this ppt make you under stand basic anatomy of spine with diagnostic importance of xray in spine.

1. ANATOMY OF SPINE
AND X-RAYS OFSPINE
DR PRATIK AGARWAL
DR SANJAY MULAY

2. ANATOMY OF
SPINE

3. PLANES AND
DIRECTION:
• ANTERIOR/VENTRAL
• POSTERIOR/DORSAL
• CRANIAL
• CAUDAL
• MEDIAL
• LATERAL
• CORONAL PLANE
• SAGITTAL PLANE
• AXIAL PLANE

4. FUNCTIONS OF SPINE
1. PROTECTION OF SPINAL CORD, MENINGES, VESSELS
AND INTERNAL ORGAN.

5. FUNCTIONS OF SPINE
2. ALLOW FLEXIBILITY
IN ALL 6 DIRECTIONS

6. FUNCTIONS OF SPINE
3. ALLOW FLEXIBILITY AND
PROVIDE SUPPORT AND
BALANCE FOR UPRIGHT
POSTURE

7. FUNCTIONS OF SPINE
INTERVERTEBRAL DICS-
• IT PROTECT AGAINST COMPRESSIVE
FORCES.
• ALLOW EQUAL WEIGHT
DISTRIBUTION

8. CURVES OF SPINE
■ PRIMARY CURVATURES:
– KYPHOTIC CURVE
– PRESENT FROM FETAL LIFE
– THORACIC (20*-40*)
– SACRAL
■ SECONDARY CURVATURES:
– LORDOTIC CURVE
– DEVELOPS DURING INFANCY OR
CHILDHOOD
– CERVICAL (20-40*)
– LUMBAR (30-50*)
Cervical(2*)
Thoracic(1*)
Lumbar(2*)
Sacral(1*)
Curvatures

9. CORONAL PLANE:
SPINE APPEARS
SYMMETRICAL AND
STRAIGHT
ABNORMAILTY SEEN IN
CORONAL PLANE:
• SCOLIOSIS
SAGITAL PLANE:
2 KYPHOTIC CURVE
(THORACIC AND
SACRAL)
2 LORDOTIC CURVE
(CERVICAL AND
LUMBAR)
ABNORMALITY SEEN
IN SAGITAL PLANE:
• LOSS OF LORDOSIS
• KNUCKLE
• KYPHOSUS
• GIBBUS

10. LEVELS OF SPINE
• ADULT SPINE IS 72 CM LONG IN MEN AND 7-10
CM LESS IN WOMEN.
• TOTAL 33 VERTEBRAE
• 5 MAIN REGION-
1) CERVICAL - C1-C7
2) THORACIC - T1-T12
3) LUMBAR - L1-L5
4) SACRAL - S1-S5
5) COCCYX - C1-C4
• THERE ARE 24 MOBILE SEGMENTS AND 9
FUSED VERTEBRAE WHICH ARE IMMOBILE.

11. VERTEBRAL ANATOMY
COMMON FEATURES SHARED BY
MOST VERTEBRAE ARE-
1. VERTEBRAL BODY
2. POSTERIOR ARCH
• PEDICLE
• LAMINA
• SPINOUS PROCESS
• TRANSVERSE PROCESS
• ARTICULAR PROCESS

12. VERTEBRAL BODY
OUTER
CORTICAL
RIM
INNER
CANCELLOUS
BONE
• VERTEBRAL BODY COMPOSED OF 2
TYPES BONE TISSUE:
I. CORTICAL BONE
II. CANCELLOUS BONE
• IT BEARS 80% OF LOAD APPLIED TO
SPINE.
• IT VARIES IN SIZE, SHAPE AND
PROPORTION IN DIFFERENT
REGIONS.

