A ‘typical’ vertebra

Insight

By learning the parts of a typical vertebra, the majority of the parts of the cervical, thoracic and lumbar vertebrae can be identified.

Main parts

Body –

cancellous bone covered with compact bone; anterior surface is convex.

Pedicles –

project back from the postero-lateral aspects of the body.

Laminae –

project back from the ends of the pedicles; fuse in the midline.

Vertebral arch –

formed by 2 pedicles and 2 laminae.

Vertebral foramen –

formed by the posterior aspect of the body and the vertebral arch. The vertebral foramina and intervertebral joints and ligaments form the vertebral canal, which transmits and protects the spinal cord, spinal nerve roots and meninges.

Transverse processes –

project laterally from the junction of the pedicles and laminae.

Spinous process –

projects backwards from the junction of the laminae.

Superior articular processes –

projections on the superior aspect of the vertebral arch at the junction of the pedicles and the laminae which carry the superior articular facets.

Inferior articular processes –

projections on the inferior aspect of the vertebral arch which carry the inferior articular facets.

Vertebral notches, superior and inferior –

formed between the body and the articular processes above and below the pedicles.

Intervertebral foramina –

formed by the vertebral notches, between the pedicles of adjacent vertebrae. Transmit the spinal nerves. Lie at an angle of 45° to the median sagittal plane and 0–15° to the horizontal.

Cervical vertebrae

3rd to 6th (typical) (Figs 9.1 and 9.2)

Features

Body –

small, oval in shape.

Lamina –

long and thin.

Vertebral foramen –

large and triangular (cervical enlargement).

Pedicles –

short, round, project laterally and backwards 45°.

Intervertebral foramen –

directed forwards and laterally.

Transverse processes –

carry the foramen transversarium for the vertebral arteries; these divide the processes into anterior and posterior roots, which end in small tubercles.

Superior articular facet –

faces upwards and backwards.

Inferior articular facet –

faces downwards and forwards.

Spinous process –

short and bifid (divided).

Radiographic appearances of the cervical vertebrae (Figs 9.3, 9.4, 9.5, 9.6 and Plate 6)

Fig. 9.3 Third to seventh cervical vertebrae: anteroposterior projection.

A–Angle of mandible

B–Larynx

C–Body of 5th cervical vertebra

D–Trachea

E–Spinous process of 7th cervical vertebra

F–Body of 1st thoracic vertebra

G–1st rib

H–Transverse process of 7th cervical vertebra

I–Spinous process

J–Level of vocal folds

K–Transverse process

L–Articular process.

(From Bryan 1996.)

Fig. 9.4 Cervical vertebrae: lateral projection.

1 – Anterior tubercle of atlas

2 – Odontoid process

3 – Mandible

4 – Body of 4th cervical vertebra

5 – Transverse process

6 – Body of 1st thoracic vertebra

7 – 1st rib

8 – Pedicle

9 – Spinous process of 7th cervical vertebra (vertebra prominens)

10 – Inferior articular process

11 – Superior articular process

12 – Lamina

13 – Spinous process of axis

14 – Posterior tubercle of atlas

15 – Occipital bone

16 – Atlanto-occipital joint.

(From Bryan 1996.)

Fig. 9.5 Cervical vertebrae: oblique anteroposterior projection.

A – Atlas

B – Spinous process of axis

C – Right intervertebral foramina

D – 1st thoracic vertebra

E – 2nd thoracic vertebra

F – 1st rib

G – Trachea

H – Mandible.

(From Bryan 1996.)

Fig. 9.6 Atlas and axis (C1 and C2): MR scan to cervical vertebrae.

A – Odontoid process

B – Body of axis (C2)

C – Spinal cord

D – Intervertebral disc

E – Posterior longitudinal ligament

F – Anterior longitudinal ligament

G – Vertebral body

H – Spinous process of 6th cervical vertebra

(From Bryan 1996.)

1st cervical vertebra (atlas) (Fig. 9.7)

Fig. 9.7 1st cervical vertebra (superior aspect).

A–Anterior tubercle

B–Superior articular facet

C–Foramen transversarium

D–Vertebral foramen

E–Posterior arch

F–Posterior tubercle

G–Groove for the vertebral artery

H–Transverse process

I–Facet for the odontoid process

J–Anterior arch.

Articulations

Superior articular facets with the occipital condyles to form the atlanto-occipital joints.

Inferior articular facets with the superior articular facets of the 2nd cervical vertebra to form the lateral atlanto-axial joints.

