The three-dimensional load displacement behavior of nine fresh adult L5-S1 spine motion segments was studied. Static test forces up to 160 N in anterior, posterior, and lateral shear, test forces up to 320 N in compression, and test moments up to 15.7 Nm in flexion, extension, lateral bending, and torsion were used. The six displacements of the center of the inferior L5 endplate were measured 15 and 60 s after the load was applied. Specimens were then retested after posterior element excision. The results show that at the maximum test force, intact specimen mean (SD) displacements ranged from 1.65 mm (0.63 mm) in lateral shear to 2.21 mm (0.87 mm) in posterior shear. Posterior element excision resulted in an average 1.66-fold increase in shear translations. At the maximum moment, rotations ranged from 3.38 degrees (1.03 degrees) in torsion to 7.19 degrees (1.77 degrees) in flexion. Posterior element excision resulted in an average 2.09-fold increase in bending rotations and a 2.74-fold increase in the average torsional rotation. In general, these L5-S1 joints were stiffer than more cranial lumbar segments in flexion, extension, and lateral bending and were less stiff in torsion tests.
Trunk proprioception was measured in 253 healthy children 7-18 years of age using infrared markers placed on the back of the head and on the skin over the T1, T8, and S1 spinous processes. The children were tested for their accuracy in sensing return of the head and trunk to a centered, neutral position in the frontal plane. Whole-body sway was also quantified during 10 s of relaxed standing by measuring mean amplitudes of trunk marker and foot center of pressure (CP) movements. The results show that trunk positioning accuracy improved significantly with age (p = 0.000). Subjects could position their trunk in the frontal plane to within a mean (+/- SD) of 2.5 (+/- 1.1) and 0.9 (+/- 0.6) degrees of the neutral position at ages 7 and 18 years, respectively. No statistically significant gender differences were found. At every age trunk positioning accuracy was diminished in the presence of a continuous external trunk moment (equivalent to 0.01 x body weight x height), although not significantly so. Neither mean trunk sway nor CP amplitudes were significantly correlated with age or sex. The overall results suggest that spine decompensation is only abnormal when it exceeds 20 mm in healthy children and adolescents.
The accuracy with which the head and spine could be positioned in the frontal and sagittal planes relative to the pelvis was measured and compared in ten healthy adult males. Subjects were tested with eyes closed, while standing with their pelvis externally restrained. The positions of markers, attached to the back of the head and over each of the T1, T6, T11, and L3 spinous processes, were measured to the nearest mm using strain-gaged flexible beam transducers. Subjects were tested for their accuracy in sensing return of the trunk to an initial neutral position under different test conditions. Results showed that positioning was 16-45% more accurate in the frontal than in the sagittal plane, although the difference did not reach statistical significance. T1 could be centered to within 7 and 10 mm in the frontal and sagittal planes, respectively. No significant differences were found between active and passive positioning accuracies. Presence of an external trunk moment did not significantly affect trunk positioning accuracy, although it systematically caused overshoot of the neutral position. Lastly, lateral trunk shifts exceeding 12 mm may be classified as abnormal in young adults.
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