13. POSTERIOR ARCH
■ 2 STOUT PILLARS BRIDGING VERTEBRAL BODY AND POSTERIOR
ARCH CALLED PEDICLE
■ PEDICLE GOES DORSALLY FUSING WITH PAIR OF ARCHED FLAT
LAMINA.
■ LAMINA DORSALLY FUSE IN MIDLINE TO FORM SPINOUS
PROCESS.
■ PEDICLE, LAMINA WITH SPINOUS PROCESS FORM VERTEBRAL
FORAMEN, COMPLETE OSSEOUS RING THAT ENCLOSE SPINAL
CORD.
■ TRANSVERSE PROCESS IS A STUCTURE EXTENDING FROM
JUNCTION OF LAMINA AND PEDICLE.
■ TRANSVERSE PROCESS ALLOW MOVEMENT OF SPINE AND
LIGAMENT AND STABALIZE THE SPINE BY GIVING ATTCHMENT TO
MUSCLES AND ARTICULATING WITH RIBS.

14. POSTERIOR ARCH
 ARTICULAR PROCESS (ZYGAPOPHYSES)
ANOTHER PROJECTION FROM JUNCTION OF
PEDICLE AND LAMINA.
 2 SUPERIOR ARTICULAR PROCESS
(PREZYGAPOPHYSES) AND 2 INFERIOR
ARTICULAR PROCESS (POSTZYGAPOPHYSES) IS
PRESENT.
 ARTICULAR SURFACE OF PROCESS IS CALLED
FACET WHICH COVERED WITH HYALINE
CARTILAGE.
 INTERVERTEBRAL FORAMEN ALLOWING SPINAL
NERVES AN EXIT POINT FROM THE CORD.

15. PARS INERARTICULARIS
 PART OF ARCH THAT LIES BETWEEN
SUPERIOR AND INFERIOR ARTICULAR
FACET.
 IT IS AREA OF MOST STRESSED BY
TRANSLATIONAL MOVEMENT BETWEEN
ADJACENT SEGMENT.
 IT IS SUSCEPTIBLE TO TRAUMATIC AND
STRESS FRACTURE
 DEFECT OF PARS INTERARTICULARIS
LEAD TO SPONDYLOLYSIS AND
SPONDYLOLISTHESIS.

16. CERVICAL VERTEBRAE
 7 VERTEBRAE
 DIFFERENTIATING FEATURE IS
PRESENCE OF TRANSVERSE
FORAMEN.
 LORDOTIC CURVE
 PROVIDES MOBILITY AND
STABILITY TO HEAD.

17. C1 (ATLAS)
■ NO BODY, NO SPINOUS PROCESS
■ DEVELOP AS A RING OF BONE WITH
ANTERIOR AND POSTERIOR
ARCHES THAT CONNECT 2 LATERAL
MSSES.

18. C2 (AXIS)
■ DURING THE DEVELOPMENT OF ATLAS, WHAT
SHOULD BE THE BODY NATURALLY FUSE TO
AXIS FORMING DENS OR ODONTOID PEG AND
PRESENTED AS BODY OF AXIS.
■ POSTERIORLY GROOVE IN THE NECK OF
ODONTOID REPRESENTS POSITION OF STRONG
TRANSVERSE ATLANTAL LIGAMMENT.
■ AT THE TIP OF ODONTOID PEG THERE IS
ATTACHMENT OF APICAL LIGAMENT. IT
CONNECTS ODONTOID TO BASE OF SKULL AT
BASION, ANTERIOR PART OF FORAMEN
MAGNUM.

19. ATLANTOAXIAL JOINT
■ IT IS A PIVOT JOINT.
■ ATLAS AND AXIS FORM COMPLEX
ARTICULAR SYSTEM THAT PERMITS
NODDING AND ROTATIONAL
MOVEMENTS OF THE HEAD.
■ DENS, TOOTH LIKE STRUCTURE ACT
AS CENTRAL POINT TO ALLOW
ROTATION FOR ATLAS.
■ NO INTERVERTEBRAL DISC BETWEEN
C1 AND C2.

