Curves

Viewed laterally the vertebral column presents several curves, which correspond to the different regions of the column, and are called cervical, thoracic, lumbar, and pelvic.
The cervical curve, convex forward, begins at the apex of the odontoid (tooth-like) process, and ends at the middle of the second thoracic vertebra; it is the least marked of all the curves. The thoracic curve, concave forward, begins at the middle of the second and ends at the middle of the twelfth thoracic vertebra. Its most prominent point behind corresponds to the spinous process of the seventh thoracic vertebra. This curve is known as a kyphotic curve.

The lumbar curve is more marked in the female than in the male; it begins at the middle of the last thoracic vertebra, and ends at the sacrovertebral angle. It is convex anteriorly, the convexity of the lower three vertebrae being much greater than that of the upper two. This curve is described as a lordotic curve.

The pelvic curve begins at the sacrovertebral articulation, and ends at the point of the coccyx; its concavity is directed downward and forward.

The thoracic and pelvic curves are termed primary curves, because they alone are present during fetal life. In the early embryo, the vertebral column is C-shaped, and the cervical and lumbar curvatures are not yet present in a newborn infant. The cervical and lumbar curves are compensatory or secondary, and are developed after birth, the former when the child is able to hold up its head (at three or four months), and to sit upright (at nine months), the latter at twelve or eighteen months, when the child begins to walk.

The thoracic portion of the vertebral column also has a slight lateral curvature, the convexity of which is directed toward the right side. This may be produced by muscular action, most persons using the right arm in preference to the left, especially in making long-continued efforts, when the body is curved to the right side. In support of this explanation it has been found that in one or two individuals who were left-handed, the convexity was to the left side. This curvature is regarded by others as being produced by the aortic arch and upper part of the descending thoracic aorta – a view which is supported by the fact that in cases of situs inversus where the viscera are transposed and the aorta is on the right side, the convexity of the curve is directed to the left side.