Clinical Anatomy of the Lumbosacral Spine



A chapter on clinical anatomy of the lumbosacral spine in a book like this can be challenging. On the one hand, if you don’t already know that there are five lumbar vertebrae in the lumbar spine, then you are reading the wrong book. On the other hand, if you do know that the L5 dorsal ramus is much longer than the other dorsal rami in the lumbar spine and that it runs along the groove between the sacral ala and the root of the S1 superior articular process [1], then this information will help you with a radiofrequency rhizotomy procedure (which is important if this is a procedure you perform) but not much else. In this chapter, we will attempt to thread that needle, to provide pertinent, high-yield clinical anatomy needed to diagnose and treat pathologies of the lumbar spine without delving into the surgical anatomy needed to perform complex procedures.


Anatomy Spine Facet joints Intervertebral discs Muscles Tendons Ligaments Nerves 

References and Suggested Further Reading

  1. 1.
    Lau P, Mercer S, Govind J, Bogduk N. The surgical anatomy of lumbar medial branch neurotomy (facet denervation). Pain Med. 2004;5(3):290–8.CrossRefGoogle Scholar
  2. 2.
    Bogduk N. Clinical anatomy of the lumbar spine and sacrum. 3rd ed. Edinburgh: Churchill Livingstone; 1999.Google Scholar
  3. 3.
    Adams MA, Dolan P. Recent advances in lumbar spinal mechanics and their clinical significance. Clin Biomech. 1995;10:3–19.CrossRefGoogle Scholar
  4. 4.
    Adams MA, Hutton WC. The effect of posture on the role of the apophyseal joints in resisting intervertebral compression force. J Bone Joint Surg. 1980;62B:358–62.Google Scholar
  5. 5.
    Vleeming A, Volkers ACW, Snijders CJ, Stoeckhart R. Relation between form and function in the sacroiliac joint. Part II: Biomechanical aspects. Spine. 1990;15:133–5.CrossRefPubMedGoogle Scholar
  6. 6.
    Naylor A. Intervertebral disc prolapse and degeneration. The biochemical and biophysical approach. Spine. 1976;1:108–14.CrossRefGoogle Scholar
  7. 7.
    Naylor A, Shental R. Biochemical aspects of intervertebral discs in ageing and disease (Ch. 14). In: Jayson MIV, editor. The lumbar spine and backache. New York: Grune and Stratton; 1976. p. 317–26.Google Scholar
  8. 8.
    Edgar MA. The nerve supply of the lumbar intervertebral disc. J Bone Joint Surg Br. 2007;89B(9):1135–9.CrossRefGoogle Scholar
  9. 9.
    Bogduk N. The lumbar disc and low back pain. Neurosurg Clin N Am. 1991;2:791–806.PubMedGoogle Scholar
  10. 10.
    Williams PL, et al., editors. Gray’s anatomy. 38th ed. Edinburgh: Chuchill Livingstone; 1995.Google Scholar
  11. 11.
    Macintosh JE, Valencia F, Bogduk N, Munro RR. The morphology of the lumbar multifidus muscles. Clin Biomech. 1986;1:196–204.CrossRefGoogle Scholar
  12. 12.
    Drake R, Vogl W, Mitchell AVM, Mitchell A. Gray’s anatomy for medical students. 2nd ed. New York: Churchill Livingstone; 2009.Google Scholar
  13. 13.
    Hall-Craggs ECB. Anatomy as a basis for clinical medicine. 2nd ed. Baltimore: Urban & Schwarzenberg; 1990.Google Scholar
  14. 14.
    Pansky B. Review of gross anatomy. 6th ed. New York: McGraw-Hill Medical; 1996.Google Scholar
  15. 15.
    Crock HV, Yoshizawa H. The blood supply of the lumbar vertebral column. Clin Orthop. 1976;115:6–21.PubMedGoogle Scholar
  16. 16.
    Crock HV, Yoshizawa H, Kame S. Observations on the venous drainage of the human vertebral body. J Bone Joint Surg. 1973;55B:528–33.Google Scholar
  17. 17.
    Parke WW, Gammell K, Rothman RH. Arterial vascularisation of the cauda equine. J Bone Joint Surg. 1981;63A:53–62.Google Scholar
  18. 18.
    Parke WW, Watanabe R. The intrinsic vasculature of the lumbosacral spinal nerve roots. Spine. 1985;10:508–15.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Princeton Spine & Joint CenterPrincetonUSA

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