Spine
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Your spine, or backbone, is your body's central support structure. It connects different parts of your musculoskeletal system. Your spine helps you sit, stand, walk, twist and bend. Back injuries, spinal cord conditions and other problems can damage the spine and cause back pain.
Strong back muscles can protect your spine and prevent back problems. Try to do back-strengthening and stretching exercises at least twice a week. Exercises like planks strengthen the core (abdominal, side and back muscles) to give your spine more support. Other protective measures include:
Your spine is a complex structure of small bones (vertebrae), cushioning disks, nerves, joints, ligaments and muscles. This part of your anatomy is susceptible to injury, arthritis, herniated disks, pinched nerves and other problems. Back pain can affect your ability to enjoy life. Your healthcare provider can help ease back pain and offer suggestions to strengthen the muscles that support your back and prevent back injuries.
Many demands are placed on your spine. It holds up your head, shoulders, and upper body. It gives you support to stand up straight, and gives you flexibility to bend and twist. It also protects your spinal cord.
Your spine is made up of three segments. When viewed from the side, these segments form three natural curves. The \"c-shaped\" curves of the neck (cervical spine) and lower back (lumbar spine) are called lordosis. The \"reverse c-shaped\" curve of the chest (thoracic spine) is called kyphosis.
Abnormal curvatures of the spine are also referred to as spinal deformity. These types of conditions include kyphosis of the thoracic spine (\"hunchback\"), lordosis of the lumbar spine (\"swayback\"), and \"flatback syndrome,\" a condition in which there is too little curvature of the spine.
Scoliosis is another type of spinal deformity. When viewing the spine from the front or back, scoliosis is a sideways curvature that makes the spine look more like an \"S\" or a \"C\" than a straight \"I.\"
The cervical spine is made up of seven small vertebrae that begin at the base of the skull and end at the upper chest. The thoracic spine is made up of 12 vertebrae that start from the upper chest to the middle back and connect to the rib cage. The lumbar vertebra consists of five larger vertebrae. These vertebrae are larger because they carry more of your body's weight.
When you are standing or moving, weight is put onto the nucleus. In response, the nucleus expands. The annulus holds the nucleus in place. This allows movement to take place, yet maintains the strength of the spine. In effect, disks act as shock absorbers for the spine.
Between the back of the vertebrae are small joints that also help your spine move. These facet joints have a cartilage surface, very much like a hip or a knee joint does. The facet joints are important for allowing rotation of the spine but may develop arthritis and become a source for low back or neck pain.
The spine is made of 33 individual bones stacked one on top of the other. This spinal column provides the main support for your body, allowing you to stand upright, bend, and twist, while protecting the spinal cord from injury. Strong muscles and bones, flexible tendons and ligaments, and sensitive nerves contribute to a healthy spine. Yet, any of these structures affected by strain, injury, or disease can cause pain.
When viewed from the side, an adult spine has a natural S-shaped curve. The neck (cervical) and low back (lumbar) regions have a slight concave curve, and the thoracic and sacral regions have a gentle convex curve (Fig. 1). The curves work like a coiled spring to absorb shock, maintain balance, and allow range of motion throughout the spinal column.
The abdominal and back muscles maintain the spine's natural curves. Good posture involves training your body to stand, walk, sit, and lie so that the least amount of strain is placed on the spine during movement or weight-bearing activities (see Posture). Excess body weight, weak muscles, and other forces can pull at the spine's alignment:
The two main muscle groups that affect the spine are extensors and flexors. The extensor muscles enable us to stand up and lift objects. The extensors are attached to the back of the spine. The flexor muscles are in the front and include the abdominal muscles. These muscles enable us to flex, or bend forward, and are important in lifting and controlling the arch in the lower back.
The back muscles stabilize your spine. Something as common as poor muscle tone or a large belly can pull your entire body out of alignment. Misalignment puts incredible strain on the spine (see Exercise for a Healthy Back).
Thoracic (mid back) - the main function of the thoracic spine is to hold the rib cage and protect the heart and lungs. The twelve thoracic vertebrae are numbered T1 to T12. The range of motion in the thoracic spine is limited.
