
● Lateral curvature of thespine greater than
10 degrees, usually thoracic or lumbar,
associated with rotation of the vertebrae
and sometimes excessive kyphosis or
lordosis
● Idiopathic scoliosis
● Lateral deviation and rotation of the
spinewithout an identifiable cause
Low Back Pain
● Spondylolysis
● Unilateral Pars defect is the
result of a fatigue/fracture
from repetitive
hyperextension