KINESIOLOGY OF BACK AND SPINE

Functions of the Spinal Column

To provide stability and maintain an erect posture.

To allow mobility of the head, neck, and trunk in space.
To support and transmit loads from the upper boy to the pelvis.
To absorb shock.
To protect spinal chord.

Components of the Spinal Column

Bony structure: 32-33 vertebrae

o 7 cervical vertebrae
o 12 thoracic vertebrae
o 5 lumbar vertebrae
o 5 fused sacral vertebrae: sacrum
o 3-4 coccyx
Joint structure
o Lumbar area
Facet joint: (apophyseal or zygapophyseal joint)
Intervertebral joint: fibrocartilage joint
o Thoracic area
Facet joint: (apophyseal or zygapophyseal joint)
Intervertebral joint: fibrocartilage joint
o Thoracic area
Facet joint: (apophyseal or zygapophyseal joint)
Intervertebral joint: fibrocartilage joint
Uncovertebral joint (joint of von Luschka) : fibrocartilage joint.
Atlanto-occipital joint
Atlantoaxial (AA) joint
Anterior atlantoaxial joint

Spinal Curvature

At birth, the spinal column is convex backward (kyphosis)

Dividing into 2 columns (anterior and posterior) or 3 columns (anterior, middle and
posterior)
Anterior column
o Vertebral body
o Intervertebral disc (IVD)
o Incinate process
o Intervertebral joint
o Incovertebral joint
o Anterior atlantoaxial joint
Posterior column

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Intervertebral foramen
Pars interarticularis
Superior articular facet
Transverse process

JOINTS OF THE SPINE

1. Facet Joint

Synovial joint
Components
o Plane inferior articular process of the upper vertebra
o Plane superior articular of the lower vertebra
Joint type : plane
o 6-direction motions when moving together
Flexion/ extentsion
Sidebending to the left / right
Rotation to the left / right
o Arthrokinematic movements
Anterior glide with flexion
Posterior glide with extension
o Closed-packed position : maximum extension
Orientation of Facet Joints
o AO joint : anterior, inferior, and medical
AA Joint : nearly horizontal
C2-C7 : 20-45 from transverse plane and 20 posterior to frontal
plane
Lumbar: 90from transverse plane and 45 posterior to frontal
plane

2. Intervertebral Joint
Fibrocartilage
Structure
o Annulus fibrosus
o Nucleus pulposus
o End plate
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Functions
o To bear and distribute loads
o To restrain excessive motions
o To allow slight motions
Motions
o Flexion

Nucleus pulposus moving posterior

Anterior fibers compressed
Posterior fibers stretched
extension
nucleus pulposus moving anterior
anterior fibers compressed
posterior fibers stretched
rotation
nucleus pulposus to opposite
annular fibers under shear stress

3. Occipito-Atlantal joint (OA Joint) or Atlanto-Occipital Joint (AO Joint)

Proximal component : concave superior facet of atlas

Distal component : convex occipital condyles
Osteokinetic motions
o Head flexion (nodding)
o Head extension
o Slight sidebending with rotation to the opposite side
Accessory movements
o Anterior glide with head extension
o Posterior glide with head flexion

4. Atlanto-Axial Joint (AA Joint)

Proximal component : convex superior facet of axis

o Distal component : convex inferior facet of atlas
o Osteokinetmatic motions : head rotation

Anterior Atlanto-Axial Joint

o Synovial joint
o Anterior transverse ligament
o Motion : slight flexion / extension / rotation

5. Uncovertebral Joint (Joint of von Luschka)

Fibrocartilage
Structure
o Unciform process, uncinatr process, semilunate process, neorocntral lip
o Posterolateral edge of the superior rim projects upwards to articulate with
the body above
o Antero-inferior margin of the body projects downwards.

Kinematics of the Spibe

Coupled Motions between Sidebending and rotation

Sidebending with ipsilateral Rot (Lysell, 1969)

Ipsilateral facets glide down and backward (extension)

Contralateral facets glide up and forward (flexion)

Axis : close to ipsilateral facet

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Compensatory derotation at AA joint for the pure horizontal motion

Compensatory sidebending at AO joint for pure frontal plan motion

MUSCLES AROUND THE SPINE

1. Muscles for Trunk Flexion
Abdominal muscles
o Rectus abdominis
o Obliquus extemus abdominis
o Obliquus intemus abdominis
o Transverse abdominis
2. Muscles for Trunk Extension
Erector spinae
Deep layer muscles
o Multifidus
o Rotator
o Interspinalis
o Intertransversarii
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3. Muscles for Trunk Side bending
Anterior and posterior muscles at the same side contract together
4. Muscles for Trunk Rotation
Ipsilateral obliquus intermus abdomis
Contralateral obliquus extemus abdomis
Multifidus
5. Muscles for Neck Flexion
Stemocleidomatoid flexes lower cervical but need assistance of flattening
cervical lordosis from
o Longus capitis
o Rectus capitis anterior

o Rectus capitis lateralis

o Supra and infra-hyoid muscles
6. Muscles for Head Tension
Suboccipital muscles
o Rectus capitis posterios major
o Rectus capitis posterior minor
o Obliquus capitis superior
o Obliquus capitis inferior

SPINE STABILITY

Factoe Affecting Stability of the Spine

Ligaments
o Anterior longitudinal ligament (ALL)
o Posterior longitudinal ligament (PLL)
o Ligamnetum of flavum
o Intersoinous ligament
Muscles : dynamic