The facet on the anterior arch with the odontoid process of the 2nd cervical vertebra to form the median atlanto-axial joint.

Features

‘Ring-shaped’ with no body.

Anterior arch –

in the midline there is a projection called the anterior tubercle. On the posterior aspect is a facet for the odontoid process of the 2nd cervical vertebra.

Posterior arch –

in the midline there is a projection called the posterior tubercle, which represents a rudimentary spinous process. There is a wide groove behind the lateral masses for the vertebral arteries.

Vertebral foramen –

oval.

Lateral masses –

lie on either side of the vertebral foramen and carry the superior and inferior articular facets. On the medial aspect is a tubercle for the transverse ligament of the atlas.

Superior articular facets –

large and oval.

Inferior articular facets –

round and flat.

Transverse process –

long, assists with rotation of the head.

Foramen transversarium –

pierces the transverse process.

Ossification

Primary centres

3 centres:

lateral masses (1 per mass) appear 7th week of intrauterine life;

the masses fuse age 3–4;

anterior arch appears age 1.

Fuse together age 6–8.

2nd cervical vertebra (axis) (Figs 9.8 and 9.9)

Articulations

Superior articular facets with the inferior articular facets of the 1st cervical vertebra to form the lateral atlanto-axial joints.

Fig. 9.8 2nd cervical vertebra (axis) (anterior aspect).

A–Odontoid process (dens)

B–Facet for the anterior arch of the atlas

C–Superior articular facet

D–Foramen transversarium

E–Transverse process

F–Body

G–Inferior articular facet.

Fig. 9.9 2nd cervical vertebra (axis) (lateral aspect).

1 – Facet for the anterior arch of the atlas

2 – Superior articular facet

3 – Foramen transversarium

4 – Body

5 – Inferior articular facet

6 – Inferior articular process

7 – Lamina

8 – Spinous process

9 – Groove for the transverse ligament of the atlas

10 – Odontoid process (dens).

Inferior articular facets with the superior articular facets of the 3rd cervical vertebra to form the joints of the vertebral arches.

The odontoid process with the anterior arch of the 1st cervical vertebra to form the median atlanto-axial joint.

The body with the body of the 3rd cervical vertebra to form the intervertebral joint.

Features

Odontoid process (dens) –

projection on the upper aspect of the body. Has a facet for articulation with the anterior arch of the 1st cervical vertebra. Represents the body of the atlas.

Insight

Whiplash injuries can cause a fracture of the base of the odontoid process as this is the weakest part of the spine, movement of the head following injury can result in damage to the spinal cord.

Ossification

Primary centres

5 centres:

odontoid process – 2 centres appear 6th month intrauterine life.

odontoid centres fuse together before birth;

vertebral arch – 2 centres appear 7th–8th month intrauterine life;

body – age 4–5 months.

Secondary centres

2 centres:

odontoid process appears age 2, fuses age 12;

thin plate under the body appears at puberty.

Thoracic vertebrae

2nd to 8th (typical) (Figs 9.13 and 9.14)

Features

Fig. 9.13 A typical thoracic vertebra (superior aspect).

A–Spinous process

B–Transverse process

C–Superior articular facet

D–Vertebral foramen

E–Body

F–Pedicle

G–Costal facet for the tubercle of the rib

H–Lamina.

Fig. 9.14 A typical thoracic vertebra (lateral aspect).

1 – Body

2 – Demi-facet for the head of the rib

3 – Inferior vertebral notch

4 – Inferior articular process

5 – Spinous process

6 – Transverse process

7 – Costal facet for the tubercle of the rib

8 – Superior articular facet

9 – Superior articular process

10 – Demi-facet for the head of the rib.

Insight

Remember the thoracic body lies near the heart and is heart shaped.

Size –

larger than the cervical and smaller than the lumbar vertebrae.

Body –

heart-shaped. On either side are 2 demi-facets; the superior demi-facets are larger and lie at the root of the pedicle, and the inferior demi-facets lie on the lower border. All 4 costal facets articulate with the heads of the ribs, the superior with the corresponding rib and the inferior with the one below.

Laminae –

short and deep, overlapping those of the vertebra below.

Vertebral foramen –

small and circular.

Pedicles –

very short, directed backwards. There is virtually no superior vertebral notch.

Transverse processes –

thick and strong. Anteriorly there is an oval facet for articulation with the tubercle of the rib.

Superior articular facets –

vertical, face backwards.

Inferior articular facets –

vertical, face forwards.

Spinous process –

long, slender and directed downwards and backwards.

