Spinous process

introduction

The spinous process is an extension on the vertebral arch that starts at the point of greatest flexion and points backwards in the middle. Depending on which vertebra the spinous process is located, it can be shaped differently. At the cervical vertebrae, the spinous process is usually forked and short except for the 7th cervical vertebra, which can be clearly felt at the transition between the neck and back. In the thoracic vertebrae, the spinous process is significantly longer and points downwards at an angle. This shape is often compared to roof tiles that are lapped on top of each other. The spinous processes of the lumbar spine, in turn, point straight back. They are used as a guide when doing a lumbar puncture to remove nerve water.

Figure spinous process

1. Spinous process -
   (mostly in cervical vertebrae
   divided into two) -
   Spinous process
2. Intervertebral disc -
   Intervertebral disc
3. Vertebral bodies -
   Corpus vertebrae
4. Inter-spinous ligament -
   Interspinous ligament
5. Extra-spinous ligament -
   Supraspinal ligament
6. 7. cervical vertebrae -
   Vertebra prominent
7. 3. Thoracic vertebrae -
   Vertebra thoracica III
8. 7. Thoracic vertebrae -
   Vertebra thoracica VII
9. 12. Thoracic vertebrae -
   Vertebra thoracica XII
10. 4.Lumbar vertebrae -
    Vertebra lumbalis IV
11. 2. Sacral vertebrae -
    Vertebra sacrale II

You can find an overview of all Dr-Gumpert images at: medical illustrations

function

The spinous process has essentially two important functions. On the one hand originate and attach ligaments and muscles to these. This function can be called lever which is used to convert the contraction of a muscle into a movement, in this case mainly the stretching of the spine backwards or the flexion to the side. The ligaments that connect the spinous processes lengthwise are the Ligamenta interspinaliathat run between the spinous processes, and that Supraspinal ligamentthat only covers the tips of the spinous processes. On the other hand, the spinous processes serve the Thoracic vertebraethat are lobed downwards at an angle, similar to roof tiles, the Spinal cord additional protection and indirectly prevent excessive stretching of the spine backwards.

Symptoms

Symptoms that can arise from a spinous process are Pain caused by a fracture, one inflammation or as part of a Baastrup's disease. These are usually linked to specific movements and can be triggered by applying pressure directly to the spinous process. In addition, the spinous processes on a Indicate misalignment of the spineif these deviate from the center line.

Spinous process pain

Spinous process pain is usually common Midline of the back to feel. You can piercing or dull be and get worse or better through certain movements. Lying on your back can be uncomfortable. Pain affecting the spinous process can be caused by an injury, such as a Upsetting or a fracture, the same can be explained in the context of an enormous force or force. On the other hand, there is a clinical picture in which the pain in the spinous processes of the Lumbar spine stand in the foreground, the so-called "Baastrup's disease".

Through the interaction of large, roughly shaped spinous processes and one excessive backward stretching of the lumbar spine, more rarely the decreased vertebral body height, it happens that the spinous processes touch. The pain mainly arises when the The lumbar spine is additionally stretched and at direct pressure on the spinous processes. Also one Inflammation of the vertebraeIn the case of "spondylitis", for example, the inflammatory reaction can spread to such an extent that the spinous processes are sensitive to knocking.

root cause

One cause of pain in the spinous process can be fracture caused by an accident or a symptom of bone fatigue. Furthermore, spinous processes that are coarser and larger tend to get in each other's way, especially if there is a strong one Lordosis in the lumbar spine, so one convex bend forward, is present. Also one Inflammatory response can sometimes spread to the spinous processes and cause pain. In addition, it comes through Bad posture or Misalignment of the vertebrae, for example with one Scoliosis or one humpback, the spinous processes by the train which the resident ligaments and muscle exerting on these can also be affected.

therapy

Since the spinous processes are held relatively securely by the ligamentous apparatus is one Treatment with a fracture is not always necessary. The Protection of the back and the Administration of pain medication can be sufficient as a therapeutic measure for minor injuries. Only when the broken spinous process causes problems, for example prolonged pain or Pressure on nerves, can a more extensive therapy be useful. An operation could be considered here, in which the disturbing part of the spinous process is removed. Much more common, however, comes in therapy physiotherapy and the Applying heat and local pain relievers for use. The physical therapy is especially at Misalignments of the spine, the Problems with the spinous processes can prepare, gladly applied.

diagnosis

To make a diagnosis with regard to the spinous processes is next to the Information on the course of the complaints and one Examination of the spine, in which a good overview can be obtained through prevention and scanning of each individual spinous process, including the assessment of one X-ray image or one MRI image significant. Here you can see a possible fracture, a misalignment or the nature of the spinous process.

forecast

The injuries and complaints of a spinous process can be described as relatively uncomplicated, as they usually do not affect any other structures. The So the prognosis is pretty good, just pain can cause problems depending on the severity.

prophylaxis

There is relatively little that can be done about prophylaxis, since injuries caused by an accident or the condition of the spinous process cannot be influenced. One can only ensure that existing Misalignment of the spine due to physiotherapy be fixed and man protects the spine as a whole by strengthening the back muscles.

Fracture of a spinous process

To a fracture a spinous process usually comes after one tremendous force on the spine. This can be directed directly to the spinous processes or indirectly through Hyperextension or Over-rotation of the spine at the spinous process arrive. Since the spinous process is relatively securely embedded in the ligamentous apparatus of the spine and, in the case of a simple fracture, there is no direct, dangerous contact to the Spinal cord has is here as a rule no surgical intervention necessary. Neither is it with a fatigue fracture, in which the spinous process of the lower cervical vertebrae has lost so much of its stability that with repeated, unusually high exertion of force, for example when shoveling, the pulling of the muscle on the spinous process predominates that it can then be broken off.

The spinous process can also be part of a more comprehensive Injury to the vertebrae canceled and then in need of treatment in the context.