9. C0-C2 Joint
surfaces very
unstable
Stability via
ligaments
Major stabiliser
C1-C2
Restricts
rotation of
occiput on dens
Major ligs of
subaxial spine
+ lig flavum +
inter + supra
spinous ligs
16. Anatomy - Neural
•
•
8 Cervical nerves
7 Vertebrae
•
•
•
Dorsal root + DRG = sensory
Ventral root = motor
Unite = spinal nerve
•
•
•
Dorsal ramus = to the back
Ventral ramus = to the front
Sinuvertebral nerve = to the
spinal column
19. Pedicles small and highly variable
Therefore – lateral mass screws
1mm
15o
Starting point 1mm Vertebral artery
medial to centre of anterior to entry
lateral mass
point
20. Place a flat probe in
the facet joint of the
level to be fused to
indicate the cephalad
angulation of the drill
or ‘K’ wire
45. Thoracic Anatomy
12 Vertebrae, Smaller than Lumbar
Facets Frontally Orientated in A-P View
Spinous Processes Longer, Distally Orientated
Transition at Thoracolumbar Junction T9-12
46. Anatomy – general considerations
•transverse processes short
but thick,
orientated postero-laterally,
articulate with ribs
•Pedicles smaller
•Spinal Canal smaller
diameter
•Ribs articulate with
vertebral bodies
47. Anatomy – body and pedicles
•Left side flattened
due to aorta
•Heart shaped
•Pedicles smallest
at T3-6 (3-4mm)
•Centre projects
intersection 1-2mm
medial to lateral
lamina with parallel
line superior 1/3 tp.
48. Anatomy -costovertebral joints and ribs
•1st, 11th and 12th ribs
soleley with named
vertebra
•2-10 with rostral
neighbour
•Articulate with anterior
tp
54. Lumbar Spine
•
L1 to L4 ‘Typical’
Lumbar Vertebrae
-
wide strong kidney
shaped bodies with
parallel endplates;
-
a wide posterior arch
fusing to form a
horizontally projecting
spinous process
-
Superior facets face
posteromedially, Inferior
facets face
anterolaterally and
therefore allow
flexion/extension but
limit rotation
82. Clinical Instability
Clinical Instability
The loss of the ability of the spine under
The loss of the ability of the spine under
physiological loads to maintain its pattern
physiological loads to maintain its pattern
of displacement so that there is no initial or
of displacement so that there is no initial or
additional neurological deficit, no major
additional neurological deficit, no major
deformity, and no incapacitating pain
deformity, and no incapacitating pain
White and Panjabi Clin Orthopaedics 1975