20. C3-C7 VERTEBRAE

21. C7 VERTEBRAE
■ C7 VERTEBRAE IS REFERRED AS
VERTEBRAE PROMINENS BECAUSE
IT HAS LONGER AND LARGER
SPINOUS PROCESS COMPARED TO
OTHER CERVICAL VERTEBRAE.
■ HERE SPINOUS PROCESS IS NOT
USUALLY BIFID.

22. THORACIC VERTEBRAE
■ 12 VERTEBRAE
■ NATURAL KYPHOTIC CURVE.
■ PEDICLE HEIGHT INCREASES T1 TO T12.
■ APEX IS PRESENT AT T7/T8, AT THIS LEVEL
DISC HAVE MAJOR ROLE IN INFLUENCING
THE CURVE.
■ DIFFERENTIATING FEATURE-PRESENCE OF
FACET FOR ARTICULATION WITH RIB

23. THORACIC VERTEBRAE
■ 2 DEMI FACET PRESENT NEAR
ROOT OF PEDICLE TO
ACCOMMODATE THE HEAD OF
CORRESPONDING RIBS.
■ SMALL COSTAL FACET PRESENT
ON TRANSVERSE PROCESS
WHICH ARTICULATE WITH
TUBERCLE OF THE RIB.
■ FROM T10-T12 ONLY SUPRIOR
COSTAL FACET PRESENT,
INFERIOR COSTAL FACET

24. LUMBAR VERTEBRAE
■ 5 VERTEBRAE
■ NATURAL LORDOTIC CURVE
■ MOST WEIGHT IS CENTERED AND
SUSTAIN GREATER STRESS.
■ HAVE MAMILLARY PROCESSES WHICH
GIVE ATTACHMENT OF THICK LOWER
DIVISION OF DEEP PARASPINAL
MUSCLES.
■ SUPERIOR ARTICULAR SURFACE
DIRECTED DORSOMEDIALLY WHEREAS
INFERIOR ARTICULAR SURFACE DIRECT
TOWARDS VENTROLATERALLY.

25. LUMBAR VERTEBRAE
■ BODY LARGE, FAIRLY FLAT AND BROAD IN
SHAPE.
■ PEDICLES ARE SHORTER, THICKER AND
OVAL SHAPED.
■ SPINOUS PROCESS ARE THICKER AND
SQUARE SHAPED.
■ INTERVERTEBRAL FORAMEN ARE LARGE
BUT INCREASED INCIDENCE OF NERVE
ROOT COMPRESSION.
■ VERTEBRAL FORAMEN TRIANGULAR IN
SHAPE.

26. SACROCOCCYGEAL VERTEBRAE
■ APPEARS TRIANGULAR
■ CONSIST OF 5 FUSED SACRAL VERTEBRAE AND 4
COCCYGEAL VERTEBRAE.
■ TRANSMIT BODY WEIGHT TO HIP.
■ MEDIAL SACRAL CREST- PRESENT POSTERIORLY
OVER FUSED SPINOUS PROCESS, ARTICULAR
PROCESS AND TRANSVERSE PROCESS
■ SACRAL PROMONTORY- 1ST SACRAL VERTEBRAE
WITH PROFILE RIDGE.
■ SACRAL ALA- FLAT BROAD AREA WHERE SACRUM
ARTICULATE WITH ILIUM AND PELVIS.

27. INTERVERTEBRAL JOINT
■ INTERVERTEBRAL JOINT
ALLOW PROPER
FUNCTIONING OF VERTEBRAL
COLUMN.
■ CONSIST OF-
– VERTEBRAL END PLATES
– INTERVERTEBRAL DISC
– APOPHYSEAL JOINT

28. VERTEBRAL END PALTES
■ CONSIST OF HYALINE CARTILAGE
AND FIBROCARTILAGE IN YOUNG.
■ IN ADULTS CONSIST OF
FIBROCARTILAGE
■ THICKNESS 0.6-1 MM
■ WEAKEST PART OF DISC
■ FUNCTION:
– NUTRITION OF DISC
– PREVENT BULGING OF NUCLEUS
INTO VERTEBRAL BODY

