Influence of spine morphology on intervertebral disc loads and stresses in asymptomatic adults: implications for the ideal spine

Keller, Tony S.; Colloca, Christopher J.; Harrison, Deed E.; Harrison, Donald D.; Janik, Tadeusz J.

doi:10.1016/j.spinee.2004.10.050

Cited by 154 publications

(128 citation statements)

References 68 publications

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“…However, the two largest modes of variation found here, 'curviness' (M1) and 'evenness' (M2), describe a similar variation to that previously described [1,3]. Although there is a large variation in spinal shapes between individuals [1,3,[24][25][26], these two modes capture most of this variation and account for between 84 % [1], 91 % [3] and, in this study, 90 % of the total variance. The factors that may underpin the variation in spinal shapes between individuals and possible biomechanical and clinical implications have been discussed previously [3].…”

Section: Discussionsupporting

confidence: 84%

The lumbar spine has an intrinsic shape specific to each individual that remains a characteristic throughout flexion and extension

et al. 2014

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Purpose We have previously shown that the lumbar spine has an intrinsic shape specific to the individual and characteristic of sitting, standing and supine postures. The purpose of this study was to test the hypothesis that this intrinsic shape is detectable throughout a range of postures from extension to full flexion in healthy adults. Methods Sagittal images of the lumbar spine were taken using a positional MRI with participants (n = 30) adopting six postures: seated extension, neutral standing, standing with 30, 45 and 60°and full flexion. Active shape modelling (ASM) was used to identify and quantify 'modes' of variation in the shape of the lumbar spine. Results ASM showed that 89.5 % of the variation in the shape of the spine could be explained by the first two modes; describing the overall curvature and the distribution of curvature of the spine. Mode scores were significantly correlated between all six postures (modes 1-9, r = 0.4-0.97, P \ 0.05), showing that an element of intrinsic shape was maintained when changing postures. The spine was most even in seated extension (P \ 0.001) and most uneven between 35 and 45°flexion (P \ 0.05). Conclusions This study shows that an individual's intrinsic lumbar spine shape is quantifiable and detectable throughout lumbar flexion and extension. These findings will enable the role of lumbar curvature in injury and low back pain to be assessed in the clinic and in the working and recreational environments.

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Section: Discussionsupporting

confidence: 84%

The lumbar spine has an intrinsic shape specific to each individual that remains a characteristic throughout flexion and extension

et al. 2014

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“…Since the barycentremetric study by Duval-Beaupere et al, 6 researchers have attempted to further study the impact of sagittal plane alignment on biomechanical loads and degenerative changes of the spine. 5,8,12,[17][18][19] Several methods have been developed to identify the location the center of gravity in the context of spine-related research. In 1992, Duval-Beaupere et al described a method 6 based on a gamma-ray scanner prototype that was combined with lateral radiography.…”

Section: Relationship Between Spinopelvic and Compensatory Parametersmentioning

confidence: 99%

Role of pelvic translation and lower-extremity compensation to maintain gravity line position in spinal deformity

Ferrero

Liabaud

Challier

et al. 2016

SPI

110

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OBJECT Previous forceplate studies analyzing the impact of sagittal-plane spinal deformity on pelvic parameters have demonstrated the compensatory mechanisms of pelvis translation in addition to rotation. However, the mechanisms recruited for this pelvic rotation were not assessed. This study aims to analyze the relationship between spinopelvic and lower-extremity parameters and clarify the role of pelvic translation. METHODS This is a retrospective study of patients with spinal deformity and full-body EOS images. Patients with only stenosis or low-back pain were excluded. Patients were grouped according to T-1 spinopelvic inclination (T1SPi): sagittal forward (forward, > 0.5°), neutral (−6.3° to 0.5°), or backward (< −6.3°). Pelvic translation was quantified by pelvic shift (sagittal offset between the posterosuperior corner of the sacrum and anterior cortex of the distal tibia), hip extension was measured using the sacrofemoral angle (SFA; the angle formed by the middle of the sacral endplate and the bicoxofemoral axis and the line between the bicoxofemoral axis and the femoral axis), and chin-brow vertical angle (CBVA). Univariate and multivariate analyses were used to compare the parameters and correlation with the Oswestry Disability Index (ODI). RESULTS In total, 336 patients (71% female; mean age 57 years; mean body mass index 27 kg/m2) had mean T1SPi values of −8.8°, −3.5°, and 5.9° in the backward, neutral, and forward groups, respectively. There were significant differences in the lower-extremity and spinopelvic parameters between T1SPi groups. The backward group had a normal lumbar lordosis (LL), negative SVA and pelvic shift, and the largest hip extension. Forward patients had a small LL and an increased SVA, with a large pelvic shift creating compensatory knee flexion. Significant correlations existed between lower-limb parameter and pelvic shift, pelvic tilt, T-1 pelvic angle, T1SPi, and sagittal vertical axis (0.3 < r < 0.8; p < 0.001). ODI was significantly correlated with knee flexion and pelvic shift. CONCLUSIONS This is the first study to describe full-body alignment in a large population of patients with spinal pathologies. Furthermore, patients categorized based on T1SPi were found to have significant differences in the pelvic shift and lower-limb compensatory mechanisms. Correlations between lower-limb angles, pelvic shift, and ODI were identified. These differences in compensatory mechanisms should be considered when evaluating and planning surgical intervention for adult patients with spinal deformity.

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“…Prior musculoskeletal models have incorporated the thorax as a single rigid segment [2], have neglected the mechanical contribution of the ribs and sternum [2][3][4][5], or have lacked an anatomically realistic model of the rib cage [6], making them unsuitable for predicting thoracic skeletal and muscular loading. A few prior models included an articulated thoracic spine, but not the rib cage or the detailed thoracic musculature [3,5,[7][8][9]. In addition, these prior models were not validated against in vivo measures of spine and trunk muscle loading, and were only used to assess vertebral loading during a neutral standing posture.…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Musculoskeletal Model of the Fully Articulated Thoracolumbar Spine and Rib Cage

Bruno

Bouxsein

Anderson

2015

Journal of Biomechanical Engineering

157

168

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We developed and validated a fully articulated model of the thoracolumbar spine in OPENSIM that includes the individual vertebrae, ribs, and sternum. To ensure trunk muscles in the model accurately represent muscles in vivo, we used a novel approach to adjust muscle cross-sectional area (CSA) and position using computed tomography (CT) scans of the trunk sampled from a community-based cohort. Model predictions of vertebral compressive loading and trunk muscle tension were highly correlated to previous in vivo measures of intradiscal pressure (IDP), vertebral loading from telemeterized implants and trunk muscle myoelectric activity recorded by electromyography (EMG).

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Influence of spine morphology on intervertebral disc loads and stresses in asymptomatic adults: implications for the ideal spine

Cited by 154 publications

References 68 publications

The lumbar spine has an intrinsic shape specific to each individual that remains a characteristic throughout flexion and extension

The lumbar spine has an intrinsic shape specific to each individual that remains a characteristic throughout flexion and extension

Role of pelvic translation and lower-extremity compensation to maintain gravity line position in spinal deformity

Development and Validation of a Musculoskeletal Model of the Fully Articulated Thoracolumbar Spine and Rib Cage

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