Thoracic Spine Anatomy

Thoracic spine is also called dorsal spine and is constituted by next 12 vertebrae after cervical spine.

If you palpate back of neck from above downwards in mid line, you would come across a sudden projection or bump in the lower part of neck. This projection is posterior spinous process of C7 vertebra and projects out due to its large size. C7 connects on top of T1.

Similarly, the lowest vertebra of the thoracic spine, T12, connects with L1 or first vertebra in lumbar spine. Between these two are ten other thoracic vertebra connected to each other.

Following features are unique to thoracic spine when compared to cervical spine

Rib Cage

Each thoracic segment is accompanied by a pair of ribs. The ribs articulate with the spinal column posteriorly, and the sternum anteriorly.

The first, eleventh, and twelfth pair of ribs articulate with their named vertebra only.

The second through tenth ribs articulate both with their named vertebral body and with the intervertebral disk and the vertebra above.

Each pair of ribs also articulates with the anterior surface of the transverse process of its named vertebrae.

Thoracic spine and rib cage provide both stability and a protect vital organs in thorax.

Thinner Discs

Discs are cushions in between two vertebrae that act as shock absorbers. In the thoracic spine, the intervertebral discs are thinner than at the cervical or lower spine.

Narrower Canal

Spinal canal is narrowest canal in the thoracic spine.

Identification of Thoracic Vertebra

The thoracic vertebrae are identified by the presence of costal facets on the sides of the vertebral bodies. Costal facets of each vertebra articulate with corresponding rib. The costal facets may be two or only one on each side. There are twelve thoracic vertebrae [both typical and atypical thoracic vertebrae], out of which the 2nd to 8th are typical and the remaining 5 i.e.1st, 9th, 10th, 11th and 12th are atypical.

Typical Thoracic Vertebra

The body is heart shaped with roughly the same measurements from side to side and anteroposteiroly. On each side it bears 2 costal facets (demifacets). The superior costal facets are larger and placed on the upper border of the body near the pedicle. They articulate with the head of the numerically corresponding rib. The inferior costal facets are smaller and placed on the lower border in front of the inferior vertebral notch. They articulate with the next lower rib.

The vertebral foramen is comparatively small and circular.

The vertebral Arch

The pedicles are directed straight backwards. The superior vertebral notch is shallow, while the inferior vertebral notch is deep and conspicuous.
The laminae overlap each other from above.
The superior articular processes project upwards from the junction of the pedicles and laminae. The articular facets are flat and are directed backwards and a little laterally and upwards. This direction permits rotatory movements of the spine.
The inferior articular processes are fused to the laminae. Their articular facets are directed forwards and slightly downwards and medially.
The transverse processes are large, and are directed laterally and backwards from the junction of the pedicles and laminae. The anterior surface of each process bears a facet near its tip, for articulation with the tubercile of the corresponding rib. In the upper 6 vertebrae the costal facets on the transverse processes are concave, and face forwards and laterally. In others the facets are flat and face upwards, laterally and slightly forwards.
The spine is long, and is directed downwards and backwards. The 5th to 9th spines are the longest, more vertical and overlap each other. The upper and lower spines are less oblique in direction.

Attachments on a Typical Thoracic Spine Vertebra

The upper and lower borders of the body give attachment, in front and behind respectively, to the anterior and posterior longitudinal ligaments.
The upper borders and lower parts of the anterior surfaces of the laminae provide attachment to the ligamenta flava.
The transverse process gives attachment to (i) the lateral costotransverse ligament (at the tip); (ii) the superior costotransverse ligament (lower border); the inferior costotransverse ligament (anterior surface); (iv) the intertransverse muscles (to upper and lower borders); (v) the levator costae (posterior surface).
The spines gives attachment to the supraspinous and interspinous ligaments. They also give attachment to several muscles including the trapezius, the rhomboids, the latissimus dorsi, the serrate posterior superior and inferior, and many deep muscles of the back.

Atypical Thoracic Vertebrae

First Thoracic Vertebra

The body resembles that of a cervical vertebra. It is broad and not heart shaped. Its upper surface is lipped laterally and beveled anteriorly. The superior costal facet on the body is complete. It articulates with the head of the first rib. The inferior costal facet is a “demifacet” for the second rib.
The spine is thick, long and nearly horizontal.
The superior vertebral notches are well marked, as in cervical vertebrae.

Ninth Thoracic Vertebra

It resembles a typical thoracic vertebra except that the body has only the superior costal facets (demifacets). The inferior costal facets are absent.

Tenth Thoracic Vertebra

It resembles a typical thoracic vertebra except that the body has a single complete superior costal facet on each side, extending on to the root of the pedicle.

Eleventh Thoracic Vertebrae

The body has a single large costal facet on each side, extending on to the upper part of the pedicle.
The transverse process is small, and has no articular facet. Sometimes it is difficult to differentiate between vertebrae T10 and T11.

