Kinematics of the Spine Under Healthy and Degenerative Conditions: A Systematic Review

Widmer, Jonas; Fornaciari, Paolo; Senteler, Marco; Roth, Tabitha; Snedeker, Jess G.; Farshad, Mazda

doi:10.1007/s10439-019-02252-x

Cited by 37 publications

(34 citation statements)

References 134 publications

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“…Lastly, in order to compare against the literature, the percentage contribution at maximum bend (MS@max) was also computed. These were compared between groups and with a systematic review of spinal kinematics by Widmer et al 2019 (Widmer, Fornaciari et al 2019)…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have examined intervertebral motion sharing during dynamic flexion and return tasks and none that can be compared directly. However, Widmer et al ( 2019) (Widmer, Fornaciari et al 2019) recently presented a review of studies of lumbar kinematics and reported the segmental contributions to flexion from multiple studies. On the whole, two different types of segmental contribution profiles (spinal rhythms) were established.…”

Section: Comparison With the Literaturementioning

confidence: 99%

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Dynamic interactions between lumbar intervertebral motion segments during forward bending and return

Breen

2020

Journal of Biomechanics

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Section: Discussionmentioning

confidence: 99%

Section: Comparison With the Literaturementioning

confidence: 99%

Dynamic interactions between lumbar intervertebral motion segments during forward bending and return

Breen

2020

Journal of Biomechanics

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“…As a consequence, however, coupled motion in the x-y plane are possible, allowing for small changes in movement patterns after each resection step, which could result in a slight over-or underestimation of the contribution due to the resection sequence. Despite this limitation, the semi-constrained setup was favored over a completely constrained setup to allow for pure moment and pure force generation, which we believe is necessary to resemble the in-vivo kinematics adequately [33]. A completely un-constrained test setup (as proposed by other authors for biomechanical testing of the spine [34]) allows for complex, three-dimensional coupled motions, which can be of great relevance in certain biomechanical experiment but introduce more uncontrolled parameters.…”

Section: Limitationsmentioning

confidence: 99%

Biomechanical contribution of spinal structures to stability of the lumbar spine—novel biomechanical insights

et al. 2020

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BACKGROUND CONTEXT: The contribution of anatomical structures to the stability of the spine is of great relevance for diagnostic, prognostic and therapeutic evaluation of spinal pathologies. Although a plethora of literature is available, the contribution of anatomical structures is still not well understood. PURPOSE: We aimed to quantify the biomechanical relevance of each of the passive spinal structure trough deliberate biomechanical test series using a stepwise reduction approach on cadavers. STUDY DESIGN: Biomechanical cadaveric study. METHODS: Fifty lumbar spinal segments originating from 22 human lumbar cadavers were biomechanically tested in a displacement-controlled stepwise reduction study: the intertransverse ligaments, the supraspinous and interspinous ligaments, the facet joint capsules (FJC), the facet joints (FJ), the ligamentum flavum (LF), the posterior longitudinal ligament (PLL), and the anterior longitudinal ligament were subsequently reduced. In the intact state and after each transection step, the segments were physiologically loaded in flexion, extension, axial rotation (AR), lateral bending (LB) and with anterior (AS), posterior (PS) and lateral shear (LS). Thirty-two specimens with only minor degeneration, representing a reasonably healthy subpopulation, were selected for the here presented evaluation. Quantitative values for load and spinal level dependent contribution patterns for the anatomical structures were derived. RESULTS: Small variability between of the contribution patterns are observed. The intervertebral disc (IVD) is exposed to about 67% of the applied load in LB and during shear loading, but less by load in flexion, extension and AR (less than 35%). The FJ&FJC are the main stabilizers in AR with 49%, but provide only 10% of the stability in extension. Beside the IVD, the LF and the PLL contribute mainly in flexion (22% and 16%, respectively), while the ALL plays a major role during extension (40%) and also contributes during LB (15%). The contribution of the intertransverse ligaments and the supraspinous and interspinous ligaments are very small in all loading directions (<2% and <6%, respectively). CONCLUSION: The IVD takes the main load in LB and absorbs shear loading, while the FJ&FJC stabilize AR. The ALL resists extension while LF and PLL stabilize flexion. With the small variability of contribution patterns, suggesting distinct adaptation of the structures to one another, the biomechanical characteristics of one structure have to be put in context of the whole spinal segment.

