Low Back Pain

Forell, Gregory A. Von; Stephens, Trevor K.; Samartzis, D; Bowden, Anton E.

doi:10.1097/brs.0000000000000982

Cited by 28 publications

(9 citation statements)

References 54 publications

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“…Our research found that the four types of endplate defects differed in segment distribution, configuration features, and strength of association with the size of MCs. We found that LBP can be accelerated by the increasing prevalence of endplate defects, MCs, and DD, which was in accordance with previous studies [24, 27, 28]. Moreover, we were surprised to find that endplate defect group 1 (focal) was associated with the highest degree of disc degeneration (DD4).…”

Section: Discussionsupporting

confidence: 91%

Relationship between Endplate Defects, Modic Change, Disc Degeneration, and Facet Joint Degeneration in Patients with Low Back Pain

Yuan

Ding

et al. 2019

BioMed Research International

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Purpose. The endplate defects (EDs), Modic changes (MCs), disc degeneration (DD), facet orientation (FO), and facet tropism (FT) were demonstrated to be related to the low back pain (LBP). The aim of this study was to investigate possible correlations between them. Methods. 75 patients were reviewed to evaluate the degenerative change in vertebral bodies (EDs and MCs), intervertebral discs (DD), and facet joint degeneration (FO and FT). All patients were categorized into four groups based on the grade of EDs. Clinical outcomes were evaluated with the visual analog scale (VAS) and Oswestry disability index (ODI) before and after surgery. Results. There was no difference between the four groups in baseline characteristics except for gender and weight. FT is positively correlated with FO. The same rule exists between EDs, the size of MCs II, FO (left) and FO (right), and VAS and ODI. The grade of EDs is positively correlated with the grade of DD. L4-L5 can bear more load than other levels; thus, the grade of EDs is higher than that of other lumbar levels. The preoperative LBP was relieved in all groups in varying degrees. The change of pain and dysfunction is inversely proportional to the grade of EDs in the general trend. Conclusion. The relationship between weight, gender, and disc degeneration provided a mechanism by which increasing weight can predispose to DD. Different grades of EDs had different effects on patients with LBP. There was a significant correlation between EDs, MCs II, DD, FT, and FO.

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Section: Discussionsupporting

confidence: 91%

Relationship between Endplate Defects, Modic Change, Disc Degeneration, and Facet Joint Degeneration in Patients with Low Back Pain

Yuan

Ding

et al. 2019

BioMed Research International

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“…This is particularly interesting considering most of the movement in the sagittal plane is contributed by the lumbar spine as compared to the dominance of thoracic spine motion for the axial and coronal planes [11, 34]. Reason for this lack of sagittal significance can be two-fold.…”

Section: Discussionmentioning

confidence: 99%

The association of lumbar curve magnitude and spinal range of motion in adolescent idiopathic scoliosis: a cross-sectional study

