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67 The report The diagnosis; causation; the prognosis; advice on acceleration.
57 Functional anatomy of the thoraco-lumbar spine
57.1 Three joint complex The vertebrae, the building blocks of the spinal column, are connected together by three main joints: the intervertebral disc in front and a pair of facet (zygapophyseal) joints, one on either side, behind.
57.2 The pair of facet joints (see chapter 6) are synovial joints, so called because they contain lubricating synovial fluid lined by a synovial membrane. The main function of the facet joints is to control range and direction of movements between the vertebrae. By way of controlling movements they offer stability to the spine. Their excision (surgical removal) on one or either side may lead to spinal instability resulting in back pain with a typical instability catch. The facet joint bears no more than 18% of the total compressive load borne by the lumbar spine.1
57.3 Ligaments Besides disc and the facet joints there are seven ligaments connecting the adjacent vertebrae: - one pair of inter-transverse ligaments and inter-laminar ligament (called ligamentum flavum because of its yellow colour) - and one each of interspinous ligament, anterior and posterior longitudinal ligaments (see chapter 6 and Figures 10 and 11 and figure 25).
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