The effects of the rib cage on thoracic spine loading are not well studied, but the rib cage may provide stability or share loads with the spine. Intervertebral disc pressure provides insight into spinal loading, but such measurements are lacking in the thoracic spine. Thus, our objective was to examine thoracic intradiscal pressures under applied pure moments, and to determine the effect of the rib cage on these pressures. Human cadaveric thoracic spine specimens were positioned upright in a testing machine, and Dynamic pure moments (0 to ±5 N·m) with a compressive follower load of 400 N were applied in axial rotation, flexion - extension, and lateral bending. Disc pressures were measured at T4-T5 and T8-T9 using needle-mounted pressure transducers, first with the rib cage intact, and again after the rib cage was removed. Changes in pressure vs. moment slopes with rib cage removal were examined. Pressure generally increased with applied moments, and pressure-moment slope increased with rib cage removal at T4-T5 for axial rotation, extension, and lateral bending, and at T8-T9 for axial rotation. The results suggest the intact rib cage carried about 62% and 56% of axial rotation moments about T4-T5 and T8-T9, respectively, as well as 42% of extension moment and 36-43% of lateral bending moment about T4-T5 only. The rib cage likely plays a larger role in supporting moments than compressive loads, and may also play a larger role in the upper thorax than the lower thorax.
This study evaluated between-session reliability of opto-electronic motion capture to measure trunk posture and three-dimensional ranges of motion (ROM). Nineteen healthy participants aged 24-74 years underwent spine curvature, pelvic tilt and trunk ROM measurements on two separate occasions. Rigid four-marker clusters were attached to the skin overlying seven spinous processes, plus single markers on pelvis landmarks. Rigid body rotations of spine marker clusters were calculated to determine neutral posture and ROM in flexion, extension, total lateral bending (left-right) and total axial rotation (left-right). Segmental spine ROM values were in line with previous reports using opto-electronic motion capture. Intraclass correlation coefficients (ICC) and standard error of measurement (SEM) were calculated as measures of between-session reliability and measurement error, respectively. Retroreflective markers showed fair to excellent between-session reliability to measure thoracic kyphosis, lumbar lordosis, and pelvic tilt (ICC = 0.82, 0.63, and 0.54, respectively). Thoracic and lumbar segments showed highest reliabilities in total axial rotation (ICC = 0.78) and flexion-extension (ICC = 0.77-0.79) ROM, respectively. Pelvic segment showed highest ICC values in flexion (ICC = 0.78) and total axial rotation (ICC = 0.81) trials. Furthermore, it was estimated that four or fewer repeated trials would provide good reliability for key ROM outcomes, including lumbar flexion, thoracic and lumbar lateral bending, and thoracic axial rotation. This demonstration of reliability is a necessary precursor to quantifying spine kinematics in clinical studies, including assessing changes due to clinical treatment or disease progression.
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