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Hayward S, Keogh PS, Miles AW, Gheduzzi S. The effect of structural changes on the low strain rate behaviour of the intervertebral disc. Proc Inst Mech Eng H 2024:9544119241272915. [PMID: 39180367 DOI: 10.1177/09544119241272915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2024]
Abstract
The annuus fibrosus (AF) and nucleus pulposus (NP) of the intervertebral disc (IVD) work in conjunction to dissipate spinal loads. In this study we have isolated the contribution of the NP to the overall response of the disc and investigated the effect of extreme structural changes to the disc on the mechanical behaviour. Linear stiffness, overall load range, hysteresis area and total energy were used to evaluate the impact of these changes on the spine and surrounding structures. Six porcine lumbar isolated disc specimens were tested in 6 DOFs with a 400 N compressive axial preload at low strain rates in three conditions: intact (IN), after total nucleotomy (NN) and after the injection of bone cement into the nuclear void (SN). The latter two conditions, NN and SN, were chosen to emulate the effect of extreme changes to the NP on disc behaviour. When comparing with intact specimens, significant changes were noted primarily in axial compression-extension, mediolateral bending and flexion-extension. NN and SN cases demonstrated significant increases in linear stiffness, overall load range and total energy for mediolateral bending and flexion-extension compared to the intact (IN) state. SN also demonstrated a significant increase in total energy for axial compression-extension, and significant decreases in the elastic contribution to total energy in all axes except flexion-extension. These changes to total energy indicate that surrounding spinal structures would incur additional loading to produce the same motion in vivo after structural changes to the disc.
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Affiliation(s)
- Samantha Hayward
- Department of Mechanical Engineering, University of Bath, Bath, UK
| | - Patrick S Keogh
- Department of Mechanical Engineering, University of Bath, Bath, UK
| | - Anthony W Miles
- Department of Mechanical Engineering, University of Bath, Bath, UK
| | - Sabina Gheduzzi
- Department of Mechanical Engineering, University of Bath, Bath, UK
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2
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Lu Y, Cheng L, Zhu H. Influence of nucleotomy on the load sharing in the spinal facet joint under the loading scenarios of different human postures. Med Eng Phys 2021; 93:35-41. [PMID: 34154773 DOI: 10.1016/j.medengphy.2021.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 03/02/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Abstract
One-in-five people suffer from chronic low back pain (LBP). The incidence of this disease has doubled since 1950s and affects not only the elderly, but also the young population. However, the mechanism of LBP is still unknown. A possible location where the LBP may develop is the facet joint and it has been revealed that the intervertebral disc (IVD) nucleotomy may be a trigger for LBP. The aim of the present study was to investigate the influence of IVD nucleotomy on the load sharing in the spinal facet joint under the loading scenarios of different postures. Finite element (FE) models of the intact and nucleotomised L4 - L5 spinal segments were generated from the clinical CT images. Seven human postures, including upright, 5° extension, 5° flexion, ± 6° lateral bending and ± 2° axial rotation, were simulated. The resultant forces in the fact joint were compared between the intact and the nucleotomised cases. It was revealed that the IVD nucleotomy significantly increased the forces in the facet joints under the loading scenarios of upright, 5° extension and 5° flexion. The IVD nucleotomy increased the force in the ipsilateral facet joint but decreased the force on the contralateral side under the loading scenarios of ± 2° axial rotation. However, the IVD nucleotomy made little influence on the resultant forces in both facet joints in the postures of ± 6° lateral bending. In conclusion, the IVD nucleotomy can cause an increase in the overall force in the facet joint, and thus may serve as a possible explanation for the LBP and a main contributing factor for the pain complaints.
