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Dimbath ED, Morino C, Middleton S, Kait J, Ortiz-Paparoni M, Slotkin TA, Luck JF, Bass CR'D. Cyclic Mechanism Affects Lumbar Spine Creep Response. Ann Biomed Eng 2024:10.1007/s10439-024-03595-w. [PMID: 39098978 DOI: 10.1007/s10439-024-03595-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/28/2024] [Indexed: 08/06/2024]
Abstract
PURPOSE This study aims to explore how cyclic loading influences creep response in the lumbar spine under combined flexion-compression loading. METHODS Ten porcine functional spinal units (FSUs) were mechanically tested in cyclic or static combined flexion-compression loading. Creep response between loading regimes was compared using strain-time histories and linear regression. High-resolution computed tomography (µCT) visualized damage to FSUs. Statistical methods, ANCOVA and ANOVA, assessed differences in behavior between loading regimes. RESULTS Cyclic and static loading regimes exhibited distinct creep response patterns and biphasic response. ANCOVA and ANOVA analyses revealed significant differences in slopes of creep behavior in both linear phases. Cyclic tests consistently showed endplate fractures in µCT imaging. CONCLUSION The study reveals statistically significant differences in creep response between cyclic and static loading regimes in porcine lumbar spinal units under combined flexion-compression loading. The observed biphasic behavior suggests distinct phases of tissue response, indicating potential shifts in load transfer mechanisms. Endplate fractures in cyclic tests suggest increased injury risk compared to static loading. These findings underscore the importance of considering loading conditions in computational models and designing preventive measures for occupations involving repetitive spinal loading.
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Affiliation(s)
- Elizabeth D Dimbath
- Department of Biomedical Engineering, Duke University, 101 Science Dr, 1427 FCIEMAS Bldg, Box 90281, Durham, NC, 27708, USA.
| | - Concetta Morino
- Department of Biomedical Engineering, Duke University, 101 Science Dr, 1427 FCIEMAS Bldg, Box 90281, Durham, NC, 27708, USA
- Department of Mechanical Engineering and Material Science, Duke University, Durham, NC, 27708, USA
| | - Shea Middleton
- Department of Biomedical Engineering, Duke University, 101 Science Dr, 1427 FCIEMAS Bldg, Box 90281, Durham, NC, 27708, USA
| | - Jason Kait
- Department of Biomedical Engineering, Duke University, 101 Science Dr, 1427 FCIEMAS Bldg, Box 90281, Durham, NC, 27708, USA
| | - Maria Ortiz-Paparoni
- Department of Biomedical Engineering, Duke University, 101 Science Dr, 1427 FCIEMAS Bldg, Box 90281, Durham, NC, 27708, USA
| | - Theodore A Slotkin
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Jason F Luck
- Department of Biomedical Engineering, Duke University, 101 Science Dr, 1427 FCIEMAS Bldg, Box 90281, Durham, NC, 27708, USA
| | - Cameron R 'Dale' Bass
- Department of Biomedical Engineering, Duke University, 101 Science Dr, 1427 FCIEMAS Bldg, Box 90281, Durham, NC, 27708, USA
- Department of Mechanical Engineering and Material Science, Duke University, Durham, NC, 27708, USA
- Department of Biomedical Engineering, Wayne State University, Detroit, MI, USA
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Buchweitz N, Sun Y, Cisewski Porto S, Kelley J, Niu Y, Wang S, Meng Z, Reitman C, Slate E, Yao H, Wu Y. Regional structure-function relationships of lumbar cartilage endplates. J Biomech 2024; 169:112131. [PMID: 38739987 PMCID: PMC11182561 DOI: 10.1016/j.jbiomech.2024.112131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/17/2024] [Accepted: 05/02/2024] [Indexed: 05/16/2024]
Abstract
Cartilage endplates (CEPs) act as protective mechanical barriers for intervertebral discs (IVDs), yet their heterogeneous structure-function relationships are poorly understood. This study addressed this gap by characterizing and correlating the regional biphasic mechanical properties and biochemical composition of human lumbar CEPs. Samples from central, lateral, anterior, and posterior portions of the disc (n = 8/region) were mechanically tested under confined compression to quantify swelling pressure, equilibrium aggregate modulus, and hydraulic permeability. These properties were correlated with CEP porosity and glycosaminoglycan (s-GAG) content, which were obtained by biochemical assays of the same specimens. Both swelling pressure (142.79 ± 85.89 kPa) and aggregate modulus (1864.10 ± 1240.99 kPa) were found to be regionally dependent (p = 0.0001 and p = 0.0067, respectively) in the CEP and trended lowest in the central location. No significant regional dependence was observed for CEP permeability (1.35 ± 0.97 * 10-16 m4/Ns). Porosity measurements correlated significantly with swelling pressure (r = -0.40, p = 0.0227), aggregate modulus (r = -0.49, p = 0.0046), and permeability (r = 0.36, p = 0.0421), and appeared to be the primary indicator of CEP biphasic mechanical properties. Second harmonic generation microscopy also revealed regional patterns of collagen fiber anchoring, with fibers inserting the CEP perpendicularly in the central region and at off-axial directions in peripheral regions. These results suggest that CEP tissue has regionally dependent mechanical properties which are likely due to the regional variation in porosity and matrix structure. This work advances our understanding of healthy baseline endplate biomechanics and lays a groundwork for further understanding the role of CEPs in IVD degeneration.
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Affiliation(s)
- Nathan Buchweitz
- Department of Bioengineering, Clemson University, Clemson, SC, USA.
| | - Yi Sun
- Department of Orthopaedics, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Sarah Cisewski Porto
- Department of Bioengineering, Clemson University, Clemson, SC, USA; School of Health Sciences, College of Charleston, Charleston, SC, USA.
| | - Joshua Kelley
- Department of Bioengineering, Clemson University, Clemson, SC, USA.
| | - Yipeng Niu
- College of Art and Science, New York University, New York City, NY, USA.
| | - Shangping Wang
- Department of Bioengineering, Clemson University, Clemson, SC, USA.
| | - Zhaoxu Meng
- Department of Mechanical Engineering, Clemson University, Clemson, SC, USA.
| | - Charles Reitman
- Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Elizabeth Slate
- Department of Statistics, Florida State University, Tallahassee, FL, USA.
| | - Hai Yao
- Department of Bioengineering, Clemson University, Clemson, SC, USA; Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Yongren Wu
- Department of Bioengineering, Clemson University, Clemson, SC, USA; Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, SC, USA.
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Davis ZR, Gossett PC, Wilson RL, Kim W, Mei Y, Butz KD, Emery NC, Nauman EA, Avril S, Neu CP, Chan DD. Intervertebral Disc Elastography to Relate Shear Modulus and Relaxometry in Compression and Bending. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.01.555817. [PMID: 37732250 PMCID: PMC10508717 DOI: 10.1101/2023.09.01.555817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Intervertebral disc degeneration is the most recognized cause of low back pain, characterized by the decline of tissue structure and mechanics. Image-based mechanical parameters (e.g., strain, stiffness) may provide an ideal assessment of disc function that is lost with degeneration but unfortunately remains underdeveloped. Moreover, it is unknown whether strain or stiffness of the disc may be predicted by MRI relaxometry (e.g. T1 or T2), an increasingly accepted quantitative measure of disc structure. In this study, we quantified T1 and T2 relaxation times and in-plane strains using displacement-encoded MRI within the disc under physiological levels of compression and bending. We then estimated shear modulus in orthogonal image planes and compared these values to relaxation times and strains within regions of the disc. Intratissue strain depended on the loading mode, and shear modulus in the nucleus pulposus was typically an order of magnitude lower than the annulus fibrosis, except in bending, where the apparent stiffness depended on the loading. Relative shear moduli estimated from strain data derived under compression generally did not correspond with those from bending experiments, with no correlations in the sagittal plane and only 4 of 15 regions correlated in the coronal plane, suggesting that future inverse models should incorporate multiple loading conditions. Strain imaging and strain-based estimation of material properties may serve as imaging biomarkers to distinguish healthy and diseased discs. Additionally, image-based elastography and relaxometry may be viewed as complementary measures of disc structure and function to assess degeneration in longitudinal studies.
