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OBJECTIVES

When you finish this chapter you will be able to:

  • Describe the anatomy of the cervical, thoracic, and lumbar spine.

  • Explain how the nerve roots from the spinal cord combine to form specific peripheral nerves.

  • Formulate measures to prevent injury to the spine.

  • Describe a process to assess injuries of the cervical and lumbar spine.

  • Recognize specific injuries that can occur to the various regions of the spine.

INTRODUCTION

The spine is one of the most complex regions of the body. It contains a multitude of bones, joints, ligaments, and muscles, all of which are collectively involved in spinal movement. The relationship of the spinal cord and the peripheral nerves and their proximity to the vertebral column adds to the complexity of this region. Injury to the cervical spine has potentially life-threatening implications.21 Low back pain is one of the most common ailments known to humans. Thus, some understanding of the anatomy, assessment techniques, and specific injuries of the spine is essential. Coaches and fitness professionals should routinely refer athletes complaining of back pain to trained health care professionals for treatment.

Regions of the spinal column:

  • Cervical

  • Thoracic

  • Lumbar

  • Sacrum

  • Coccyx

ANATOMY OF THE SPINE

Bones

The spine, or vertebral column, is composed of thirty-three individual bones called vertebrae (Figure 20–1).23 Twenty-four are classified as movable, or true, and nine are classified as immovable, or false. The movable vertebrae are the cervical vertebrae, thoracic vertebrae, and lumbar vertebrae. The false vertebrae, which are fixed by fusion, form the sacrum and the coccyx. The design of the spine allows a high degree of flexibility forward and laterally and limited mobility backward. Rotation around a central axis in the areas of the neck and the lower back is also permitted.

FIGURE 20–1

Vertebrae and curves of the different regions of the spinal column. (From Van De Graaff, K: Human anatomy, ed. 6, Dubuque, IA: McGraw-Hill Higher Education, 2002.)

Movements of the vertebral column:

  • Flexion

  • Extension

  • Lateral flexion

  • Rotation

The Cervical Spine

Because of the vulnerability of the cervical spine to sports injuries, coaches and fitness professionals should have a general knowledge of the cervical spine anatomy and its susceptibility to sports injuries.5,22 The cervical spine consists of seven vertebrae, with the first two differing from the other true vertebrae (Figure 20–2). These first two are called the atlas and the axis, respectively, and they function together to support the head on the spinal column and to permit cervical rotation.

FIGURE 20–2

Anatomy of (A) the atlas, axis, and ...

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