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Affiliation(s)
- Yongtao Lu
- Department of Engineering Mechanics, Dalian University of Technology, Dalian 116024, China; State Key Laboratory of Structural Analysis for Industrial Equipment, Dalian University of Technology, Dalian 116024, China; DUT-BSU Joint Institute, Dalian University of Technology, Dalian, China.
| | - LiangLiang Cheng
- Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.
| | - Hanxing Zhu
- School of Engineering, Cardiff University, Queen's Buildings, the Parade, CF24 3AA Cardiff, UK
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Goehre F, Ludtka C, Hamperl M, Friedmann A, Straube A, Mendel T, Heilmann A, Meisel HJ, Schwan S. Micro-computed tomography, scanning electron microscopy and energy X-ray spectroscopy studies of facet joint degeneration: A comparison to clinical imaging. Micron 2017; 100:50-59. [DOI: 10.1016/j.micron.2017.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 04/25/2017] [Accepted: 04/25/2017] [Indexed: 11/28/2022]
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Monaco LA, DeWitte-Orr SJ, Gregory DE. A comparison between porcine, ovine, and bovine intervertebral disc anatomy and single lamella annulus fibrosus tensile properties. J Morphol 2015; 277:244-51. [PMID: 26558749 DOI: 10.1002/jmor.20492] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 08/14/2015] [Accepted: 10/18/2015] [Indexed: 01/06/2023]
Affiliation(s)
- Lauren A. Monaco
- Department of Biology; Wilfrid Laurier University; 75 University Ave West Waterloo Ontario Canada
| | - Stephanie J. DeWitte-Orr
- Department of Biology; Wilfrid Laurier University; 75 University Ave West Waterloo Ontario Canada
- Department of Health Sciences; Wilfrid Laurier University; 75 University Ave West Waterloo Ontario Canada
| | - Diane E. Gregory
- Department of Health Sciences; Wilfrid Laurier University; 75 University Ave West Waterloo Ontario Canada
- Department of Kinesiology and Physical Education; Wilfrid Laurier University; 75 University Ave West Waterloo Ontario Canada
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Hartman RA, Yurube T, Ngo K, Merzlak NE, Debski RE, Brown BN, Kang JD, Sowa GA. Biological responses to flexion/extension in spinal segments ex-vivo. J Orthop Res 2015; 33:1255-64. [PMID: 25865090 DOI: 10.1002/jor.22900] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 03/10/2015] [Indexed: 02/04/2023]
Abstract
Mechanical loading is a salient factor in the progression of spinal disorders that contribute to back pain. Biological responses to loading modes like flexion/extension (F/E) in relevant spinal tissues remain unstudied. A novel, multi-axial experimental system was developed to subject viable functional spinal units (FSUs) to complex, in-situ loading. The objective was to determine biological effects of F/E in multiple spinal tissues-annulus fibrosus, nucleus pulposus, facet cartilage, and ligamentum flavum. Rabbit lumbar FSUs were mounted in a bioreactor within a robotic testing system. FSUs underwent small (0.17/0.05 Nm) and large (0.5/0.15 Nm) range-of-motion F/E for 1 or 2 h of cycling. Outcomes in each tissue, compared to unloaded FSUs, included (i) relative mRNA expression of catabolic (MMP-1, 3 and ADAMTS-5), pro-inflammatory (COX-2), and anabolic (ACAN) genes and (ii) immunoblotting of aggrecan degradation. Total energy applied to FSUs increased in groups subject to large range-of-motion and 2-h cycling, and moment relaxation was higher with large range-of-motion. F/E significantly modulated MMP1,-3 and COX-2 in facet cartilage and MMP-3 and ACAN in annulus fibrosus. Large range-of-motion loading increased MMP-mediated aggrecan fragmentation in annulus fibrosus. Biological responses to complex loading ex vivo showed variation among spinal tissues that reflect tissue structure and mechanical loading in F/E.