Radiographic appearances of the thoracic vertebrae (Figs 9.15, 9.16 and 9.17)

Fig. 9.15 Thoracic vertebrae: anteroposterior projection.

A–Costovertebral joint

B–12th rib

C–Body of 12th thoracic vertebra

D–Left dome of diaphragm

I–Body of 1st thoracic vertebra.

(From Bryan 1996.)

Fig. 9.16 Thoracic vertebrae: lateral projection.

1 – Body of 3rd thoracic vertebra

6 – Body of 12th thoracic vertebra

7 – 12th pair of ribs

8 – Superior articular process

9 – Inferior articular process

10 – Spinous process

11 – Pedicle

12 – Intervertebral foramen.

(From Bryan 1996.)

Fig. 9.17 Thoracic vertebra: CT scan.

E–Costovertebral joint

F–Neural canal

G–Vertebral body.

(From Bryan 1996.)

1st thoracic vertebra

Special features

Body –

full superior costal facets are circular and articulate with the 1st ribs; inferior costal demi-facets are semicircular and articulate with the 2nd ribs.

Spinous process –

thick, long and horizontal.

9th thoracic vertebra

Special features

Body –

inferior costal demi-facets are sometimes absent.

Lumbar vertebrae

1st to 4th (typical) (Figs 9.18 and 9.19)

Features

Fig. 9.18 A typical lumbar vertebra (superior aspect).

A–Spinous process

B–Superior articular process

G–Superior articular facet

H–Lamina.

Fig. 9.19 A typical lumbar vertebra (lateral aspect).

1 – Body

2 – Inferior vertebral notch

3 – Inferior articular facet

4 – Spinous process

5 – Transverse process

6 – Superior articular process.

Insight

Remember the lumbar body lies near the kidneys and is kidney-shaped.

Size –

larger than the cervical and thoracic vertebrae.

Body –

large and kidney-shaped.

Laminae –

short and thick, inclined downwards.

Vertebral foramen –

triangular, smaller than the cervical and larger than the thoracic.

Pedicles –

short and thick, set on the upper half of the body.

Transverse processes –

long and thin.

Superior articular processes –

have a rough elevation on the posterior border called the mamillary process.

Superior articular facets –

vertical, facing medially and posteriorly.

Inferior articular facets –

vertical, facing laterally and anteriorly.

Pars interarticularis –

between the superior and inferior articular processes. Deficient in spondylolisthesis. Demonstrated radiographically in the oblique projection.

Spinous process –

quadrilateral in shape, thickened on the posterior and inferior margins.

Accessory transverse process –

found at the inferior aspect of the root of the transverse process.

Radiographic appearances of the lumbar vertebrae (Figs 9.20, 9.21, 9.22 and 9.23)

Fig. 9.20 Lumbar vertebrae: anteroposterior projection.

A–Body of 12th thoracic vertebra

B–Vertebral canal

C–Spinous process

D–Pedicle

E–Superior articular process

F–Transverse process of 5th lumbar vertebra

G–Sacrum

H–Spinous process of 5th lumbar vertebra

I–Crest of ilium

J–Inferior articular process

K–Transverse process

L–Psoas muscle

M–Body of 1st lumbar vertebra.

(From Bryan 1996.)

Fig. 9.21 Lumbar vertebrae: lateral projection.

1 – Intervertebral foramen

2 – Spinous process

3 – Sacral promontory

4 – Lumbosacral joint

5 – Body of 1st lumbar vertebra.

(From Bryan 1996.)

Fig. 9.22 Lumbar vertebrae: left posterior oblique projection.

A–Right transverse process

B–Superior right articular process

C–Inferior right articular process

H–Body of 5th lumbar vertebra

I–Pars interarticularis

J–Left inferior articular process

K–Left transverse process

L–Left superior articular process

M–Pedicle

N–Left 12th rib.

(From Bryan 1996.)

Fig. 9.23 Lumbar spine: CT scan.

1 – Transverse process

(From Bryan 1996.)

Sacrum (Figs 9.24 and 9.25)

The sacrum is composed of 5 sacral segments, which are fused together to form a single bone.

Fig. 9.24 Sacrum (anterior aspect).

A–Sacral promontory

B–Pelvic sacral foramen

C–Pedicle

D–Body

E–Apex: facet for the coccyx

F–Ala.

Fig. 9.25 Sacrum (lateral aspect).