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Affiliation(s)
- Zachary R. Davis
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Paull C. Gossett
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Robert L. Wilson
- Paul M. Rady Department of Mechanical Engineering, University of Colorado, Boulder, CO, USA
| | - Woong Kim
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Yue Mei
- State Key Laboratory of Structural Analysis for Industrial Equipment and International Research Center for Computational Mechanics, Department of Engineering Mechanics, Dalian University of Technology, Dalian, China
- Mines Saint-Étienne, Université Jean Monnet, INSERM, U 1059 Sainbiose, 42023, SaintÉtienne, France
| | - Kent D. Butz
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA
| | - Nancy C. Emery
- Department of Ecology and Evolutionary Biology, University of Colorado, Boulder, CO, USA
| | - Eric A. Nauman
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA
| | - Stéphane Avril
- Mines Saint-Étienne, Université Jean Monnet, INSERM, U 1059 Sainbiose, 42023, SaintÉtienne, France
| | - Corey P. Neu
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
- Paul M. Rady Department of Mechanical Engineering, University of Colorado, Boulder, CO, USA
- Biomedical Engineering Program, University of Colorado, Boulder, CO, USA
- BioFrontiers Institute, University of Colorado, Boulder, CO, USA
| | - Deva D. Chan
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
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Tavana S, Davis B, Canali I, Scott K, Leong JJH, Freedman BA, Newell N. A novel tool to quantify in vivo lumbar spine kinematics and 3D intervertebral disc strains using clinical MRI. J Mech Behav Biomed Mater 2023; 140:105730. [PMID: 36801782 DOI: 10.1016/j.jmbbm.2023.105730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/27/2023] [Accepted: 02/11/2023] [Indexed: 02/15/2023]
Abstract
Medical imaging modalities that calculate tissue morphology alone cannot provide direct information regarding the mechanical behaviour of load-bearing musculoskeletal organs. Accurate in vivo measurement of spine kinematics and intervertebral disc (IVD) strains can provide important information regarding the mechanical behaviour of the spine, help to investigate the effects of injuries on the mechanics of the spine, and assess the effectiveness of treatments. Additionally, strains can serve as a functional biomechanical marker for detecting normal and pathologic tissues. We hypothesised that combining digital volume correlation (DVC) with 3T clinical MRI can provide direct information regarding the mechanics of the spine. Here, we have developed a novel non-invasive tool for in vivo displacement and strain measurement within the human lumbar spine and we used this tool to calculate lumbar kinematics and IVD strains in six healthy subjects during lumbar extension. The proposed tool enabled spine kinematics and IVD strains to be measured with errors that did not exceed 0.17 mm and 0.5%, respectively. The findings of the kinematics study identified that during extension the lumbar spine of healthy subjects experiences total 3D translations ranging from 1 mm to 4.5 mm for different vertebral levels. The findings of strain analysis identified that the average of the maximum tensile, compressive, and shear strains for different lumbar levels during extension ranged from 3.5% to 7.2%. This tool can provide base-line data that can be used to describe the mechanical environment of healthy lumbar spine, which can help clinicians manage preventative treatments, define patient-specific treatments, and to monitor the effectiveness of surgical and non-surgical interventions.
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Affiliation(s)
- S Tavana
- Department of Bioengineering, Imperial College London, London, UK
| | - B Davis
- Fortius Clinic, Fitzhardinge Street, London, UK
| | - I Canali
- Fortius Clinic, Fitzhardinge Street, London, UK
| | - K Scott
- Fortius Clinic, Fitzhardinge Street, London, UK
| | - J J H Leong
- Royal National Orthopaedic Hospital, Stanmore, UK; UCL Institute of Orthopaedics and Musculoskeletal Science, London, UK
| | | | - N Newell
- Department of Bioengineering, Imperial College London, London, UK.
