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Dr. Finkenberg introduces himself and describes the anatomy of the spine.
Dr. Finkenberg:
Hello. I am John Finkenberg, orthopedic spine specialist at Alvarado Hospital in San Diego, California.
The vertebrae, approximately 26, make up the spine. There are seven cervical vertebrae, and those are at the top. There are 12 thoracic vertebrae, and then there’s five lumbar vertebrae, and then there are vertebrae that are fused together in the sacrum which makes up your tailbone, the coccyx at the very bottom or caudal end of the vertebrae.
The muscles attached to the bony surfaces on the posterior as well as the anterior aspects of the spine, the spinous processes which you can feel down the middle of your spine are these pointed objects on the back side of each vertebra. As you look at this particular spine, the thoracic vertebrae are the ones that are green in the center with the lumbar being at the bottom, and they are in light blue, and the cervical being at the top in purple.
The occiput or the skull is at the very top of the spine. The bony protrusions on the lateral aspect to the sides of the spinous process are the transverse processes, and those are put there for attachments to the ribs in the thoracic region as well as the muscles in the thoracic area and lumbar region. Muscle attachments are also present in the cervical area.
The yellow tubes coming out of the neuroforamen or tunnels on the posterior lateral aspect of the vertebrae are the nerve roots. And these are the ones that are getting pressed on by degenerative bone or disc herniations that can be present anywhere from the skull all the way down to the sacrum.
The anterior part of the vertebrae are where the vertebral bodies are, and you can see the shapes of the vertebral bodies are a little bit different as you go from the skull all the way down to the lumbar spine. If you see a cross section view on the lumbar spine, you can see that the vertebrae have discs in between them, and those are the ones that tend to dry out and herniate as we get older or involved in traumatic accidents.
The spine sits on top of the sacrum, and the sacrum is wedged with two joints to the pelvis at the very bottom. So you have heard of sacroiliac joints, and those are the joints between the sacrum and the ilium which is part of the pelvis, and they can sometimes be a cause for pain and inflammation that is located at the very lowest part of the spine.
The pelvis, from the front view, you can see is sort of a ring-shaped structure which houses all the pelvic organs. You can see bone in the very front with the hip joints coming off to the side from the acetabulum. The sciatic nerve which is a commonly injured nerve or irritated nerve represents these five nerve roots that come out from the lower lumbar spine region, and they pass through the pelvis and out into the extremities through small openings in the pelvis.
There are blood vessels that run very close to the spine as well as multiple branches to the nerves that go to the vertebrae as well as to the discs, and that’s pretty much a quick review of the human spine.
About Dr. Finkenberg, M.D.
Dr. John Finkenberg has been in practice at Alvarado Hospital for 16 years. He completed his undergraduate and medical degree at UCLA. Following his orthopedic residency at Harbor/UCLA, he received fellowship training in Advanced Spinal Reconstruction Surgery at Johns Hopkins University Hospital in Maryland.
Dr. Finkenberg’s great interest in the advancement of spinal surgery developed from 15 years as a spine consultant assisting with the creation of new technology and procedures. He is a primary investigator for multi-center national research studies and lectures around the world on current research projects.