Lumbar (low back) - the main function of the lumbar spine is to bear the weight of the body. The five lumbar vertebrae are numbered L1 to L5. These vertebrae are much larger in size to absorb the stress of lifting and carrying heavy objects.
Sacrum - the main function of the sacrum is to connect the spine to the hip bones (iliac). There are five sacral vertebrae, which are fused together. Together with the iliac bones, they form a ring called the pelvic girdle.
Each vertebra in your spine is separated and cushioned by an intervertebral disc, which keeps the bones from rubbing together. Discs are designed like a radial car tire. The outer ring, called the annulus, has crisscrossing fibrous bands, much like a tire tread. These bands attach between the bodies of each vertebra. Inside the disc is a gel-filled center called the nucleus, much like a tire tube (Fig. 4).
The facet joints of the spine allow back motion. Each vertebra has four facet joints, one pair that connects to the vertebra above (superior facets) and one pair that connects to the vertebra below (inferior facets) (Fig. 6).
The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations.
The Spine Journal is the #1 ranked spine journal in the Orthopaedics category and the Clinical Neurology category in the most recent Journal Citation Reports, published by Clarivate. The journal has an Impact Factor of 4.297 and a Citescore of 6.9. To learn more, please visit the Journal Metrics page.
As the open access publication of the North American Spine Society, NASSJ is a multidisciplinary, indexed, international journal welcoming peer-reviewed research, systematic and narrative reviews, case reports and commentaries related to spine surgery and spine care.
Submit your abstracts and proposals for the NASS 38th Annual Meeting, held October 18-21, 2023 in Los Angeles, CA. The meeting will feature podium presentations, symposia and electronic posters addressing research, issues and trends in spine.
Viewed from the side, there are four slight natural curves in a healthy adult spine: the cervical (neck) and lumbar (lower back) sections of the spine curve inward, and the thoracic (upper back) and sacral (bottom of the spine) sections curve outward. This S-shaped curvature makes the spine stable: It helps you keep your balance when you are in an upright position, acts like a shock absorber when you walk, and protects the individual bones in the spine (the vertebrae) from fractures.
The disks have a solid, multi-layered casing of cartilage fiber and a gel-like core. They keep the spine flexible so that we can lean over and rotate our upper body. They also absorb shocks that are transferred to the spine when we run or jump, for instance.
When we put pressure on our spine, the spinal disks release fluid and become thinner (\"compress\"); when the pressure is relieved, they absorb fluid and become thicker (\"decompress\"). Because we usually put more pressure on our spine during the day and relieve the pressure at night, we are around 1.5 to 2 centimeters shorter by the end of the day. Over many years our spine starts to wear, meaning that as we age our spinal disks become thinner, the vertebrae become compressed and the spine curves more. That is why we usually \"shrink\" a little (a few centimeters) as we age.
Dr. Elizabeth Lord is a Board Certified fellowship trained spine surgeon and an Assistant Professor of Orthopaedic Surgery and Neurosurgery. Dr. Lord specializes in complex spine conditions including adult and adolescent spinal deformity and scoliosis, reconstructive surgery of the cervical, thoracic, and lumbar spine, and primary and metastatic tumors of the spine. Dr. Lord received dual fellowship training in Orthopaedic and Neurosurgical spine surgery at the prestigious New York University Langone/Hospital for Joint Disease with an emphasis on complex and revision spine deformity, minimally invasive surgery, and robotic surgery. This dual training has provided her with a unique background to treat complex spine disorders. Dr. Lord attended Harvard University for her undergraduate studies where she was a starting member of the nationally-ranked sailing team. Dr. Lord completed her premedical studies at Georgetown University and received her medical degree from Columbia University College of Physicians and Surgeons. Dr. Lord completed her intern year of orthopaedic surgery at Washington University/Barnes-Jewish Hospital. Dr. Lord completed her orthopaedic surgery residency at UCLA in addition to a research fellowship focused on bony fusion in spine surgery. Dr. Lord's research includes bone biology and fusion, pediatric and adult spinal deformities, and innovation in spine surgery. She has authored numerous basic science and clinical articles in peer-reviewed journals. She has presented her research internationally and nationally. Dr.