29. INTERVERTEBRAL DISC
• COMPOSED OF-
1. ANNULUS FIBROSUS- (TOUGH RING)
o CONSIST OF CONCENTRIC LAMINAL LAYER OF TYPE 1
COLLAGEN.
o IT CONTAINS AND LIMIT THE EXPANSION OF NUCLEUS.
1. NUCLEUS PULPOSUS- (SEMI FLUID GEL)
o CONSIST OFTYPE 2 CALLAGEN ARRANGED IN LOOSE MESH
SEMI FLUID PROTEIOGLYCAN GEL.
o MAKES 40- 60%.
o ABLE TO CHANGE SHAPE AND TRANSMIT PRESSURE IN
ALL DIRECTIONS.
o IT PROVIDE ELASTICITY AND COMPRESSIBILITY.

30. INTERVERTEBRAL DISC
 CUSHION LIKE STRUCTURE.
 PREVENT AGAINST COMPRESSIVE FORCES.
 OVERALL BODY HEIGHT DECREASES BY 15-20 MM DURING
DAY WHICH IS RECUPERATED DURING NIGHT
 NUTRITION- DISC IS AVASCULAR AFTER 10 YRS AND RELIES
ON DIFFUSION OF NUTRIENT SUCH AS OXYGEN, GLUCOSE
AND SULFATE.
 3 BIOMECHANICAL GOAL-
 WEIGHT DISTRIBUTION FROM 1 VERTEBRAE TO ANOTHER.
 FLEXIBILITY ALLOW FLEXION, EXTENSION, LATERAL
BENDING AND ROTATION.
 STRENGHT TO PREVENT ANY INJURY DURING MOVEMENT.

31. LIGAMENTS
■ IT IS CONNECTING TISSUE FROM 1 BONE TO
ANOTHER.
■ MAINTAIN STABILITY IN UPRIGHT POSITION PROTECT
AGAINST TENSILE FORCE.
■ 6 LIGAMENTS ARE THERE-
– ANTERIOR LONGITUDINAL LIGAMENT
– POSTERIOR LONGITUDINAL LIGAMENT
– SUPRASPINOUS LIGAMENT
– INTERSPINOUS LIGAMENT
– LIGAMENTUM FLAVUM
– FACET OR ARTICULAR CAPSULE ( SURROUNDS
ZYGAPOPHYSEAL JOINT ALLOW MOVEMENT IN
SAGITTAL PLANE)

32. ANTERIOR LONGITUDINAL LIGAMENT
■ EXTENDS FROM ANTERIOR ASPECT OF
BASE OF OCCIPUT VIA THE ATLAS DOWN
THE ANTERIOR SURFACE OF EACH
VERTEBRAE AND DISC UPTO SACRUM.
■ 20 MM WIDE
■ PREVENT ANTERIOR SEPARATION OF
EACH VERTEBRAL BODY WHEN IN
EXTENSION AND FLEXION.

33. POSTERIOR LONGITUDINAL LIGAMENT
■ POSTERIOR TO BODY AND DISC
■ EXTENDS FROM POSTERIOR
ASPECT OF BASE OF OCCIPUT VIA
ODONTOID PEG DOWN UPTO
COCCYX.
■ BROADER OVER DISC AND
NARROWER OVER BODY.

