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Vertebral BodyEdit

The vertebral body is the thick, anterior block that forms the main load-bearing segment of a typical vertebra in the spinal column. Along with the intervertebral disc above and below, it transmits axial weight from the spine to the pelvis and lower limbs. The body’s size and shape vary along the spine: cervical, thoracic, and lumbar regions each present characteristic geometry that reflects their mechanical and mobility demands. In the developing skeleton, the vertebral body arises from the sclerotomes of somites, undergoes primary and secondary ossification, and fuses with neighboring elements over the first two decades of life. The body also provides a compact shell of cortical bone surrounding a trabecular core, and it participates in the complex vascular and hematopoietic system that evolves from red marrow in youth to fatty marrow in adulthood. Vertebral column Vertebral body

Anatomy and structure

General architecture

  • The vertebral body forms the anterior portion of each vertebra and is the principal weight-bearing unit of the spine. It is separated from the adjacent body by an intervertebral disc, and it interfaces with the disc via the vertebral endplates. Intervertebral disc Vertebral endplate
  • The posterior elements—the pedicles, laminae, and processes—support the vertebral arch and form the vertebral canal that houses the spinal cord or cauda equina. The body and arch together create a strong, load-sharing structure capable of withstanding compressive and shear forces. Vertebral column Spinal cord Cauda equina

Endplates and discs

  • Each vertebral body bears superior and inferior endplates, which are thin layers of hyaline cartilage that cap the top and bottom surfaces. These endplates transmit load to the adjacent intervertebral disc and help regulate nutrient diffusion to the underlying cancellous bone. Vertebral endplate Intervertebral disc
  • The superior and inferior surfaces of the endplates contribute to the disc–bone interface, and pathological changes here can give rise to Schmorl’s nodes, where nucleus pulposus material herniates into the endplate. Schmorl's node

Internal composition

  • The outer shell is cortical bone, which provides structural rigidity, while the interior contains cancellous (trabecular) bone that resists compressive loads through a lattice of trabeculae oriented along principal stress directions. In youth, red marrow fills portions of the cancellous lattice; with age, marrow often converts toward fatty (yellow) marrow. Cortical bone Trabecular bone Red bone marrow Yellow bone marrow

Regional variation

  • Cervical vertebral bodies, excluding the atlas (C1) and axis (C2), tend to be relatively small and may have concavities on their superior surfaces. The atlas lacks a vertebral body entirely, while the axis bears a prominent odontoid process (dens) that acts as a pivotal peg for rotational movement. Atlas (C1) Axis (C2)
  • Thoracic vertebral bodies are more heart‑shaped and include facets on the bodies (costovertebral joints) for articulation with ribs. This region supports rib attachments and contributes to the rigid, protective thoracic cage. Costovertebral joint Ribs
  • Lumbar vertebral bodies are large and kidney‑shaped to accommodate substantial frontal and axial loading, with strong pedicles and facets that limit rotation. Lumbar vertebrae
  • In the sacrum, vertebral bodies are fused to form part of a single, pyramidal bone that contributes to the pelvic ring. The coccygeal region continues as a fused or semi-fused series of small vertebral bodies. Sacrum Coccyx

Development and growth

  • The vertebral body develops from primary ossification centers that appear prenatally, followed by secondary centers for the ring apophyses (endplates). Fusion typically progresses during late adolescence to early adulthood, completing the maturation of the vertebral column. Ossification Vertebral endplate Vertebral column

Blood supply and innervation

  • The vertebral bodies receive arterial supply from segmental arteries, including branches that accompany the vertebral column. The basivertebral arteries contribute to the intrinsic blood supply within the vertebral body, and venous drainage occurs through the anterior and posterior internal vertebral venous plexuses. Vertebral artery Internal vertebral venous plexus
  • Sensory innervation of the vertebral body is mainly via periosteal nerves; pain signals from vertebral body pathology often arise through referral to surrounding structures such as the discs, ligaments, and facet joints. Nervous system Facet joint

Clinical significance

Common conditions

  • Osteoporosis can reduce vertebral bone density and integrity, elevating the risk of compression fractures that typically involve the anterior portion of the body, producing wedge-shaped deformities and potential kyphosis. Osteoporosis Compression fracture
  • Vertebral metastases are a frequent site of cancer spread and can involve the bodies of the thoracic and lumbar spine (and cervical spine in some cases), with mixed lytic and sclerotic patterns depending on the primary tumor. Bone metastasis Vertebral metastasis
  • Schmorl’s nodes, herniation of nucleus pulposus into the endplate, reflect loading and disc–endplate interactions and may be incidental or associated with back pain. Schmorl's node
  • Infections such as vertebral osteomyelitis or discitis can involve the vertebral bodies and adjacent discs, requiring prompt recognition and treatment to prevent collapse or spread. Vertebral osteomyelitis
  • Degenerative changes at the anterior column, including modulation of endplates and adjacent disc space, can contribute to spinal stenosis and radiculopathy. Spinal stenosis Osteoarthritis

Acute and traumatic injuries

  • Traumatic injuries range from compression fractures to burst fractures and dislocations, with the risk of spinal canal compromise depending on the pattern and level. High-energy trauma can produce significant injury to the vertebral body and surrounding structures. Vertebral fracture Kyphosis

Imaging and assessment

  • Plain radiographs (X-rays) provide initial evaluation of vertebral body height, alignment, and gross bone quality.
  • Computed tomography (CT) offers detailed assessment of bony architecture, fracture morphology, and cortical integrity, and is often used in trauma settings. X-ray Computed tomography
  • Magnetic resonance imaging (MRI) provides superior evaluation of the vertebral body marrow, endplates, and adjacent discs, along with neural structures, and is essential for detecting infection, tumor, or inflammatory changes. Magnetic resonance imaging
  • Nuclear medicine techniques (such as bone scintigraphy) can help identify metabolic activity in vertebral bodies when suspicion for multifocal disease exists. Bone scan

See also