Eyvazov

Samartzis

2017

BMC Musculoskelet Disord

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BackgroundSpinal deformities affect the overall alignment of the spine and thus the vectors of loading on the lumbar region and intervertebral discs. Due to wedging of the disc or vertebrae of unbalanced spinal segments, alignment change may affect the range of motion (ROM) of individual spinal segments or the global spine. This is particularly important in adolescent idiopathic scoliosis (AIS) patients who may suffer from early degeneration, back stiffness and pain. Hence, this study aimed to determine the correlation between spine range of motion (ROM) and adolescent idiopathic scoliosis (AIS) curve magnitude.MethodsConsecutive recruitment of all AIS patients with Lenke 5 (thoracolumbar/lumbar) curves within one month was performed with ROM assessments in the coronal, sagittal and axial planes using the change in C7-S1 distance on standing upright, active flexion and extension positions, change in finger-floor distance on forward bending position and lateral bending, lateral bending angles, modified Schober’s test, and trunk rotation in seating position. Patients were further stratified into two groups based on their lumbar spine curve magnitude: Group A with curves of 10 to 39 degrees and Group B with 40 degrees or greater. Univariate and multivariate analyses were conducted, with lumbar curve magnitude severity being the dependent variable.ResultsIn total, 58 patients (n = 12 males, n = 46 females; mean age: 15.7 years) were recruited. The mean curve magnitudes were 25 ± 6.5 degrees in Group A and 48 ± 10.6 degrees in Group B. Mean axial rotation (Group A: 90 ± 21.7 degree; Group B: 76 ± 19.6 degrees; p = 0.038) and lateral bending ROM (Group A: 67 ± 13.4 degrees; Group B: 58 ± 14.3 degrees; p = 0.045) decreased in more severe curves. These two parameters continued to remain significant irrespective of the curve severity cut-off values.ConclusionsThis is the first study to determine associations between spinal ROM parameters with the lumbar curve magnitude in AIS patients. We found that the coronal curve severity is associated with reduced axial and coronal ROM. This is a platform for future studies assessing lumbar spine biomechanics in AIS and to determine the effects of altered spine motion in this context and its implication in patient management and outcomes.

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“…In this paper we focus on subject-specific finite element (FE) analysis of articular joint contact mechanics. Both generic and subject-specific models of articular contact have been developed and validated to gain insight into load transfer, cartilage mechanics and the etiology of osteoarthritis in the knee (Khoshgoftar et al, 2015; Luczkiewicz et al, 2015), hip (Harris et al, 2012; Henak et al, 2014) ankle (Anderson et al, 2007; Kern and Anderson, 2015) and spine (Dreischarf et al, 2014; Von Forell et al, 2015), among other joints. Despite the progress that has been made in modeling subject-specific joint contact mechanics, many challenges still remain.…”

Section: Introductionmentioning

confidence: 99%

Finite element simulation of articular contact mechanics with quadratic tetrahedral elements

Maas

Ellis

Rawlins

et al. 2016

Journal of Biomechanics

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Although it is easier to generate finite element discretizations with tetrahedral elements, trilinear hexahedral (HEX8) elements are more often used in simulations of articular contact mechanics. This is due to numerical shortcomings of linear tetrahedral (TET4) elements, limited availability of quadratic tetrahedron elements in combination with effective contact algorithms, and the perceived increased computational expense of quadratic finite elements. In this study we implemented both ten-node (TET10) and fifteen-node (TET15) quadratic tetrahedral elements in FEBio (www.febio.org) and compared their accuracy, robustness in terms of convergence behavior and computational cost for simulations relevant to articular contact mechanics. Suitable volume integration and surface integration rules were determined by comparing the results of several benchmark contact problems. The results demonstrated that the surface integration rule used to evaluate the contact integrals for quadratic elements affected both convergence behavior and accuracy of predicted stresses. The computational expense and robustness of both quadratic tetrahedral formulations compared favorably to the HEX8 models. Of note, the TET15 element demonstrated superior convergence behavior and lower computational cost than both the TET10 and HEX8 elements for meshes with similar numbers of degrees of freedom in the contact problems that we examined. Finally, the excellent accuracy and relative efficiency of these quadratic tetrahedral elements was illustrated by comparing their predictions with those for a HEX8 mesh for simulation of articular contact in a fully validated model of the hip. These results demonstrate that TET10 and TET15 elements provide viable alternatives to HEX8 elements for simulation of articular contact mechanics.

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Low Back Pain

Abstract: N/A.

Cited by 28 publications

References 54 publications

Relationship between Endplate Defects, Modic Change, Disc Degeneration, and Facet Joint Degeneration in Patients with Low Back Pain

Relationship between Endplate Defects, Modic Change, Disc Degeneration, and Facet Joint Degeneration in Patients with Low Back Pain

The association of lumbar curve magnitude and spinal range of motion in adolescent idiopathic scoliosis: a cross-sectional study

Finite element simulation of articular contact mechanics with quadratic tetrahedral elements

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