1 – Sacral promontory

2 – Auricular facet

3 – Sacrococcygeal joint

4 – Coccyx

5 – Coccygeal cornu

6 – Sacral cornu

7 – Dorsal sacral foramen

8 – Spinous tubercles.

Type

Irregular bone.

Position

Forms the posterior part of the pelvic girdle, between the hip bones.

Articulations

The base articulates with the body of the 5th lumbar vertebra to form the lumbosacral joint.

The apex articulates with the base of the coccyx to form the sacrococcygeal joint.

The auricular facet articulates with the auricular surface of the hip bone to form the sacroiliac joint.

Main parts

Pelvic surface

This faces inferiorly and anteriorly, is concave and relatively smooth, and has the following features:

Pelvic sacral foramina –

4 pairs which carry the first 4 sacral spinal nerves from the sacral canal.

Transverse ridges –

4 ridges between the pelvic sacral foramina, denoting the fusion of the vertebral bodies.

Costal elements –

formed by the area between the pelvic sacral foramina, and lateral to them, where the costal elements are fused with the transverse processes.

Dorsal surface

This faces superiorly and posteriorly, is convex and has the following features:

Medial sacral crest –

raised promontory of bone in the midline representing the fused spinous processes.

Spinous tubercles –

4 (sometimes 3) tubercles on the crest.

Sacral hiatus –

the laminae of the 5th sacral segment fail to meet in the midline, forming a gap in the posterior wall of sacral canal.

Dorsal sacral foramina –

four pairs of foramina which carry the first four dorsal sacral nerves from the sacral canal.

Intermediate sacral crests –

each crest is formed by 4 tubercles and lies medial to the dorsal sacral foramina, representing the fused articular processes.

Sacral cornua –

formed by the inferior articular processes of the 5th sacral segment, and lie either side of the sacral hiatus.

Lateral sacral crests –

formed by the fused transverse processes, lateral to the dorsal sacral foramina.

Transverse tubercles –

a row of tubercles on the lateral sacral crests.

Lateral surface

Triangular, with the following features:

Auricular facet –

‘ear-shaped’ surface for articulation with the ilium.

Lateral border –

thin, lies below the auricular surface.

Inferior lateral angle –

towards the lower end of the lateral border at the level of the 5th segment.

Apex

The inferior aspect of the 5th sacral segment. It has the following feature:

Oval facet –

for articulation with the coccyx.

Sacral canal

Triangular, formed by the vertebral foramina.

The upper opening lies obliquely and the canal terminates at the sacral hiatus.

Radiographic appearances of the sacrum (Figs 9.26, 9.27, 9.28 and 9.29)

Fig. 9.27 Sacrum and coccyx: lateral projection.

1 – Superior articular process

2 – Sacrum

3 – Sacral canal

4 – Spinous tubercles

5 – Gas in rectum

6 – Coccyx

7 – Sacral promontory

8 – Lumbosacral joint

9 – 5th lumbar vertebra.

(From Bryan 1996.)

Fig. 9.28 Sacrum: CT scan.

A – Ilium

B – Sacroiliac joint

C – Margin of sacral foramen

D – Spinous tubercle

E – Sacral canal

F – Anterior sacral foramen

G – Lateral mass of sacrum

H – Sacral promontory.

(From Bryan 1996.)

Coccyx (Fig. 9.30)

The coccyx is composed of between 3 and 5 segments, partly or totally fused together to form a triangular bone.

Fig. 9.29 Sacral fracture (arrowed). CT scan.

(From Resnick Kransdorf, 2005.)

Fig. 9.30 Coccyx (anterior aspect).

A–Coccygeal cornu

B–Rudimentary transverse process

C–Facet for the sacrum

D–1st coccygeal segment

E–2nd coccygeal segment

F–3rd coccygeal segment

G–4th coccygeal segment.

Type

Irregular bone.

Position

Lies on the inferior aspect of the sacrum in the midline and forms the base of the spine.

Articulations

The base articulates with the apex of the sacrum to form the sacrococcygeal joint.

Ossification

Primary centres

Body –

1 centre per body, 1st present at birth.

Rest appear up to age 20.

Fuse together up to age 30.

Radiographic appearances of the coccyx (Fig. 9.31)

Fig. 9.31 Coccyx: anteroposterior projection.

G–Sacrococcygeal joint

H–Sacral cornua

I–Pelvic brim

J–Lumbosacral joint.

(From Bryan 1996.)

Vertebral curvatures (Fig. 9.32)

The curves of the spinal column can be divided into primary and secondary curves.

Fig. 9.32 Vertebral column (lateral aspect).