34. LIGAMENTUM FLAVUM AND INTERSPINOUS
LIGAMENT■ LIGAMENTUM FLAVUM:
– SHORT AND THICK
– PROTECT DISC BY LIMITING MOVEMENT.
– YELLOW LIGAMENT DUE TO DISTINCTIVE
COLOUR.
– MOST ELACTIC TISSUE IN BODY
■ INTERSPINOUS LIGAMENT:
– SERIES OF SHORT LIGAMENT THAT CONNECT
ADJACENT SPINOUS PROCESS
– IT LACKS CONTINUITY

35. SUPRASPINOUS LIGAMENT AND INTERTRANSVERSE
LIGAMENT
■ SUPRASPINOUS LIGAMENT:
– FIBROUS CORD ATTACHES AT TIP OF
EACH SPINOUS PROCESS.
– IT CEASES BETWEEN L4-L5 VERTEBRAE.
– BELOW THIS THORACOLUMBAR FASCIA
TAKES OVER ROLE OF PROVIDING
STRENGTH AND SAGITTAL MOVEMENT OF
LS SPINE.
■ INTERTRANSVERSE LIGAMENT:
– IT LIMITS LATERAL FLEXION OF SPINE

36. MUSCLES
■ CREATES COVER OF SOFT TISSUE
■ PERMITS MOVEMENT AND STABILITY OF SPINAL
COLUMN.
■ IT IS KNOWN AS PARASPINAL MUSCLES.
■ ROLE OF PARASPINAL MUSCLES-
– STABALIZATION OF BONES
– INFLUENCE POSTURE
– IT INFLUENCE MOVEMENT- EXTENSION, FLEXION AND
ROTATION.

37. ANTERIOR MUSCLES
■ GROUP OF MUSCLE ASSOCIATED WITH FLEXION.
■ LONGUS CAPITIS- FROM LATERAL MASSES TO
FORAMEN MAGNUM.
■ LONGUS COLI- FROM ATLAS TO T3.
■ PSOAS MAJOR- IN LUMBAR REGION AND EXTEND
TO THE HIP.
■ PSOAS MINOR- LIES ON SURFACE OF PSOAS
MAJOR FROM T12-L1.

38. POSTERIOR MUSCLES
■ DEEP LAYER-
– INTERSPINATE MUSCLES
– INTERTRANSVERSALE MUSCLE
■ INTERMEDIATE LAYER-
– TRANSVERSOSPINALIS- EXTEND FROM
TRANSVERSE PROCESS TO SPINE.
I. MULTIFIDUS
II. SEMISPINALIS CERVICIS
III. SEMISPINALIS CAPITIS
IV. SEMISPINALIS THORACIS

39. POSTERIOR MUSCLES
■ SUPERFICIAL LAYER- ERRECTOR
SPINAE
– ILIOCOSTALIS
– LONGISSIMUS
– SPINALIS CERVICIS
– SPINALIS THORACIS

40. MUSCLES
■ OTHER MUSCLES- CONTROLLING MOVEMENT OF THE SPINE
– SERRATUS POSTERIOR SUPERIOR
– RHOMBOID MINOR
– TRAPEZIUS
– RHOMBOID MAJOR
– LATTISMUS DORSI
– SERRATUS POSTERIOR INFERIOR

41. SPINAL CORD
■ SPINAL CORD IS SURROUNDED BY THREE
MEMBRANES-
– DURA MATER- EXTERNAL LOOSE SHEETH WHICH
DOESNOT ADHERE TO CORD.
– ARACHNOID- THIN DELICATE LAYER BETWEEN
DURA MATER AND PIA MATER.
– PIA MATER- INNERMOST LAYER WHICH ADHERE
TO CORD.
■ SUBDURAL SPACE CONTAIN SEROUS FLUID.
■ SUBARACHNOID SPACE CONTAIN CSF.
■ ALL NERVE DIVIDE INTO ANTERIOR AND
POSTERIOR SEGMENT WHICH CONNECT TO THE
CORD VIA ANTERIOR AND POSTERIOR NERVE
ROOT.

