The human lower back is a complex structure that plays a crucial role in supporting the upper body’s weight. It comprises five vertebral bodies, intervertebral discs, ligaments, and muscles, which work together to provide stability, flexibility, and support to the spine and torso. Understanding the anatomy and biomechanics of the lower back can help individuals take steps to maintain their health and prevent injury.
Vertebrae
The vertebrae[1] are the bones that build up the spinal column. The lower back, or lumbar region, consists of five vertebral bodies, numbered L1 to L5. They are separated by intervertebral discs, which act as cushions and allow for smooth spinal movements. Proper alignment is crucial for maintaining a healthy lower back and preventing injury.
Structure a Reflection of Function
The structure of the lower back[2] reflects its function as a critical component of the body’s musculoskeletal system. The vertebral bodies, intervertebral discs, ligaments, and muscles work together to provide stability, support, and flexibility to the spine and torso. The larger and stronger vertebrae in the lumbar region are designed to support the upper body’s weight.
Pedicles
These are bony projections that arise from the vertebral bodies. The pedicles play an essential role in providing stability to the spinal column. Any damage or injury to the pedicles can result in pain, weakness, or other neurological symptoms and may require medical intervention.
Lamina
It is a bony plate that forms part of the vertebral arch and is located in the spinal column. The lamina and the pedicles protect the spinal cord and provide stability to the spine. Damage or injury to the laminae can result in serious complications, including nerve damage and spinal instability.
The facet joints
These are synovial joints located in the posterior aspect of the vertebral column. They help maintain the spinal column’s stability and prevent excessive movement between vertebrae. Conditions such as osteoarthritis, spinal stenosis, and spinal degeneration can cause pain in the facet joints.
Intervertebral discs
These are porous, fibrous structures[1] between the spinal column’s vertebral bodies. In the lower back, they serve as shock absorbers and help distribute the upper body’s weight evenly across the vertebrae. They are composed of a tough outer layer called the annulus fibrosus and an inner substance called the nucleus pulposus.
Endplate
It is a bony structure at the spinal column’s top and bottom of each intervertebral disc. It provides a surface for the disc to rest on and helps distribute the upper body’s weight evenly. The endplate also helps to limit the movement of the disc and prevent it from herniating or bulging.
Annulus Fibrosus
It is a tough, fibrous outer layer of the intervertebral disc in the spinal column. It also encases the gel-like inner substance of the disc, called the nucleus pulposus, and provides structural support and stability. But it can damage or weaken over time due to aging, injury, or disease. These factors can result in herniated discs, bulging discs, or degenerative disc disease.
Nucleus Pulposus
It is a gel-like substance in the spinal column’s center of each intervertebral disc. It is the main shock absorber and helps distribute the upper body’s weight evenly across the vertebral bodies and protect the spine from impact. The gel’s nature allows it to compress and expand, which helps absorb shock and reduce the stress on the vertebrae.
Functions of the Disc
The intervertebral disc[2] has several essential functions in the lower back, including:
- Weight Distribution: The intervertebral disc helps distribute weight evenly across the vertebral bodies, reducing the stress on individual vertebral bodies and surrounding structures.
- Spinal Stability: The annulus fibrosus of the intervertebral disc provides structural support and stability to the spine, helping maintain the spinal column’s proper alignment and shape.
- Movement: The intervertebral disc acts as a cushion and allows for limited movement between the vertebral bodies, allowing for flexibility and mobility of the lower back.
- Protection of the Spinal Nerves: The intervertebral disc helps to protect the spinal nerves by acting as a barrier between the spinal canal and the surrounding vertebral bodies and soft tissues.
The weak intervertebral disc zone
It is where the annulus fibrosus is the thinnest and most susceptible to injury or damage. Damage to this area can cause herniated discs, bulging discs, or degenerative disc disease. The most required focus that can be necessary to ease discomfort and enhance function is to maintain good posture, exercise frequently, and a healthy weight to reduce stress.