A–Secondary curve, cervical

B–Primary curve, thoracic

C–Secondary curve, lumbar

D–Primary curve, pelvic (sacrococcygeal).

Joints of the vertebral column

Atlanto-occipital joints

Type

Synovial ellipsoid joints.

Bony articular surfaces

Superior articular facets of the atlas with the condyles of the occipital bone. Both surfaces are covered with articular hyaline cartilage.

Fibrous capsule

Surrounds the condyles of the occipital bone and the superior articular facets of the atlas; is sometimes absent medially.

Synovial membrane

Lines the fibrous capsule and secretes synovial fluid, which lubricates the joint. May communicate with the synovial bursa between the odontoid process and the transverse ligament of the atlas.

Supporting membranes

Anterior atlanto-occipital membrane –

from the anterior margins of the foramen magnum to the anterior arch of the atlas.

Posterior atlanto-occipital membrane –

from the posterior margins of the foramen magnum to the posterior arch of the atlas.

Movements

Flexion/extension –

nodding of the head.

Lateral flexion

Median atlanto-axial joint

Type

Synovial pivot joint.

Bony articular surfaces

Odontoid process of the axis and the anterior arch of the atlas. Both surfaces are covered with articular hyaline cartilage.

Fibrous capsule

Surrounds the odontoid process of the axis and the facet on the arch of the atlas. It is weak and loose.

Synovial membrane

Lines the fibrous capsule and the bursa and secretes synovial fluid, which lubricates the joint. Posteriorly is a bursa between the anterior surface of the transverse ligament and the posterior surface of the odontoid process.

Strengthening ligaments

Transverse ligament of the atlas –

maintains the odontoid process in contact with the anterior arch of the atlas.

Movements

Rotation –

shaking of the head.

Intervertebral joints (Fig. 9.33)

Type

Cartilaginous symphyses.

Fig. 9.33 Intervertebral joint (sagittal section).

A–Anterior longitudinal ligament

B–Articular hyaline cartilage

C–Annulus fibrosus

D–Vertebral body

E–Nucleus pulposus

F–Posterior longitudinal ligament.

Bony articular surfaces

The upper and lower surfaces of the respective vertebral bodies. Both surfaces are covered with articular hyaline cartilage recessed within a peripheral non-articular strip.

Strengthening ligaments

Anterior longitudinal ligament –

extends from the basilar part of the occipital bone to the anterior aspect of the sacrum. It is attached to the intervertebral discs and the margins of the vertebral bodies.

Posterior longitudinal ligament –

extends from the body of the axis to the posterior aspect of the sacrum. It is attached to the intervertebral discs and the margins of the vertebral bodies.

Intracapsular structures

Intervertebral disc –

consists of an outer portion, the annulus fibrosus, and an inner core, the nucleus pulposus, which is nearer the posterior aspect; therefore the annulus is thinner and weaker behind than in front.

Movements

Individually allow a limited degree of:

Summated over the length of the spinal column the movement is considerable.

Radiographic appearances of the ligaments of the vertebral column (Fig. 9.34)

Fig. 9.34 Ligaments of the vertebral column: MR scan.

A–Intervertebral disc

B–Spinal canal

C–Spinous process

D–Anterior longitudinal ligament

E–Cauda equina

F–Posterior longitudinal ligament

G–Vertebral body

H–Conus medullaris

(From Bryan 1996.)

Joints of the vertebral arches

Type

Synovial plane joints.

Bony articular surfaces

Superior articular facet with the inferior articular facet of the vertebra above. Both surfaces are covered with articular hyaline cartilage.

Fibrous capsule

Thin, loose and attached to the margins of the articular facets.

Synovial membrane

Lines the fibrous capsule and secretes synovial fluid, which lubricates the joint.

Movements

Gliding.

Costovertebral joints

Type

Synovial plane joints.

Bony articular surfaces

Head of the rib with the facets on the adjoining vertebrae. Both surfaces are covered with articular hyaline cartilage.

Fibrous capsule

Surrounds the head of the rib and the margins of the costal facets of the vertebrae.

Synovial membrane

Lines the fibrous capsule and secretes synovial fluid, which lubricates the joint.

Strengthening ligaments

Intra-articular ligament –

divides the joint into 2 halves.

Radiate ligament

Trauma

Insight

If the spinal cord is damaged due to trauma of the spine there is a danger of paralysis below the area of damage.

Fig. 9.35 Fracture dislocation C6–C7, fractures of the C6 laminae.

(From Resnick Kransdorf, 2005.)