42. SPINAL CORD
■ HOUSED WITHIN VERTEBRAL FORAMEN AND PROTECTED BY
BONE ALL AROUND.
■ EXTENDS FROM FORAMEN MAGNUM TO WHERE IT
CONNECTS WITH MEDULLA OBLONGATA AND ENDS AT
LOWER BORDER OF L1 .
■ BELOW THIS LEVEL IT DIVIDED AS CONUS MEDULLARIS,
SEEN AS BUNDLE OF FILAMENTS.
■ BUNDLE CONSIST OF LUMBAR AND SACRAL NERVE ROOTS.
■ THEY RESEMBLE HORSE’S TAIL AND ARE CALLED CAUDA
EQUINA.
■ AT MOST DISTAL PART IT IS ATTACHED TO COCCYX BY FILUM
TERMINALE.

43. SPINAL NERVES
■ 31 PAIR OF SPINAL NERVES-
– CERVICAL: 8 PAIRS
– THORACIC: 12 PAIRS
– LUMBAR: 5 PAIRS
– SACRAL: 5 PAIRS
– COCCYGEAL: 1 PAIR
■ C1 NERVE ROOT EXIT BETWEEN OCCIPITAL AND C1
■ C2 EXIT BETWEEN C1 AND C2.
■ IN CERVICAL SPINE NERVE ROOT EXIT ABOVE THE LEVEL IT IS
NAMED.
■ WHEREAS OTHER REGION NERVE ROOT EXIT AT THE SAME
LEVEL IT IS NAMED.

44. SPINAL NERVE
■ ALL NERVE DIVIDE INTO ANTERIOR
AND POSTERIOR SEGMENT WHICH
CONNECT TO THE CORD VIA ANTERIOR
AND POSTERIOR NERVE ROOT.
■ ANTERIOR NERVE ROOT ACT AS
MOTOR NERVE WHEREAS POSTERIOR
NERVE ROOT PROVIDES SENSORY
INFORMATION.

45. SPINAL NERVE
 PLEXUS NETWORK IS AN ADDITIONAL BRANCHES OF THE
NERVES.
 THROUGH CONTINOUS DIVISION AND REFORMATION,
PLEXUS IS FORMED.
 4 PLEXUS-
 CERVICAL PLEXUS: DUE TO ANTERIOR DIVISION OF
UPPER 4 CERVICAL NERVES.
 BRACHIAL PLEXUS: DUE TO MERGER OF LOWER 4
CERVICAL NERVE AND 1ST THORACIC NERVE
 LUMBAR PLEXUS: DUE TO ANTERIOR DIVISION OF
UPPER FOUR LUMBAR NERVE AND 12TH THORACIC
NERVE.
 SACRAL PLEXUS: DUE TO LUMBOSACRAL CORD,
ANTERIOR DIVIDION OF UPPER THREE SACRAL NERVE
AND SECTION OF 4TH SACRAL NERVE.

46. DERMATOMES
 SENSORY COMPONENT OF EACH
SPINAL NERVE DISTRIBUTES TO A
SEGMENTAL PART OF SKIN CALLED
DERMATOME.
 PATTERN FOLLOWS SEGMENTAL
DISTRIBUTION OF UNDERLYING
MUSCLE INNERVATIONS.
 TESTING THE SENSATION ON THE SKIN
AS WELL AS TESTIONG POWER IS
USEFULL IN DETERMINING THE
PRESENCE OF A NERVE, SPINAL
TRACT OR SPINAL CORD LESION.

47. X-RAYS OF
SPINE

48. GOAL OF X-RAYS OF SPINE
■ TO DIAGNOSE
– CAUSE OF BACK PAIN OR NECK PAIN
– FRACTURE
– ARTHRITIS
– SPONDYLOLISTHESIS
– DEGENERATION OF DISC
– TUMOR
– ABNORMALITIES OF CURVATURE
– CONGENITAL ABNORMALITIES

49. X-RAYS OF CERVICAL SPINE
■ DIFFERENT VIEW FOR CERVICAL SPINE:
– ANTEROPOSTERIOR VIEW
– LATERAL VIEW
– ODONTOID (OPEN MOUTH) VIEW
– SWIMMERS VIEW
– LATERAL VIEW WITH TRACTION OF BOTH ARM
– FUNCTIONAL VIEW (LATERAL FLEXION AND EXTENSION VIEW)

