The lumbar spine refers to the lower back, where the spine curves inward toward the abdomen. It starts about five or six inches below the shoulder blades, and connects with the thoracic spine at the top and extends downward to the sacral spine.The lumbar vertebrae are the five vertebrae between the rib cage and the pelvis. They are the largest segments of the vertebral column. They are designated L1 to L5, starting at the top. The lumbar vertebrae help support the weight of the body, and permit movement.
Discs form the main connection between vertebrae. They bear loading during axial compression and allow movement between the vertebrae. Their size varies depending on the adjacent vertebrae size and comprises approximately one quarter the length of the vertebral column.
Each disc consists of the nucleus pulposus, a central but slightly posterior mucoid substance embedded with reticular and collagenous fibers, surrounded by the annulus fibrosus, a fibrocartilaginous lamina. The annulus fibrosus can be divided into the outermost, middle, and innermost fibers. The anterior fibers are strengthened by the powerful anterior longitudinal ligament (ALL). The posterior longitudinal ligament (PLL) affords only weak midline reinforcement, especially at L4-5 and L5-S1, as it is a narrow structure attached to the annulus. The anterior and middle fibers of the annulus are most numerous anteriorly and laterally but deficient posteriorly, where most of the fibers are attached to the cartilage plate. The annular fibers are firmly attached to the vertebral bodies and are arranged in lamellae. This annular arrangement permits limiting vertebral movements, reinforced by investing ligaments.
Common conditions of lumbar disc include:
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