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Hashmi SS, Seifert KD, Massoud TF. Thoracic and Lumbosacral Spine Anatomy. Neuroimaging Clin N Am 2022; 32:889-902. [DOI: 10.1016/j.nic.2022.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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6
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Naidoo N, Khan R, Abdulwahab T, Almqvist KF, Lakshmanan J, Prithishkumar IJ. A novel reconstructive approach of the lumbar vertebral column from 2D MRI to 3D models. TRANSLATIONAL RESEARCH IN ANATOMY 2022. [DOI: 10.1016/j.tria.2022.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Johansson F, Sirat Z, Hebelka H, Brisby H, Nordström F, Lagerstrand K. Non-Invasive Evaluation of Intradiscal Deformation during Axial Loading of the Spine Using Deformation-Field Magnetic Resonance Imaging: A Potential Tool for Micro-Instability Measurements. J Clin Med 2022; 11:jcm11164665. [PMID: 36012904 PMCID: PMC9410209 DOI: 10.3390/jcm11164665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/27/2022] [Accepted: 08/01/2022] [Indexed: 12/03/2022] Open
Abstract
Degeneration alters the structural components of the disc and its mechanical behavior. Understanding this pathophysiological process is of great importance, as it may lead to back pain. However, non-invasive methods to characterize the disc mechanics in vivo are lacking. Here, a potential method for measurements of the intradiscal deformation under stress is presented. The method utilizes a standard MRI protocol, commercial loading equipment, and registration software. The lumbar spine (L1/L2–L5/S1) of 36 human subjects was imaged with and without axial loading of the spine. The resulting images were registered, and changes in the images during the registration were displayed pixel-by-pixel to visualize the internal deformation of the disc. The degeneration grade, disc height, disc angle and tilt angle were determined and correlated with the deformation using multivariate regression analysis. The largest deformation was found at the lower lumbar spine, and differences in regional behaviors between individual discs were found. Weak to moderate correlations between the deformation and different disc characteristics were found, where the degeneration grade and tilt angle were the main contributing factors. To conclude, the image-based method offers a potential tool to study the pathophysiological process of the disc.
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Affiliation(s)
- Frida Johansson
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
- Correspondence:
| | - Zainab Sirat
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
| | - Hanna Hebelka
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
- Department of Radiology, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| | - Helena Brisby
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| | - Fredrik Nordström
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| | - Kerstin Lagerstrand
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
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8
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Medeiros Borsagli FGL, Rodrigues JS, Aguiar RA, Paiva AE, Vasquez JFB, Ramos WTDS, Allibrandini P, Rocha EPA, Gonçalves MP, de Souza FE. Low-cost luminescent scaffolds-based on thiol chitosans by microwave radiation for vertebral disc repair/theragnostic. Int J Biol Macromol 2022; 209:2109-2118. [PMID: 35513089 DOI: 10.1016/j.ijbiomac.2022.04.191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/19/2022] [Accepted: 04/25/2022] [Indexed: 12/18/2022]
Abstract
This study introduces a new 3D scaffold based on thiolated chitosans with luminescence by microwave radiation using cysteine (Chi_CT_Cys) and 11-mercaptoundecanoic acid (Chi_CT_MUA) for vertebral disc regeneration/theragnostic. These scaffolds were characterized by Raman, PL spectroscopy, swelling, gel-fraction, and morphologies. Cytocompatibility and mechanical behavior were evaluated. Raman showed that disulfide bonds improved the grafting degree (Chi_CT_Cys (1072 ± 136) μmol·g-1 and Chi_CT_MUA (3245 ± 105) μmol·g-1). Morphologies showed interesting characteristics. Swelling behavior showed that Chi_CT_MUA presented a slight minor swelling (2101 ± 251) % compared to Chi_CT_Cys (2589 ± 188) %. Differently, gel-fraction showed that the chemical stability of Chi_CT_Cys was worse (29 ± 4) % than Chi_CT_MUA (15 ± 3) %. PL showed a possibility to use theragnostic evaluation of points of greater compression in a vertebral disc. The mechanical behavior of Chi_CT_MUA presented better results ((70 ± 3) MPa) than Chi_CT_Cys ((37 ± 3) MPa). Cytocompatible showed that the scaffolds presented cell viability >90%. Thusly, these 3D scaffolds presented an incredible potential for tissue engineering applications.