Articular processes (Fig. 9.35)

Can cause a fracture –

dislocation; therefore there is a danger of paraplegia or quadriplegia below the level of the fracture.

Cause –

crushing, e.g. mining accidents.

Examples of treatment –

Cervical region; traction via skull calipers. Thoracic region: if no injury to spinal cord, plaster jacket; if injury to spinal cord, treatment for paraplegia and rehabilitation. Lumbar region: if no injury or partial damage to spinal cord, internal fixation with metal plate or stainless steel wires; if the cord is severed, treatment for paraplegia and rehabilitation.

Spinous process

The 7th cervical/1st thoracic vertebrae is the most common site.

Cause –

direct violence, e.g. a heavy blow.

Example of treatment –

rest.

Transverse process

The lumbar spine is the most common site.

Cause –

muscular action, e.g. heavy shovelling.

Example of treatment –

bed rest.

Dislocation

The cervical spine is most common. There is danger of damage to the spinal cord, therefore careful handling is essential.

Cause –

whiplash injury: car driver’s (or passenger’s) head goes forward and then back quickly.

Example of treatment –

traction via skull calipers.

Pathology

Cervical rib

An additional rib from the 7th cervical vertebra. Surgical removal is indicated if it causes pressure on the subclavian artery or the brachial nerve plexus; the latter results in loss of sensation along the medial border of the forearm and wasting of the small muscles of the hand.

Schmorl’s nodes (Fig. 9.38)

Erosion of the bodies of the vertebrae due to pressure from the nucleus pulposus. It may result in narrowing of the disc space.

Fig. 9.38 Schmorl’s nodes and multiple degenerative discs. MR scan.

(From Resnick Kransdorf, 2005.)

Lordosis

Excessive secondary curvature, usually in the lumbar region.

Spina bifida

Abnormality of the vertebral arch, which is incomplete posteriorly because of failure of fusion of the laminae.

Spina bifida cystica –

protrusion of the meninges or meninges and spinal cord through the defect.

Spondylolisthesis

The moving forward of part of one vertebra on another owing to a defect or failure in the pars articularis. The body, pedicles, transverse and superior articular processes separate from the rest of the vertebral arch and slide forwards.

Facet disease (Plate 7)

Degeneration of the joints of the vertebral arch

Scoliosis (Fig. 9.39)

Abnormal lateral curvature of the spine with, in severe cases, rotation of the vertebrae. Vertebral bodies become wedge-shaped.

Fig. 9.39 Scoliosis. Note disc space narrowing, osteophyte formation, vertebral sclerosis and lateral vertebral subluxation.

(From Resnick Kransdorf, 2005.)

Ankylosing spondylitis (Fig. 9.40)

An inflammatory disorder in which the articular hyaline cartilage is destroyed, the bones fuse and the spinal ligaments ossify. It usually commences in the sacroiliac joints and progresses upwards. Radiographically it is described as a ‘bamboo spine’.

Fig. 9.40 Ankylosing spondylitis, lumbar spine.

(Courtesy of Ernest Higginbottom.)

Osteoarthritis (Fig. 9.44)

Worn articular hyaline cartilage and the formation of osteophytes (bony spurs round the joint margins).

Fig. 9.44 Osteoarthritis, lumbar spine.

(Courtesy of Ernest Higginbottom.)

Spondylosis (Fig. 9.45, Plate 8)

The formation of bony spurs at the disc margins of the vertebral bodies; causes degenerative changes in the intervertebral discs.

Fig. 9.45 Spondylosis cervical spine. MR scan.

(From Resnick Kransdorf, 2005.)

Spondylitis

Inflammation of more than one vertebra.

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Vertebral column

3rd to 6th (typical) (Figs 9.1 and 9.2)

Radiographic appearances of the cervical vertebrae (Figs 9.3, 9.4, 9.5, 9.6 and Plate 6)

1st cervical vertebra (atlas) (Fig. 9.7)

2nd cervical vertebra (axis) (Figs 9.8 and 9.9)

Radiographic appearances of the upper cervical vertebrae (Figs 9.10, 9.11 and 9.12)

2nd to 8th (typical) (Figs 9.13 and 9.14)

Radiographic appearances of the thoracic vertebrae (Figs 9.15, 9.16 and 9.17)

1st to 4th (typical) (Figs 9.18 and 9.19)

Radiographic appearances of the lumbar vertebrae (Figs 9.20, 9.21, 9.22 and 9.23)

Sacrum (Figs 9.24 and 9.25)