Motion in Lumbar Functional Spine Units During Side Bending and Axial Rotation Moments Depending on the Degree of Degeneration

Krismer, Martin; Haid, Christian; Behensky, H.; Kapfinger, Peter; Landauer, Franz; Rachbauer, Franz

doi:10.1097/00007632-200008150-00004

Cited by 66 publications

(74 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An individualized analysis of each movement shows that the largest increases are detected in axial rotation mobility, in agree with [13,15]. Increased mobility is also more pronounced in extension, which is in agreement with [16,24].…”

Section: Discussionsupporting

confidence: 77%

“…Some authors found an increased range of motion [13], particularly in rotational movements, flexion-extension movements, and combined lateral bending and rotation movements [14]. In [15] is described an increased range of motion especially in axial rotation. In [16] an increase of vertebral displacement and mobility in flexion and extension is found in a group of patients with disc degeneration.…”

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Instability of the lumbar spine due to disc degeneration. A finite element simulation

Ibarz¹,

Más²,

Mateo³

et al. 2013

ABB

View full text Add to dashboard Cite

Low back pain, which most common cause is degenerative disc disease, currently represents a serious problem due to its socio-economic repercussions. Different factors are involved in the degenerative process, being the most common: the loads on the spine, repeated flexion movements and individual genetic characteristics. Nowadays, there is no agreement on whether instability is the main cause of low back pain, or only one reason among many, and on whether increased spinal mobility, associated with instability, occurs either locally or at the lumbar spine as a whole. In this work, the simulation of disc degeneration is based on a finite element model of lumbar spine. A parametric study based on mechanical properties was established, for each lumbar spine movement, by evaluating the disc degeneration in 10% steps, from healthy disc to maximum degeneration. The results show as general trend a progressive mobility increase as the disc degeneration level raises. As main conclusion, disc degeneration causes increased mobility at all vertebral levels, with moderate values for incipient degeneration and much higher values for advanced degeneration, affecting more severely to the levels closest to degenerated disk. The great mobility increase detected at L5 could explain the instability detected as a clinical symptom.

show abstract

Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 98%

Instability of the lumbar spine due to disc degeneration. A finite element simulation

Ibarz¹,

Más²,

Mateo³

et al. 2013

ABB

View full text Add to dashboard Cite

show abstract

“…The hypothesis of increased flexibility for early, mildly degenerated discs was tested in numerous in vitro studies. Some papers have reported an increment in spinal flexibility for mild degeneration [20,41,63] while other investigations have found either an increase in spinal stiffness with progressing degeneration [37,45,78] or a combination of both [50]. Tanaka et al [63] found maximal flexibility in axial rotation in the lower lumbar spine for the grade III of the Thompson scale [64], whereas minimal changes in the spine motion were found in flexion, extension and lateral bending.…”

Section: Flexibilitymentioning

confidence: 99%

“…Both papers showed reduced mobility for severely degenerated spines (grade V). Krismer et al [41] did not analyze flexion-extension, but found increased flexibility of lumbar specimens in axial rotation and lateral bending starting from grade III. On the contrary, a recent study [9] reported increased range of motion only in axial rotation for severely degenerated specimens (grade IV, V), whereas in flexionextension and lateral bending disc degeneration was correlated with decreased flexibility.…”

Section: Flexibilitymentioning

confidence: 99%

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

et al. 2014

View full text Add to dashboard Cite

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.

show abstract

“…Flexibility tests up to 8.5 Nm (Krismer et al 2000) and compression up to 1300 N (Lin et al 1978) were conducted without deterioration of the disc. The first loading consisted in 5 cycles of compression up to 1000 N were applied at 2000 N/min loading rate via a servohydraulic device (MTS, Bionix, USA).…”

Section: Parameters Identification Against Biomechanical Testsmentioning

confidence: 99%

Compressive strength of elderly vertebrae is reduced by disc degeneration and additional flexion

Maquer

Schwiedrzik

Huber

et al. 2015

Journal of the Mechanical Behavior of Biomedical Materials

View full text Add to dashboard Cite

Computer tomography (CT)-based finite element (FE) models assess vertebral strength better than dual energy X-ray absorptiometry. Osteoporotic vertebrae are usually loaded via degenerated intervertebral discs (IVD) and potentially at higher risk under forward bending, but the influences of the IVD and loading conditions are generally overlooked. Accordingly, Magnetic Resonance Imaging was performed on 14 lumbar discs to generate FE models for the healthiest and most degenerated specimens. Compression, torsion, bending, flexion and extension conducted experimentally were used to calibrate both models. They were combined with CT-based FE models of 12 lumbar vertebral bodies to evaluate the effect of disc degeneration compared to a loading via endplates embedded in a stiff resin, the usual experimental paradigm. Compression and lifting were simulated, load and damage pattern were evaluated at failure. Adding flexion to the compression (lifting) and higher disc degeneration reduces the failure load (8-14%, 5-7%) and increases damage in the vertebrae.Under both loading scenarios, decreasing the disc height slightly increases the failure load; embedding and degenerated IVD provides respectively the highest and lowest failure load.Embedded vertebrae are more brittle, but failure loads induced via IVDs correlate highly with vertebral strength. In conclusion, osteoporotic vertebrae with degenerated IVDs are consistently weaker -especially under lifting, but clinical assessment of their strength is possible via FE analysis without extensive disc modelling, by extrapolating measures from the embedded situation.

show abstract

Motion in Lumbar Functional Spine Units During Side Bending and Axial Rotation Moments Depending on the Degree of Degeneration

Abstract: A reduced lumbar disc height in radiographs seems to be associated with fissure formation in the disc. In this case, the range axial rotation after torque is increased in comparison with cases with less degeneration.

Cited by 66 publications

References 15 publications

Instability of the lumbar spine due to disc degeneration. A finite element simulation

Instability of the lumbar spine due to disc degeneration. A finite element simulation

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

Compressive strength of elderly vertebrae is reduced by disc degeneration and additional flexion

Contact Info

Product

Resources

About