The Mechanical Properties of the Human L4–5 Functional Spinal Unit During Cyclic Loading

Asano, Satoshi; Kaneda, Kiyoshi; Umehara, Shinji; Tadano, Shigeru

doi:10.1097/00007632-199211000-00014

Cited by 56 publications

(20 citation statements)

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“…In the lumbar region, the facet joints are inclined to a nearly vertical orientation, and are curvilinear, 31 a shape that highlights their role in preventing rotation as well as forward displacement; an average of only 8° rotation is allowed in the lumbar spine, limited primarily by the facet joints. 31–33 …”

Section: Anatomy and Biomechanicsmentioning

confidence: 99%

Osteoarthritis of the spine: the facet joints

2012

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Osteoarthritis (OA) of the spine involves the facet joints, which are located in the posterior aspect of the vertebral column and, in humans, are the only true synovial joints between adjacent spinal levels. Facet joint osteoarthritis (FJ OA) is widely prevalent in older adults, and is thought to be a common cause of back and neck pain. The prevalence of facet-mediated pain in clinical populations increases with increasing age, suggesting that FJ OA might have a particularly important role in older adults with spinal pain. Nevertheless, to date FJ OA has received far less study than other important OA phenotypes such as knee OA, and other features of spine pathoanatomy such as degenerative disc disease. This Review presents the current state of knowledge of FJ OA, including relevant anatomy, biomechanics, epidemiology, and clinical manifestations. We present the view that the modern concept of FJ OA is consonant with the concept of OA as a failure of the whole joint, and not simply of facet joint cartilage.

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Section: Anatomy and Biomechanicsmentioning

confidence: 99%

Osteoarthritis of the spine: the facet joints

2012

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“…We also corrected for the absence of posterior elements in our finite element models by accounting for the 26% load-bearing contribution of the facets under axial compression when still attached within the continuum of a spinal segment. 30,31 The new definition of the 3 fracture risk groups are: high-risk group with ultimate stress less than 1.6 MPa and fracture risk of 100%, medium-risk group with ultimate stress from 1.6 to 2.7 MPa, and low-risk group with stress greater than 2.7 MPa and fracture risk near 0%. For posterolateral vertebroplasty approaches, reinforcement of vertebral bodies, with average QCT densities below 0.048 g/cm 3 require about 30% PMMA volume fill in order to achieve success in improving vertebral stress from high fracture risk levels to over 2.7 MPa, into the low-risk zone, whereas only 20% PMMA fill was needed for a bipedicular case.…”

Section: Optimal Polymethyl Methacrylate Volumementioning

confidence: 99%

Biomechanics of Prophylactic Vertebral Reinforcement

Sun

Liebschner

2004

Spine

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Prophylactic vertebroplasty can be effective in reducing fracture risk. However, for the polymethyl methacrylate volume (20%) required for the successful reinforcement of high-risk vertebral bodies, the risk of complications will be as high as that for current vertebroplasty procedure for fracture repair. Therefore, alternative materials have to be investigated for prophylactic vertebroplasty. Furthermore, bipedicular vertebroplasty is the recommended approach due to its higher strengthening effect and easier surgical access than the posterolateral case.

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“…[62] Biomechanical studies on cadavers demonstrate that the posterior ligaments, notably the supraspinous and interspinous ligaments, exert a significant effect on tensile stiffness. [4] The neural foramen is bordered by the superior and inferior articular processes and pars interarticularis of the superior vertebra dorsally, sequential pedicles superiorly and inferiorly, and the intervertebral disc and the posterolateral surface of the vertebral body ventrally. The nerve root exists caudal to the pedicle, and the dorsal root ganglion lies in the superior and lateral portion of the foramen.…”

Section: Anatomical Characteristicsmentioning

confidence: 99%

“…[10,28,32,50] Surgical removal of the posterior elements during decompressive laminectomy or hemilaminectomy places additional load on the disc and may accelerate degeneration. [4,30,47,51] Postoperative progressive slippage as a result of segmental instability often leads to recurrent symptomatic spinal stenosis. [26] Brodsky [10] evaluated a series of 552 patients with lumbar stenosis and determined that nearly half (41%) had undergone previous laminectomy or fusion procedures.…”

Section: Pathological Characteristicsmentioning

confidence: 99%

Posterior lumbar interbody fusion in the treatment of symptomatic spinal stenosis

Coric

Branch²

1997

FOC

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Lumbar spinal stenosis is often the result of advanced degeneration of motion segments of the lumbar spine. Loss of disc height, facet displacement and hypertrophy, spondylosis, and spondylolisthesis, as well as buckling of the ligamentum flavum and annulus fibrosus, all contribute to impingement on the spinal canal and intervertebral foramen in lumbar stenosis. There is a subgroup of patients with spinal stenosis in whom the spine is unstable preoperatively or becomes destabilized following decompression who would benefit from an initial fusion procedure. Posterior lumbar interbody fusion (PLIF) addresses several aspects of the multifactorial pathophysiology responsible for spinal stenosis and may arrest the degenerative changes at the fused level. Fusion, in particular PLIF, should be considered in complex cases of lumbar spinal stenosis, most notably in patients with postlaminectomy stenosis or stenosis associated with spondylolisthesis.

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The Mechanical Properties of the Human L4–5 Functional Spinal Unit During Cyclic Loading

Cited by 56 publications

References 0 publications

Osteoarthritis of the spine: the facet joints

Osteoarthritis of the spine: the facet joints

Biomechanics of Prophylactic Vertebral Reinforcement

Posterior lumbar interbody fusion in the treatment of symptomatic spinal stenosis

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