The in vivo three-dimensional motion of the human lumbar spine during gait

Rozumalski, Adam; Schwartz, Michael H.; Wervey, Roy; Swanson, Andrew N.; Dykes, Daryll C.; Novacheck, Tom F.

doi:10.1016/j.gaitpost.2008.05.005

Cited by 88 publications

(85 citation statements)

References 35 publications

(28 reference statements)

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“…However, the L4-L5 level showed an opposite coupled bending as observed in our study. Rozumalski et al [23] inserted K-wire into the spinous process of a volunteer-individual to perform a voluntary motion of a standing position, but did not report the direction of the coupled bending rotation. Li et al [9] used a similar dual fluoroscopic image technique in a previous study to study quasi-static lumbar axial rotation with no weight in the hands.…”

Section: Discussionmentioning

confidence: 99%

Investigation of coupled bending of the lumbar spine during dynamic axial rotation of the body

et al. 2013

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Purpose Little is known about the coupled motions of the spine during functional dynamic motion of the body. This study investigated the in vivo characteristic motion patterns of the human lumbar spine during a dynamic axial rotation of the body. Specifically, the contribution of each motion segment to the lumbar axial rotation and the coupled bending of the vertebrae during the dynamic axial rotation of the body were analyzed. Methods Eight asymptomatic subjects (M/F, 7/1; age, 40-60 years) were recruited. The lumbar segment of each subject was MRI scanned for construction of 3D models of the vertebrae from L2 to S1. The lumbar spine was then imaged using a dual fluoroscopic system while the subject performed a dynamic axial rotation from maximal left to maximal right in a standing position. The 3D vertebral models and the fluoroscopic images were used to reproduce the in vivo vertebral motion. In this study, we analyzed the primary left-right axial rotation, the coupled left-right bending of each vertebral segment from L2 to S1 levels. ResultsThe primary axial rotations of all segments (L2-S1) followed the direction of the body axial rotation. Contributions of each to the overall segment axial rotation were 6.7°± 3.0°(27.9 %) for the L2-L3, 4.4°± 1.2°( 18.5 %) for the L3-L4, 6.4°± 2.2°(26.7 %) for the L4-L5, and 6.4°± 2.6°(27.0 %) for the L5-S1 vertebral motion segments. The upper segments of L2-L3 and L3-L4 demonstrated a coupled contralateral bending towards the opposite direction of the axial rotation, while the lower segments of L4-L5 and L5-S1 demonstrated a coupled ipsilateral bending motion towards the same direction of the axial rotation. Strong correlation between the primary axial rotation and the coupled bending was found at each vertebral level. We did not observe patterns of coupled flexion/extension rotation with the primary axial rotation. Conclusions This study demonstrated that a dynamic lumbar axial rotation coupling with lateral bendings is segment-dependent and can create a coordinated dynamic coupling to maintain the global dynamic balance of the body. The results could improve our understanding of the normal physiologic lumbar axial rotation and to establish guidelines for diagnosing pathological lumbar motion.

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Section: Discussionmentioning

confidence: 99%

Investigation of coupled bending of the lumbar spine during dynamic axial rotation of the body

et al. 2013

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“…Table 3). The values used to determine the amount of flexionextension motion were taken from Wong et al (2006), while data from Rozumalski et al (2008) were utilized for lateral bending motion. However, these data were normalized to 25 • in accordance with the ROM of the lumbar spine in lateral bending as mentioned in the study by Troke et al (2001).…”

Section: Joint Kinematicsmentioning

confidence: 99%

A Musculoskeletal model for the lumbar spine

Christophy

Senan

Lotz

et al. 2011

Biomech Model Mechanobiol

252

228

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A new musculoskeletal model for the lumbar spine is described in this paper. This model features a rigid pelvis and sacrum, the five lumbar vertebrae, and a rigid torso consisting of a lumped thoracic spine and ribcage. The motion of the individual lumbar vertebrae was defined as a fraction of the net lumbar movement about the three rotational degrees of freedom: flexion-extension lateral bending, and axial rotation. Additionally, the eight main muscle groups of the lumbar spine were incorporated using 238 muscle fascicles with prescriptions for the parameters in the Hill-type muscle models obtained with the help of an extensive literature survey. The features of the model include the abilities to predict joint reactions, muscle forces, and muscle activation patterns. To illustrate the capabilities of the model and validate its physiological similarity, the model's predictions for the moment arms of the muscles are shown for a range of flexion-extension motions of the lower back. The model uses the OpenSim platform and is freely available on https://www.simtk.org/home/lumbarspine to other spinal researchers interested in analyzing the kinematics of the spine. The model can also be integrated with existing OpenSim models to build more comprehensive models of the human body.

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“…Walking causes an axial force which is about 30% higher than that for standing [38]. In addition, the spine is twisted during walking [39]. Thus, walking was simulated by applying a follower load of 650 N and a torsional moment of 7.5 Nm.…”

Section: Loadingmentioning

confidence: 99%

A probabilistic finite element analysis of the stresses in the augmented vertebral body after vertebroplasty

et al. 2010

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Fractured vertebral bodies are often stabilized by vertebroplasty. Several parameters, including fracture type, cement filling shape, cement volume, elastic moduli of cement, cancellous bone and fractured region, may all affect the stresses in the augmented vertebral body and in bone cement. The aim of this study was to determine numerically the effects of these input parameters on the stresses caused. In a probabilistic finite element study, an osteoligamentous model of the lumbar spine was employed. Seven input parameters were simultaneously and randomly varied within appropriate limits for [110 combinations thereof. The maximum von Mises stresses in cancellous and cortical bone of the treated vertebral body L3 and in bone cement were calculated. The loading cases standing, flexion, extension, lateral bending, axial rotation and walking were simulated. In a subsequent sensitivity analysis, the coefficients of correlation and determination of the input parameters on the von Mises stresses were calculated. The loading case has a strong influence on the maximum von Mises stress. In cancellous bone, the median value of the maximum von Mises stresses for the different input parameter combinations varied between 1.5 (standing) and 4.5 MPa (flexion). The ranges of the stresses are large for all loading cases studied. Depending on the loading case, up to 69% of the maximum stress variation could be explained by the seven input parameters. The fracture shape and the elastic modulus of the fractured region have the highest influence. In cortical bone, the median values of the maximum von Mises stresses varied between 31.1 (standing) and 61.8 MPa (flexion). The seven input parameters could explain up to 80% of the stress variation here. It is the fracture shape, which has always the highest influence on the stress variation. In bone cement, the median value of the maximum von Mises stresses varied between 3.8 (standing) and 12.7 MPa (flexion). Up to 75% of the maximum stress variation in cement could be explained by the seven input parameters. Fracture shape, and the elastic moduli of bone cement and of the fracture region are those input parameters with the highest influence on the stress variation. In the model with no fracture, the maximum von Mises stresses are generally low. The present probabilistic and sensitivity study clearly showed that in vertebroplasty the maximum stresses in the augmented vertebral body and in bone cement depend mainly on the loading case and fracture shape. Elastic moduli of cement, fracture region and cancellous bone as well as cement volume have sometimes a moderate effect while number and symmetry of cement plugs have virtually no effect on the maximum stresses.

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The in vivo three-dimensional motion of the human lumbar spine during gait

Cited by 88 publications

References 35 publications

Investigation of coupled bending of the lumbar spine during dynamic axial rotation of the body

Investigation of coupled bending of the lumbar spine during dynamic axial rotation of the body

A Musculoskeletal model for the lumbar spine

A probabilistic finite element analysis of the stresses in the augmented vertebral body after vertebroplasty

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