Biomechanics of lumbar instability

Krismer, Martin; Haid, Ch.; Ogon, M; Behensky, H.; Wimmer, Cornelius

doi:10.1007/pl00003406

Cited by 8 publications

(8 citation statements)

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“…Changes in SMS mechanical function with mild disk degeneration have been explored both ex vivo and in silico. Ex vivo, some studies confirmed the hypothesis,111213 whereas others, including a comprehensive study with over 200 cadaveric motion segments, demonstrated the opposite (i.e., decreasing range of motion and/or increasing stiffness) 1415. Using a phenomenological finite element (FE) approach, the main characteristics of disk degeneration and their severity were combined to build a variety of motion segment models 16.…”

Section: Indirect Painmentioning

confidence: 95%

Mechanisms of Intervertebral Disk Degeneration/Injury and Pain: A Review

Ito

Creemers

2013

Global Spine Journal

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Degeneration of the intervertebral disk and its treatments are currently intensely investigated topics. Back pain is a condition whose chronic and debilitating nature combined with its prevalence make it a major health issue of substantial socioeconomic importance. Although researchers, and even sometimes clinicians, focus on the degenerated disk as the problem, to most patients, pain is the factor that limits their function and impacts their well-being. The purpose of this review is to delineate the changes associated with disk degeneration and to outline mechanisms by which they could be the source of back pain. Although the healthy disk is only innervated in the external layer of its annulus fibrosus, adjacent structures are plentiful with nociceptive receptors. Stimulation of such structures as a consequence of processes initiated by disk degeneration is explored. The concept of discogenic pain and possible mechanisms such as neoinnervation and solute transport are discussed. Finally, how such pain mechanisms may relate to current and proposed treatment strategies is discussed.

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Section: Indirect Painmentioning

confidence: 95%

Mechanisms of Intervertebral Disk Degeneration/Injury and Pain: A Review

Ito

Creemers

2013

Global Spine Journal

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“…The degenerative process in the disk results in a gradual disruption of the collagen fibers and reduction in the proteoglycan contents, with a gradual loss of water contents and elasticity of the disk (35). More than 50% of autopsy specimens obtained from individuals in their 3rd and 4th decade of life show peripheral tears of the annulus fibrosus (36). After age 40 years, the disk becomes progressively more fibrous and disorganized due to aging and degeneration; the final stage is represented by regions of amorphous fibrocartilage (37).…”

Section: Degenerative Lumbar Intervertebral Instabilitymentioning

confidence: 99%

Lumbar Intervertebral Instability: A Review

Leone¹,

Guglielmi²,

et al. 2007

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Intervertebral instability of the lumbar spine is thought to be a possible pathomechanical mechanism underlying low back pain and sciatica and is often an important factor in determining surgical indication for spinal fusion and decompression. Instability of the lumbar spine, however, remains a controversial and poorly understood topic. At present, much controversy exists regarding the proper definition of the condition, the best diagnostic methods, and the most efficacious treatment approaches. Clinical presentation is not specific, and the relationship between radiologic evidence of instability and its symptoms is controversial. Because of its simplicity, low expense, and pervasive availability, functional flexion-extension radiography is the most thoroughly studied and the most widely used method in the imaging diagnosis of lumbar intervertebral instability. In this article, we provide an overview of the current concepts of vertebral instability, focusing on degenerative lumbar intervertebral instability, and review the different imaging modalities most indicated in diagnosing vertebral instability.

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“…Although these abnormalities may be related to each other, and gradually overlap the physiological ageing course [12], in most of the literature they are described and defined as degenerative disc disease [4,76] and are, therefore, clearly distinct from natural ageing. An analysis of midsagittal sections of cadaveric specimens showed that more than 50 % of intervertebral discs in the third and fourth decade of life exhibit annular tears and fissures [40]. Tears were shown to have different orientations and extents and are classified following the terminology shown in Fig.…”

Section: Structural Changesmentioning

confidence: 99%

Ageing and degenerative changes of the intervertebral disc and their impact on spinal flexibility

et al. 2014

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Purpose Degeneration of the intervertebral disc is associated with various morphological changes of the disc itself and of the adjacent structures, such as reduction of the water content, collapse of the intervertebral space, disruption and tears, and osteophytes. These morphological changes of the disc are linked to alterations of the spine flexibility. This paper aims to review the literature about the ageing and degenerative changes of the intervertebral disc and their link with alterations in spinal biomechanics, with emphasis on flexibility. Methods Narrative literature review. Results Clinical instability of the motion segment, usually related to increased flexibility and hypothesized to be connected to early, mild disc degeneration and believed to be responsible for low back pain, was tested in numerous in vitro studies. Despite some disagreement in the findings, a trend toward spinal stiffening with the increasing degeneration was observed in most studies. Tests about tears and fissures showed inconsistent results, as well as for disc collapse and dehydration. Vertebral osteophytes were found to be effective in stabilizing the spine in bending motions. Conclusions The literature suggests that the degenerative changes of the intervertebral disc and surrounding structures lead to subtle alteration of the mechanical properties of the functional spinal unit. A trend toward spinal stiffening with the increasing degeneration has been observed in most studies.

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Biomechanics of lumbar instability

Cited by 8 publications

References 0 publications

Mechanisms of Intervertebral Disk Degeneration/Injury and Pain: A Review

Mechanisms of Intervertebral Disk Degeneration/Injury and Pain: A Review

Lumbar Intervertebral Instability: A Review

Ageing and degenerative changes of the intervertebral disc and their impact on spinal flexibility

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