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Patients with skipped-level disk degeneration (SLDD) were recently reported as having a higher prevalence of Schmorl's nodes than patients with contiguous multi-level disk degeneration (CMDD). Fourteen versions of a nonlinear finite element model of a lumbar spine, representing different patterns of single and multi-level disk degeneration, were simulated under physiological loading. Results show that vertebral strain energy is a possible predictor in the development of Schmorl's nodes. The analysis also shows evidence that the development of Schmorl's nodes may be highly dependent on the location of the degeneration disk, with a higher prevalence at superior levels of the lumbar spine.

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Many lumbar spine surgeries either intentionally or inadvertently damage or transect spinal ligaments. The purpose of this work was to quantify the previously unknown biomechanical consequences of isolated spinal ligament transection on the remaining spinal ligaments (stress transfer), vertebrae (bone remodelling stimulus) and intervertebral discs (disc pressure) of the lumbar spine. A finite element model of the full lumbar spine was developed and validated against experimental data and tested in the primary modes of spinal motion in the intact condition. Once a ligament was removed, stress increased in the remaining spinal ligaments and changes occurred in vertebral strain energy, but disc pressure remained similar. All major biomechanical changes occurred at the same spinal level as the transected ligament, with minor changes at adjacent levels. This work demonstrates that iatrogenic damage to spinal ligaments disturbs the load sharing within the spinal ligament network and may induce significant clinically relevant changes in the spinal motion segment.