Dalley, 10th Edition

99

Vertebral Column

between the ligament and the bony surface. This ligament weakly resists hyper exion of the vertebral column and helps prevent or redirect posterior herniation of the nucleus pulpo sus. It is well provided with nociceptive (pain) nerve endings. JOINTS OF VERTEBRAL ARCHES The joints of the vertebral arches are the zygapophysial joints (facet joints) . These articulations are plane syno vial joints between the superior and inferior articular pro cesses (G. zygapophyses ) of adjacent vertebrae (Figs. 2.16 and 2.19). Each joint is surrounded by a thin joint capsule . Those in the cervical region are especially thin and loose, re ecting the wide range of movement (Fig. 2.20). The joint capsule is attached to the margins of the articular surfaces of

Right and left uncus of vertebral body (uncinate processes)

2

Uncus (cut)

Articular cavity of uncovertebral joint

Vertebral body

Zygapophysial joint cavity Transverse process and transverse costal facet Superior articular process

Anterior view

T9

Nucleus pulposus

Inferior articular process

Anulus fibrosus

Pedicle of vertebral arch (cut)

Ligamentum flavum

FIGURE 2.18. Uncovertebral joints. These small, synovial joint-like structures are between the unci of the bodies of the lower vertebrae and the beveled surfaces of the vertebral bodies superior to them. These joints are at the posterolateral margins of the IV discs.

Lamina of vertebral arch Intervertebral (IV) foramen

Posterior longitudinal ligament

“joints” are frequent sites of bone spur formation in later years, which may cause neck pain. The anterior longitudinal ligament is a strong, broad brous band that covers and connects the anterolateral as pects of the vertebral bodies and IV discs (Fig. 2.19). The ligament extends longitudinally from the pelvic surface of the sacrum to the anterior tubercle of vertebra C1 and the occipital bone anterior to the foramen magnum are the su periormost parts, the anterior atlantoaxial and atlantooccipi tal ligaments. Although thickest on the anterior aspect of the vertebral bodies (illustrations often depict only this portion), the anterior longitudinal ligament also covers the lateral as pects of the bodies to the IV foramen. This ligament pre vents hyperextension of the vertebral column, maintaining stability of the joints between the vertebral bodies. The an terior longitudinal ligament is the only ligament that limits extension ; all other IV ligaments limit forms of exion. The posterior longitudinal ligament is a much nar rower, somewhat weaker band than the anterior longitudinal ligament (Figs. 2.19 and 2.20B). The posterior longitudinal ligament runs within the vertebral canal along the posterior aspect of the vertebral bodies. It is attached mainly to the IV discs and less so to the posterior aspects of the vertebral bodies from C2 to the sacrum, often bridging fat and vessels

Vertebral body

Anterior longitudinal

Anterior longitudinal ligament blending with anulus fibers of IV disc

ligament covering vertebral body

Foramina for blood vessels entering or exiting vertebral bodies

IV disc

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FIGURE 2.19. Relationship of ligaments to vertebrae and IV discs. The inferior thoracic (T9–T12) and superior lumbar (L1–L2) vertebrae, with associated discs and ligaments, are shown. The pedicles of the T9–T11 vertebrae have been sawn through and their bodies and intervening discs removed to provide an anterior view of the posterior wall of the vertebral canal. Between the adjacent left or right pedicles, the inferior and superior articular processes and the zygapophysial joints between them (from which joint capsules have been removed) and the lateral most extent of the ligamenta ava form the posterior boundaries of IV foramina. The anterior longitudinal ligament is broad, whereas the posterior longitudinal ligament is narrow. Anterior view