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Affiliation(s)
- Fernanda G L Medeiros Borsagli
- Institute of Engineering, Science and Technology, Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Av. 01, 4050 Cidade Universitária, 39440-039, Janaúba, MG, Brazil.
| | - Jordane S Rodrigues
- Institute of Engineering, Science and Technology, Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Av. 01, 4050 Cidade Universitária, 39440-039, Janaúba, MG, Brazil
| | - Rafaella A Aguiar
- Institute of Engineering, Science and Technology, Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Av. 01, 4050 Cidade Universitária, 39440-039, Janaúba, MG, Brazil
| | | | | | - Welyson Tiano do Santos Ramos
- Institute of Engineering, Science and Technology, Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Av. 01, 4050 Cidade Universitária, 39440-039, Janaúba, MG, Brazil
| | - Paulo Allibrandini
- Institute of Engineering, Science and Technology, Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Av. 01, 4050 Cidade Universitária, 39440-039, Janaúba, MG, Brazil
| | - Elém Patrícia Alves Rocha
- Institute of Engineering, Science and Technology, Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Av. 01, 4050 Cidade Universitária, 39440-039, Janaúba, MG, Brazil
| | - Max P Gonçalves
- Institute of Engineering, Science and Technology, Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Av. 01, 4050 Cidade Universitária, 39440-039, Janaúba, MG, Brazil
| | - Fidel Edson de Souza
- Institute of Engineering, Science and Technology, Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Av. 01, 4050 Cidade Universitária, 39440-039, Janaúba, MG, Brazil
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Investigation of geometric deformations of the lumbar disc during axial body rotations. BMC Musculoskelet Disord 2022; 23:225. [PMID: 35260128 PMCID: PMC8905741 DOI: 10.1186/s12891-022-05160-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/28/2022] [Indexed: 12/03/2022] Open
Abstract
Background Quantitative data on in vivo vertebral disc deformations are critical for enhancing our understanding of spinal pathology and improving the design of surgical materials. This study investigated in vivo lumbar intervertebral disc deformations during axial rotations under different load-bearing conditions. Methods Twelve healthy subjects (7 males and 5 females) between the ages of 25 and 39 were recruited. Using a combination of a dual fluoroscopic imaging system (DFIS) and CT, the images of L3–5 segments scanned by CT were transformed into three-dimensional models, which matched the instantaneous images of the lumbar spine taken by a double fluorescent X-ray system during axial rotations to reproduce motions. Then, the kinematic data of the compression and shear deformations of the lumbar disc and the coupled bending of the vertebral body were obtained. Results Relative to the supine position, the average compression deformation caused by rotation is between + 10% and − 40%, and the shear deformation is between 17 and 50%. Under physiological weightbearing loads, different levels of lumbar discs exhibit similar deformation patterns, and the deformation patterns of left and right rotations are approximately symmetrical. The deformation patterns change significantly under a 10 kg load, with the exception of the L3–4 disc during the right rotation. Conclusion The deformation of the lumbar disc was direction-specific and level-specific during axial rotations and was affected by extra weight. These data can provide new insights into the biomechanics of the lumbar spine and optimize the parameters of artificial lumbar spine devices.