50. NORMAL RADIOLOGICAL FINDING IN C-SPINE
■ LATERAL VIEW CERVICAL SPINE
■ F: FACET JOINT
■ SP: SPINOUS PROCESS
■ H: HYOID BONE
■ Ph: PHARYNX
■ Tr: TRACHEA
■ PREDENTAL SPACE
■ RETROPHARYNGEAL SPACE
■ RETROTRACHEAL SPACE
■ POSTERIOR CERVICAL LINE FROM C1 TO C3

51. NORMAL RADIOLOGICAL FINDING IN C-
SPINE
■ ANTEROPOSTERIOR VIEW OF
CERVICAL SPINE
■ D: INTERVERTEBRAL DISC
■ U: UNCOVERTEBRAL JOINT
■ T: TRANSVERSE PROCESS
■ SP: SPINOUS PROCESS

52. OPEN MOUTH VIEW

53. SWIMMERS VIEW

54. FUNCTIONAL VIEW

55. X-RAYS OF THORACOLUMBAR SPINE
■ DIFFERENT VIEW FOR THORACOLUMBAR SPINE:
– ANTEROPOSTERIOR VIEW
– LATERAL VIEW
– FUNCTIONAL VIEW (LATERAL FLEXION AND EXTENSION VIEW)
– OBLIQUE VIEW
– FERGUSON VIEW: 20* CAUDOCEPHALIC ANTEROPOSTERIOR
– ANGLED CAUDAL VIEW: FOR FACET OR LAMINAR PATHOLOGICAL CONDITION

56. RADIOGRAPHIC ANATOMY OF LUMBAR
SPINE
■ LATERAL VIEW OF LUMBAR SPINE
– B: BODY OF VERTEBRAE
– D: INTERVERTEBRAL DISC
– P: PEDICLE
– F: FACET
– Fo: INTERVERTEBRAL FORAMEN
– I: INFERIOR ARTICULAR PROCESS
– S: SUPERIOR ARTICULAR PROCESS
– SP: SPINOUS PROCESS

57. RADIOGRAPHIC ANATOMY OF LUMBAR
SPINE
■ ANTEROPOSTERIOR VIEW OF
LUMBAR VERTEBRAE
– I: INFERIOR ARTICULAR PROCESS
– S: SUPERIOR ARTICULAR PROCESS
– P: PEDICLE
– L: LAMINA
– T: TRANSVERSE PROCESS
– SP: SPINOUS PROCESS

58. RADIOGRAPH OF LS SPINE- AP/ LATERAL/ LATERAL
FLEXION AND LATERAL EXTENSION VIEW

59. RADIOGRAPHIC ANATOMY OF THORACIC
SPINE ■ ADDITIONAL
FEATURE IN
THORACIC SPINE IS
ARTICULATION OF
RIB WITH FACET
PRESENT OVER
VERTEBRAL BODY.

60. DENNIS THREE COLUMN CLASSIFICATION
■ FOR TREATMENT OF SPINAL INJURIES, IT IS
CRUCIAL TO ASSESS STABILITY OF SPINE .
■ IN 3 COLUMN CLASSIFICATION, SPINE IS
DIVIDED INTO 3 COLUMN.
■ WHEN ONLY 1 COLUMN IS DISRUPTED ,
SPINE IS STABLE.
■ WHEN 2 OR MORE THAN 2 COLUMN IS
INVOLVED, SPINE IS UNSTABLE.