Twelfth Thoracic Vertebra

The shape of the body, pedicles, transverse processes and spine are similar to those of a lumbar vertebra. However the body bears a single costal facet on each side, which lies more on the lower part of the pedicle than on the body.
The transverse process is small and has no facet, but has superior, inferior and lateral tubercles.
The inferior articular facets are lumbar in type, and are directed laterally (everted), but the superior articular facets are thoracic in type.

Joints of Thoracic Spine

Present throughout Vertebral Column

These joints are present in other regions of spine as well.

There are two types of joints present throughout the vertebral column

Symphyses

Adjacent vertebral bodies are joined by intervertebral discs, made of fibrocartilage.

Facet Joints

These are synovial joints formed by the articulation of superior and inferior articular processes from adjacent vertebrae.

Following joints are unique to thoracic spine.

Costovertebral Joint

Each costovertebral joint consists of the head of the rib articulating with:

Superior costal facet of the corresponding vertebra
Inferior costal facet of the superior vertebra
Intervertebral disc separating the two vertebrae

The joint is stabilized by the intra-articular ligament of head of rib which attaches the rib head to the intervertebral disc. Only slight gliding movements can occur at these joints.

Costotransverse Joint

The costotransverse joints are formed by the articulation of transverse processes of a thoracic vertebra and the tubercle of the adjacent rib. They are present in all vertebrae except T11 and T12.

Ligaments of Thoracic Spine

The thoracic spine is strengthened by the presence of numerous ligaments.

Ligaments Present in Other Parts of Spine Also

Anterior Longitudinal Ligament

The anterior longitudinal ligament runs down the anterior surface of the vertebral bodies from the occiput to the sacrum. The anterior longitudinal ligament is thicker and narrower in the thoracic region. The ligament firmly attaches to the edges of the vertebral bodies.

This is thick and slightly more narrow over the vertebral bodies and thinner but slightly wider over the intervertebral discs. It also loosely attaches to annulus of disc.

It is a three layered ligment – superficial, intermediate and deep.

Posterior Longitudinal Ligament

The posterior longitudinal ligament arises from the posterior aspect of the basiocciput, is continuous with the membrana tectoria, and runs over the posterior surfaces of the bodies of the vertebrae, down to the coccyx. It is within the vertebral canal.

Intertransverse Ligaments

These ligaments are situated between the transverse processes. In the thoracic region, they are closely connected with the deep muscles of the back.

Capsular Ligaments

The capsular ligaments are attached to the articular margins of the articular processes. The fibers are oriented perpendicular to the facet joint and are stronger in the thoracic and lumbar region than in the cervical region.

Ligamentum Flavum

Also called Yellow Ligament, the ligamentum flavum connects the anteroinferior edge of the lamina to the posterosuperior edge of the lamina below. The ligamentum flavum is thicker in the thoracic region. This ligament is composed mainly of elastic fibers, and that elasticity serves to preserve the upright posture, and to assist the vertebral column to resume after flexion.

Interspinous Ligaments

The interspinous ligaments connect adjacent spinous processes, and runs obliquely from the anterior inferior aspect of the spinous process above to the posterior superior aspect of the spinous process

Supraspinous Ligament

This strong ligament is a strong fibrous cord, which connects together the tips of the spinous processes from the C7 to the sacrum.

In the cervical spine, the interspinous and supraspinous ligaments thicken and combine to form the nuchal ligament

Ligaments Unique to Thoracic Spine

Radiate ligament of head of rib

This ligament fans outwards from the head of the rib to the bodies of the two vertebrae and intervertebral disc.

Costotransverse ligament

This connects the neck of the rib and the transverse process.

Lateral costotransverse ligament

It extends from the transverse process to the tubercle of the rib.

Superior costotransverse ligament

It passes from the upper border of the neck of the rib to the transverse process of the vertebra superior to it.

Muscles of Thoracic Spine

There are two types of muscles in the back

Extrinsic which are responsible for limb and respiratory movements
Intrinsic which maintain posture and carry out spinal movements.

Extrinsic Back Muscles

The extrinsic back muscles include superficial and intermediate muscles.

The superficial extrinsic back muscles

Trapezius, latissimus dorsi, levator scapulae, and rhomboids.

The function of this muscle group is to connect the upper limbs to the trunk and produce and control limb movements.

The intermediate extrinsic back muscles include serratus posterior superior and inferior. Those are thin, superficial respiratory muscles.

Intrinsic Back Muscles

The intrinsic or deep back muscles maintain posture and control movements of the vertebral column.

The deep back muscles can be grouped into superficial, intermediate, and deep layers

Superficial layer

Splenius capitis
Splenius cervicis muscles.

Intermediate layer [Erector spinae muscles]

Iliocostalis
Longissimus
spinalis muscles.

This group is the chief extensor of the vertebral column.

Deep Layer [Transversospinal muscle]

Semispinalis
Multifidus
Rotators

Apart from these, following muscles are present.

Interspinals which connect spinous processes
Intertransverse which connects transverse processes