Prediction of the compressive strength of human lumbar vertebrae

Brinckmann, Paul; Biggemann, M; Hilweg, D

doi:10.1016/0268-0033(89)90071-5

Cited by 150 publications

(79 citation statements)

References 16 publications

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“…7) is well in agreement with published data compiled as the average from L1 to L3 on non-exposed controls [16]. Comparing densities of L3 alone is valid, as previous work [4] has shown that trabecular bone density is close to uniform along the whole lumbar spine. This shows that long-term exposure to whole-body vibration had no general effect on bone density in the lumbar vertebrae.…”

Section: Discussionsupporting

confidence: 90%

“…This finding is in agreement with the literature [4,15,16]. No significant correlation was found between length of exposure and radiological findings including mean disc height and mean water equivalent.…”

Section: Correlationssupporting

confidence: 93%

“…It provided the area of the lower end-plate of L3 (in cm 2 ). Together with bone density, it allowed the compressive strength (in kN) to be predicted with an error of ± 1.06 kN [4].…”

Section: Radiologymentioning

confidence: 99%

“…Altered trabecular bone density and calculated compressive strength of the vertebra is measured by quantitative computed tomography [4] (QCT). Preparatory to the QCT investigation, a lateral scout image was obtained, which served for evaluating disc height according to the method of Farfan (described by Pope and co-workers [23]).…”

Section: Introductionmentioning

confidence: 99%

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Assessment of disc injury in subjects exposed to long-term whole-body vibration

Drerup

Granitzka

Assheuer

et al. 1999

European Spine Journal

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Long-term exposure to whole-body vibration is known to increase the risk of low back problems. The chain of events leading from repeated loading of the lumbar spine to back complaints and the exact nature of the vibration-induced damage are, however, obscure. Fluid in-and outflow as well as viscoelastic deformation are important aspects of the physiological function of the lumbar disc. Precision measurement of stature, termed 'stadiometry', has previously been applied in healthy subjects to document changes in disc height in relation to the load on the lumbar spine. The purpose of this study was to explore the relation between spinal loading and stature in a cohort of 20 subjects with longterm exposure to whole-body vibration. If the change of stature (and thus the change of disc height) caused by changes in spinal loading differed between exposed and normal subjects, this would point to vibration-induced changes in structure and material properties of the discs. For this purpose, four hypotheses were tested: (1) the viscoelastic deformation and fluid exchange of intervertebral discs during phases of spinal loading and unloading differs from normal; (2) the water content of lumbar discs of subjects exposed to long-term wholebody vibration deviates from normal; (3) the mean disc height of the lumbar spine depends on the total time of vibration exposure; (4) repeated loading influences trabecular bone density of vertebrae in the lumbar spine. A cohort of 20 operators of heavy earth-moving machinery was enrolled. Back complaints suspected to be due to long-term exposure (mean 17.6 ± 2.1 years) to wholebody vibration and application for early retirement were the selection criteria used. Change of stature during a regular 8-h shift and change of stature in standing, carrying and sitting activities were measured. The stadiometric investigations were supplemented by magnetic resonance imaging (MRI) of the lumbar spine to assess whether the water content of the discs exhibited deviations from normal. In addition, quantitative computed tomography (QCT) was performed to assess whether the trabecular bone density of the third lumbar vertebra deviated from normal. The results showed no significant difference in change of stature while standing, carrying or sitting between exposed machine operators and non-exposed operators. Likewise, MRI examinations revealed no significant differences in the water content of the discs averaged over the lumbar spine. In addition, QCT examinations revealed no significant difference in the trabecular bone density of the third lumbar vertebra. The study thus revealed no significant difference between a cohort with longterm exposure and non-exposed controls with respect to viscoelastic properties of discs as determined by stadiometry, average water content of lumbar discs and trabecular bone density of L3. Key words

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Section: Discussionsupporting

confidence: 90%

Section: Correlationssupporting

confidence: 93%

“…It provided the area of the lower end-plate of L3 (in cm 2 ). Together with bone density, it allowed the compressive strength (in kN) to be predicted with an error of ± 1.06 kN [4].…”

Section: Radiologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of disc injury in subjects exposed to long-term whole-body vibration

Drerup

Granitzka

Assheuer

et al. 1999

European Spine Journal

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“…Transverse movements were allowed, so segments were able to find their physiological motion patterns and to correct for possible differences in embedding. Segments were loaded with a continuous axial compressive force of 1,600 N [2-4, 24, 26], a force that is compatible with lumbar spine compression forces that occur while moderately bending forward and low enough to avoid damage from compression alone [6]. The force was applied using a pneumatic cylinder that had been calibrated using a load cell (Hottinger Baldwin MesstechnikÓ, Force Transducer Type C2, Darmstadt, Germany).…”

Section: Parametersmentioning

confidence: 99%

Which factors prognosticate rotational instability following lumbar laminectomy?

