Lumbar vertebrae

Infobox Bone
Name = Lumbar vertebrae
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Caption = A typical lumbar vertebra


Caption2 = Vertebral column.
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The lumbar vertebrae are the largest segments of the movable part of the vertebral column, and are characterized by the absence of the foramen transversarium within the transverse process, and by the absence of facets on the sides of the body. They are designated L1 to L5, starting at the top.

General characteristics

These are the general characteristics of the first through fourth lumbar vertebrae. The fifth vertebra contain certain peculiarities, which are detailed below.

As with other vertebrae, each lumbar vertebra consists of a "vertebral body" and a "vertebral arch". The vertebral arch, consisting of a pair of "pedicles" and a pair of "laminae", encloses the "vertebral foramen" (opening) and supports seven processes.

Body

The vertebral body of each lumbar vertebra is large, wider from side to side than from front to back, and a little thicker in front than in back. It is flattened or slightly concave above and below, concave behind, and deeply constricted in front and at the sides.

Arch

The Pedicles are very strong, directed backward from the upper part of the vertebral body; consequently, the inferior vertebral notches are of considerable depth. The pedicles change in morphology from the upper lumbar to the lower lumbar. They increase in sagittal width from 9 mm to up to 18 mm at L5. They increase in angulation in the axial plane from 10 degrees to 20 degrees by L5. The pedicle is sometimes used as a portal of entrance into the vertebral body for fixation with pedicle screws or for placement of bone cement as with kyphoplasty or vertebroplasty.

The laminae are broad, short, and strong. They form the posterior portion of the vertebral arch. In the upper lumbar region the lamina are taller than wide but in the lower lumbar vertebra the lamina are wider than tall. The lamina connect the spinous process to the pedicles.

The vertebral foramen within the arch is triangular, larger than in the thoracic vertebrae, but smaller than in the cervical vertebrae.

Processes

The "spinous process" is thick, broad, and somewhat quadrilateral; it projects backward and ends in a rough, uneven border, thickest below where it is occasionally notched.

The superior and inferior "articular processes" are well-defined, projecting respectively upward and downward from the junctions of pedicles and laminae. The facets on the superior processes are concave, and look backward and medialward; those on the inferior are convex, and are directed forward and lateralward. The former are wider apart than the latter, since in the articulated column the inferior articular processes are embraced by the superior processes of the subjacent vertebra.

The "transverse processes" are long and slender. They are horizontal in the upper three lumbar vertebrae and incline a little upward in the lower two. In the upper three vertebrae they arise from the junctions of the pedicles and laminae, but in the lower two they are set farther forward and spring from the pedicles and posterior parts of the vertebral bodies. They are situated in front of the articular processes instead of behind them as in the thoracic vertebrae, and are homologous with the ribs.

Of the three "tubercles" noticed in connection with the transverse processes of the lower thoracic vertebrae, the superior one is connected in the lumbar region with the back part of the superior articular process, and is named the "mammillary process". The inferior is situated at the back part of the base of the transverse process, and is called the "accessory process".

First and fifth lumbar vertebrae

Some individuals have four lumbar vertebrae, while others have six. Lumbar disorders that normally affect L5 will affect L4 or L6 in these individuals.

The first lumbar vertebra is level with the anterior end of the ninth rib. This level is also called the important transpyloric plane, since the pylorus of the stomach is at this level.

The fifth lumbar vertebra is characterized by its body being much deeper in front than behind, which accords with the prominence of the sacrovertebral articulation; by the smaller size of its spinous process; by the wide interval between the inferior articular processes; and by the thickness of its transverse processes, which spring from the body as well as from the pedicles.

The fifth lumbar vertebra is by far the most common site of spondylolysis and spondylolisthesis.

Segmental movements

The range of segmental movements in a single segment is difficult to measure clinically, not only because of variations between individuals, but also because it is age and gender dependent. Furthermore, flexion and extension in the lumbal spine is the product of a combination of rotation and translation in the sagittal plane between each vertebra. [cite web
url = http://www.medscape.com/viewarticle/542466_2
title = Anatomy and Biomechanics of the Back Muscles in the Lumbar Spine With Reference to Biomechanical Modeling
publisher = Medscape | author = Hansen et al | year = 2006 (Section 2)]

Ranges of segmental movements in the lumbal spine (White and Panjabi, 1990) are (in degrees): [cite web
url = http://www.medscape.com/viewarticle/542466_Tables#T1
title = Ranges of Segmental Motion for the Lumbar Spine
publisher = Medscape | author = Hansen et al
year = 2006]

=Additional

ee also

* Bertolotti's syndrome

References

External links

* cite web
url = http://www.spineuniverse.com/displayarticle.php/article44.html
title = Lower back pain: Conditions and treatment
publisher = SpineUniverse
* cite web
url = http://www.spineuniverse.com/displayarticle.php/article1948.html
title = Cleveland Clinic videos
publisher = SpineUniverse