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Affiliation(s)
- Robert A Hartman
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, 3471 5th Avenue, Pittsburgh, Pennsylvania, 15213.,Department of Bioengineering, University of Pittsburgh, 300 Technology Drive, 360B Center for Bioengineering, Pittsburgh, Pennsylvania, 15219
| | - Takashi Yurube
- Department of Orthopaedic Surgery, University of Pittsburgh, 200 Lothrop Street, E1641 Biomedical Science Tower, Pittsburgh, Pennsylvania, 15261
| | - Kevin Ngo
- Department of Orthopaedic Surgery, University of Pittsburgh, 200 Lothrop Street, E1641 Biomedical Science Tower, Pittsburgh, Pennsylvania, 15261
| | - Nicolas E Merzlak
- Department of Orthopaedic Surgery, University of Pittsburgh, 200 Lothrop Street, E1641 Biomedical Science Tower, Pittsburgh, Pennsylvania, 15261
| | - Richard E Debski
- Department of Bioengineering, University of Pittsburgh, 300 Technology Drive, 360B Center for Bioengineering, Pittsburgh, Pennsylvania, 15219.,Department of Orthopaedic Surgery, University of Pittsburgh, 200 Lothrop Street, E1641 Biomedical Science Tower, Pittsburgh, Pennsylvania, 15261
| | - Bryan N Brown
- Department of Bioengineering, University of Pittsburgh, 300 Technology Drive, 360B Center for Bioengineering, Pittsburgh, Pennsylvania, 15219.,McGowan Institute for Regenerative Medicine, 450 Technology Drive, Suite 300, Pittsburgh, Pennsylvania, 15219
| | - James D Kang
- Department of Orthopaedic Surgery, University of Pittsburgh, 200 Lothrop Street, E1641 Biomedical Science Tower, Pittsburgh, Pennsylvania, 15261
| | - Gwendolyn A Sowa
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, 3471 5th Avenue, Pittsburgh, Pennsylvania, 15213.,Department of Bioengineering, University of Pittsburgh, 300 Technology Drive, 360B Center for Bioengineering, Pittsburgh, Pennsylvania, 15219.,Department of Orthopaedic Surgery, University of Pittsburgh, 200 Lothrop Street, E1641 Biomedical Science Tower, Pittsburgh, Pennsylvania, 15261
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Ivicsics MF, Bishop NE, Püschel K, Morlock MM, Huber G. Increase in facet joint loading after nucleotomy in the human lumbar spine. J Biomech 2014; 47:1712-7. [PMID: 24661835 DOI: 10.1016/j.jbiomech.2014.02.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 02/12/2014] [Accepted: 02/13/2014] [Indexed: 11/25/2022]
Abstract
Low-back pain has been related to degenerative changes after nucleotomy. Although several etiologies for pain after nucleotomy have been proposed, there is evidence of pain arising in the facet joints in general, which may be related to changes in load transfer. This study addresses the effect of nucleotomy on facet joint loading. Nine human lumbar motion segments (age: 40-59 years) were loaded in axial compression and extension-flexion. Reaction forces were compared with soft tissue structures sequentially removed. After nucleotomy the facets supported significantly greater load, almost doubling from a median of 8.6% of the applied external force to 15.8%. Force transmission related to the capsular ligament increased significantly from an intact median of 1.2-5.1% after nucleotomy. No correlation was observed between force increase on the facets and the proportion of disc nucleus removed. Even a small quantity of nucleus removal (range: 0.7-1.7g) increased the forces transmitted over the facet joints, both with and without capsular ligaments. This suggests that the proportion of material removed might not be important clinically with regard to facet joint degeneration and pain.
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Affiliation(s)
- M F Ivicsics
- Institute of Biomechanics, TUHH Hamburg University of Technology, Denickestrasse 15, 21073 Hamburg, Germany.
| | - N E Bishop
- Institute of Biomechanics, TUHH Hamburg University of Technology, Denickestrasse 15, 21073 Hamburg, Germany
| | - K Püschel
- Department of legal medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M M Morlock
- Institute of Biomechanics, TUHH Hamburg University of Technology, Denickestrasse 15, 21073 Hamburg, Germany
| | - G Huber
- Institute of Biomechanics, TUHH Hamburg University of Technology, Denickestrasse 15, 21073 Hamburg, Germany
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