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“…Changes in (lumbar) spinal kinematics have been observed following surgical procedures (spondylodesis using different techniques (Nomoto et al 2019), facetectomy (Zeng et al 2017), implantation of disk prothesis (Yue et al 2019) or pedicle screw-based dynamic implants (Prud'homme et al 2015)), but do also occur naturally due to degeneration or trauma (Amevo et al 1992) as well as in obese patients (Rodriguez-Martinez et al 2016). In addition, several studies, in vitro and in vivo, have been conducted to analyze lumbar spinal kinematics and to determine the centrode under healthy and degenerative conditions, see (Widmer et al 2019) for a review. So far, however, there exists neither mechanistic nor statistical criteria linking the mere observation to a quantitative kinematic assessment, let alone to predicting the effects of surgical interventions.…”

Section: Centrodes From a Medical Point Of Viewmentioning

confidence: 99%

“…(1) recognizing general patterns in order to "give base-line references for potential diagnostic applications" (Aiyangar et al 2017), "predicting...injurious vectors" (Qiu et al 2003), and finding an "indicator for mechanical disorders" (Schmidt et al 2008) or "motion characteristics of the normal lumbar spine" (Yoshioka et al 1990), (2) evaluating "the quality, rather than the quantity, of cervical spine movement" (Baillargeon and Anderst 2013), (3) hoping for the ICR to be "interpreted in terms of...anatomical and pathological factors" (Bogduk et al 1995), (4) describing the change in ICR location as a consequence of disk degeneration (Cossette et al 1971;Ellingson and Nuckley 2015;Gertzbein et al 1985), (5) attempting to relate the ICR location to the "choice of anterior and posterior instrumentation" (Haher et al 1991) or certain implant parameters (Niosi et al 2006), (6) demonstrating that "analysis for sagittal plane motion of the lumbar spine is possible" (Ogston et al 1986), and 7correlating ICR paths to facet forces (Rousseau et al 2006). However, a recent review (Widmer et al 2019) had revealed that, up to now, the ICR provides only faint criteria for the description of spinal kinematics under healthy and degenerative conditions.…”

Section: Introductionmentioning

confidence: 99%

Muscle-driven and torque-driven centrodes during modeled flexion of individual lumbar spines are disparate

Rockenfeller

Müller

Damm

et al. 2020

Biomech Model Mechanobiol

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Lumbar spine biomechanics during the forward-bending of the upper body (flexion) are well investigated by both in vivo and in vitro experiments. In both cases, the experimentally observed relative motion of vertebral bodies can be used to calculate the instantaneous center of rotation (ICR). The timely evolution of the ICR, the centrode, is widely utilized for validating computer models and is thought to serve as a criterion for distinguishing healthy and degenerative motion patterns. While in vivo motion can be induced by physiological active structures (muscles), in vitro spinal segments have to be driven by external torque-applying equipment such as spine testers. It is implicitly assumed that muscle-driven and torque-driven centrodes are similar. Here, however, we show that centrodes qualitatively depend on the impetus. Distinction is achieved by introducing confidence regions (ellipses) that comprise centrodes of seven individual multi-body simulation models, performing flexion with and without preload. Muscle-driven centrodes were generally directed superior–anterior and tail-shaped, while torque-driven centrodes were located in a comparably narrow region close to the center of mass of the caudal vertebrae. We thus argue that centrodes resulting from different experimental conditions ought to be compared with caution. Finally, the applicability of our method regarding the analysis of clinical syndromes and the assessment of surgical methods is discussed.

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Kinematics of the Spine Under Healthy and Degenerative Conditions: A Systematic Review

Cited by 37 publications

References 134 publications

Dynamic interactions between lumbar intervertebral motion segments during forward bending and return

Dynamic interactions between lumbar intervertebral motion segments during forward bending and return

Biomechanical contribution of spinal structures to stability of the lumbar spine—novel biomechanical insights

Muscle-driven and torque-driven centrodes during modeled flexion of individual lumbar spines are disparate

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