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Galbusera F, Niemeyer F, Tao Y, Cina A, Sconfienza LM, Kienle A, Wilke HJ. ISSLS Prize in Bioengineering Science 2021: in vivo sagittal motion of the lumbar spine in low back pain patients-a radiological big data study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:1108-1116. [PMID: 33475843 DOI: 10.1007/s00586-021-06729-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 10/15/2020] [Accepted: 01/09/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE We investigated the flexion-extension range of motion and centre of rotation of lumbar motion segments in a large population of 602 patients (3612 levels), and the associations between lumbar motion and other parameters such as sex, age and intervertebral disc degeneration. METHODS Lumbar radiographs in flexion-extension of 602 patients suffering from low back pain and/or suspect instability were collected; magnetic resonance images were retrieved and used to score the degree of disc degeneration for a subgroup of 354 patients. Range of motion and centre of rotation were calculated for all lumbosacral levels with in-house software allowing for high degree of automation. Associations between motion parameters and age, sex, spinal level and disc degeneration were then assessed. RESULTS The median range of motion was 6.6° (range 0.1-28.9°). Associations between range of motion and age as well as spinal level, but not sex, were found. Disc degeneration determined a consistent reduction in the range of motion. The centre of rotation was most commonly located at the centre of the lower endplate or slightly lower. With progressive degeneration, centres of rotation were increasingly dispersed with no preferential directions. CONCLUSION This study constitutes the largest analysis of the in vivo lumbar motion currently available and covers a wide range of clinical scenarios in terms of age and degeneration. Findings confirmed that ageing determines a reduction in the mobility independently of degeneration and that in degenerative levels, centres of rotation are dispersed around the centre of the intervertebral space.
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Affiliation(s)
- Fabio Galbusera
- Laboratory of Biological Structures Mechanics, IRCCS Istituto Ortopedico Galeazzi, viale Galeazzi 4, 20161, Milan, Italy.
| | - Frank Niemeyer
- Institute of Orthopaedic Research and Biomechanics, Center for Trauma Research Ulm, Ulm University, Ulm, Germany
| | - Youping Tao
- Institute of Orthopaedic Research and Biomechanics, Center for Trauma Research Ulm, Ulm University, Ulm, Germany
| | - Andrea Cina
- Laboratory of Biological Structures Mechanics, IRCCS Istituto Ortopedico Galeazzi, viale Galeazzi 4, 20161, Milan, Italy
| | - Luca Maria Sconfienza
- Laboratory of Biological Structures Mechanics, IRCCS Istituto Ortopedico Galeazzi, viale Galeazzi 4, 20161, Milan, Italy.,Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy
| | | | - Hans-Joachim Wilke
- Institute of Orthopaedic Research and Biomechanics, Center for Trauma Research Ulm, Ulm University, Ulm, Germany
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11
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Viggiani D, Mannen EM, Nelson-Wong E, Wong A, Ghiselli G, Shelburne KB, Davidson BS, Callaghan JP. Lumbar Intervertebral Kinematics During an Unstable Sitting Task and Its Association With Standing-Induced Low Back Pain. J Appl Biomech 2020; 36:423-435. [PMID: 32971516 DOI: 10.1123/jab.2019-0382] [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: 12/06/2019] [Revised: 05/05/2020] [Accepted: 06/30/2020] [Indexed: 11/18/2022]
Abstract
People developing transient low back pain during standing have altered control of their spine and hips during standing tasks, but the transfer of these responses to other tasks has not been assessed. This study used video fluoroscopy to assess lumbar spine intervertebral kinematics of people who do and do not develop standing-induced low back pain during a seated chair-tilting task. A total of 9 females and 8 males were categorized as pain developers (5 females and 3 males) or nonpain developers (4 females and 5 males) using a 2-hour standing exposure; pain developers reported transient low back pain and nonpain developers did not. Participants were imaged with sagittal plane fluoroscopy at 25 Hz while cyclically tilting their pelvises anteriorly and posteriorly on an unstable chair. Intervertebral angles, relative contributions, and anterior-posterior translations were measured for the L3/L4, L4/L5, and L5/S1 joints and compared between sexes, pain groups, joints, and tilting directions. Female pain developers experienced more extension in their L5/S1 joints in both tilting directions compared with female nonpain developers, a finding not present in males. The specificity in intervertebral kinematics to sex-pain group combinations suggests that these subgroups of pain developers and nonpain developers may implement different control strategies.
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Affiliation(s)
| | - Erin M Mannen
- University of Denver
- University of Arkansas for Medical Sciences
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