Ligaments
These are muscular, fibrous tissues[1] that connect bones to other bones and help provide stability and support to joints in the body. Several important ligaments in the lower back play a role in the anatomy and biomechanics of the region. These include:
- ligamentum flavum: The ligament flavum is a thin, elastic ligament that runs along the back of the vertebral column and helps support the spinal column and maintain its shape.
- Ligamentum Nuchae: The ligament nuchae is a thick, fibrous ligament that runs along the base of the skull and helps support the head and neck.
- Posterior Longitudinal Ligament: The posterior longitudinal ligament runs along the front of the vertebral column and helps resist excessive flexion or extension movements of the spinal column.
The muscles and fasciae of the lower back
It plays a critical role in the anatomy and biomechanics of the region[2]. These structures help support the spine, maintain posture, and facilitate movement. Some of the most important muscles and fasciae in the lower back include:
- Erector Spinae: It is made up of a trio of muscles that travel along the vertebral column’s back and support upright posture by preventing spinal flexion.
- Multifidus: The multifidus is a small muscle that runs along the spine and helps stabilize the vertebral column and maintain posture.
- Quadratus Lumborum: It is a muscle that runs along the side of the vertebral column and helps support the lower back and maintain posture.
- Transversus Abdominis: The transversus abdominis is a deep abdominal muscle that helps support the lower back and maintain posture.
- External Oblique: The external oblique is a muscle that runs along the side of the abdomen and helps support the lower back and maintain posture.
The spinal canal
It is a bony tunnel that runs the vertebral column length. It also provides a protected environment for the spinal cord. It enables nerves to flow from the brain to other organs. The spinal canal can become narrow or compressed due to spinal stenosis, herniated discs, bone spurs, or tumors. Medical intervention may be necessary to relieve symptoms of spinal canal compression.
The dura mater
It is a thick, fibrous membrane that surrounds the spinal cord and acts as its outermost protective layer[1]. It is composed of dense connective tissue and forms a sac-like structure called the dural sac that extends from the skull’s base to the coccyx (tailbone).
The dura mater has several essential functions, including:
- Protection: The dura mater protects the spinal cord from injury by acting as a barrier against external forces, such as trauma or compression.
- Blood Supply: The dura mater contains blood vessels that supply blood to the spinal cord and surrounding structures.
- Support: The dura mater helps maintain the shape and position of the spinal cord within the spinal canal.
Nerve Roots
A different level of the spinal cord is where each of the 31 pairs of spinal nerves in the human body begins[2]. The nerve roots are a spinal nerve that exits the spinal canal and branches out to innervate various body parts. Damage or injury to the nerve roots can cause pain, numbness, tingling, and weakness. Treating nerve root injuries may include physical therapy, medications, injections, or surgery.
Significant Facts
- The lower back (lumbar spine) comprises five vertebral bodies, the intervertebral discs between them, the facet joints, and surrounding ligaments, muscles, and fasciae.
- The vertebral bodies are separated by intervertebral discs, which act as shock absorbers and allow for movement between the vertebral bodies.
- The spinal canal, which contains the spinal cord and nerve roots, is protected by the bony vertebral bodies and surrounding ligaments and is maintained in position by the dura mater.
- The lumbar spine has a high degree of mobility. It is subjected to considerable stress and strain, making it vulnerable to injury and degenerative changes.
- The facet joints between each vertebral body limit excessive movement in the lumbar spine and help maintain stability.
The lower back is composed of multiple structures, including the vertebral bodies, intervertebral discs, facet joints, ligaments, muscles, and fasciae. Maintaining proper exercise, posture, and lifestyle habits can help maintain the health of the lower back and reduce the risk of injury or degenerative changes. Understanding the anatomy and biomechanics of the lumbar spine is essential for recognizing the causes of lower back pain.
Reference
1. Waxenbaum JA, Futterman B. Anatomy, back, lumbar vertebrae. InStatPearls [Internet] 2018 Dec 13. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459278/
2. Musculoskeletal key Applied anatomy of the lumbar spine Available from:https://musculoskeletalkey.com/applied-anatomy-of-the-lumbar-spine/
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