61. FLEXION INJURY EXTENSION INJURY

62. COMPRESSION FRACTURE OF L1 VERTEBRAE TRANSVERSE FRACTURE AT L3 VERTEBRAE

63. SCOLIOSIS
■ ABNORMAL CURVATURE OF SPINE WITH LATERAL
COMPONENT OF MORE THAN 10*.
■ ASSESSED RADIOLOGICALLY WITH SINGLE AP LONG
FILM OF THORACIC AND LUMBAR SPINE TAKEN IN
PATIENT WITH ERECT POSITION.
■ COBBS ANGLE OF 10* OR MORE IS CONSIDERED
ABNORMAL.
■ ROTATION OF VERTEBRAE WITH 1 PRIMARY AND 2
SECONDARY CURVES.
■ FULCRUM BENDING RADIOGRAPH TO DETERMINE
FLEXIBILITY OF SCOLIOTIC CURE

64. SCOLIOSIS
■ HOW TO MEASURE COBBS
ANGLE?
1. DRAW A LINE PARALLEL TO
SUPERIOR END PLATE OF
MOST TILTED VERTEBRAE AT
UPPER END OF CURVE.
2. DRAW A LINE PARALLEL TO
INFERIOR END PLATE OF
MOST TILTED VERTEBRAE AT
LOWER END OF CURVE.
■ ANGLE BETWEEN THESE TWO
LINE OR ANGLE BETWEEN
TWO LINE PERPENDICULAR
TO ABOVE TWO LINE IS COBBS
ANGLE.

65. FULCRUM BENDING RADIOGRAPH IN CASE
OF SCOLIOSIS

66. KYPHOSIS
■ EXCESSIVE BACKWARD CONVEXITY OF SPINE.
■ ASSESSED RADIOLOGICALLY WITH SINGLE
LATERAL LONG FILM OF THORACIC AND LUMBAR
SPINE TAKEN IN PATIENT WITH ERECT POSITION.
■ COBBS ANGLE IS MEASURE TO EVAVLUATE
SEVERITY.
■ HYPEREXTENSION FILM TO DETERMINE
FLEXIBILITY ON HYPEREXTENSION.

67. DEFECT IN PARS INTERARTICULARIS

68. SPONDYLOSIS
■ DEFECT IN PARS
INTERARTICULARIS
■ OBLIQUE VIEW OF SPINE IS
IMPORTANT TO SHOW DEFECT IN
PARS INTERARTICULARIS.
■ SCOTTISH DOG WITH COLLAR SIGN
SEEN IN X-RAY

69. SPONDYLOLISTHESIS
■ DEFECT IN PARS INTERARTICULARIS
WITH DISPLACEMENT OF ONE
VERTEBRAE OVER OTHER (ANTERIOR
> POSTERIOR)
■ OBLIQUE VIEW OF SPINE IS
IMPORTANT TO SHOW DEFECT IN
PARS INTERARTICULARIS.
■ SCOTTISH DOG HEAD AWAY FROM
THE BODY SIGN SEEN IN X-RAY

70. POTT’S SPINE
■ X-RAY FINDING IN TB OF SPINE:
 EARLY CASE, MINIMAL LOSS OF DISC SPACE
 COMPLETE LOSS OF DISC SPACE
 DESTRUCTION OF VERTEBRAL BODIES WITH LOSS OF DISC SPACE
 ADVANCED DESTRUCTION AND WEDGING OF VERTEBRAE
 PARAVERTEBRAL ABSCESS
 PSOAS ABSCESS
 RETROPHARYNGEAL ABSCESS

71. POTT’S SPINE

72. POTT’S SPINE

73. SIGN OF HEALING IN
CASE OF POTT’S SPINE

74. TUMOR
SCLEROTIC
LESION
SECONDARY TO
PRIMARY TUMOR
FROM PROSTATE,
BREAST,LUNGS
ETC….
LYTIC LESION
SECONDARY TO
MULTIPLE
MYELOMA

75. FACET JOINT SUBLUXATION FACET JOINT DISLOCATION

76. HANGMAN FRACTURE: FRACTURE OF PEDICLE OF C2
JAFFERSON FRACTURE: FRACTURE OF C1
VERTEBRAE WITH NO ALINGMENT OF
LATERAL MASSES

77. OSTEOARTHRITIS

78. THANK YOU