Bisschop

Kingma²,

Bleys³

et al. 2013

Eur Spine J

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Purpose Reduced strength and stiffness of lumbar spinal motion segments following laminectomy may lead to instability. Factors that predict shear biomechanical properties of the lumbar spine were previously published. The purpose of the present study was to predict spinal torsion biomechanical properties with and without laminectomy from a total of 21 imaging parameters. Method Radiographs and MRI of ten human cadaveric lumbar spines (mean age 75.5, range 59-88 years) were obtained to quantify geometry and degeneration of the motion segments. Additionally, dual X-ray absorptiometry (DXA) scans were performed to measure bone mineral content and density. Facet-sparing lumbar laminectomy was performed either on L2 or L4. Spinal motion segments were dissected (L2-L3 and L4-L5) and tested in torsion, under 1,600 N axial compression. Torsion moment to failure (TMF), early torsion stiffness (ETS, at 20-40 % TMF) and late torsion stiffness (LTS, at 60-80 % TMF) were determined and bivariate correlations with all parameters were established. For dichotomized parameters, independent-sample t tests were used. Results Univariate analyses showed that a range of geometric characteristics and disc and bone quality parameters were associated with torsion biomechanical properties of lumbar segments. Multivariate models showed that ETS, LTS and TMF could be predicted for segments without laminectomy (r 2 values 0.693, 0.610 and 0.452, respectively) and with laminectomy (r 2 values 0.952, 0.871 and 0.932, respectively), with DXA-derived measures of bone quality and quantity as the main predictors. Conclusions Vertebral bone content and geometry, i.e. intervertebral disc width, frontal area and facet joint tropism, were found to be strong predictors of ETS, LTS and TMF following laminectomy, suggesting that these variables could predict the possible development of postoperative rotational instability following lumbar laminectomy. Proposed diagnostic parameters might aid surgical decision-making when deciding upon the use of instrumentation techniques.

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Intervertebral disc disorganisation and its relationship to age adjusted vertebral body morphometry and vertebral bone architecture

2001

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Vertebral deformity, intervertebral disc disorganisation, and change to vertebral bone architecture are morphological features that are associated with low back pain. The purpose of this study was to examine the influence of the morphological disorganisation of the intervertebral disc on vertebral body shape indices and vertebral cancellous bone architecture. Lumbar spines, T12–S1, were collected from 27 cadavers. The motion segments T12–L1, L2–L3 and L4–L5 were selected for the study. There were 8 females aged 35–94 years and 19 males aged 20–90 years. An intervertebral disc grade signifying the severity of disc disorganisation was assigned to each disc using the macroscopic disc grading criteria of Hansson and Roos (Spine, 1981; 6:147–153.). Vertebral shape indices and vertebral body bone histomorphometric analyses were performed on the vertebral bodies. Where appropriate, data were age adjusted and the influence of morphological disc disorganisation on vertebral body deformity and cancellous bone architecture analysed. Increased vertebral body axial area and the ratio of vertebral body axial area to sagittal area were associated with an increase in vertebral deformity and disc disorganisation. This suggests that vertebral deformity that remains clinically silent in the general population is influenced by intervertebral disc disorganisation. Vertebral cancellous bone architecture undergoes change associated with increased disc disorganisation, consistent with increased vertebral deformity. Vertebral bodies adjacent to degenerate discs (Grade 4) showed increased BV/TV and Tb.Th and decreased BS/BV. This shows that disc disorganisation may modulate vertebral cancellous bone architecture such that it protects against age‐related bone changes. In addition, vertebral body wedging and concavity are associated with smaller vertebral body size and vertebral body compression is associated with larger vertebral body size and compromised cancellous bone architecture. Anat Rec 262:331–339, 2001. © 2001 Wiley‐Liss, Inc.

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Prediction of the compressive strength of human lumbar vertebrae

Cited by 150 publications

References 16 publications

Assessment of disc injury in subjects exposed to long-term whole-body vibration

Assessment of disc injury in subjects exposed to long-term whole-body vibration

Which factors prognosticate rotational instability following lumbar laminectomy?

Intervertebral disc disorganisation and its relationship to age adjusted vertebral body morphometry and vertebral bone architecture

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