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Finite element (FE) analysis has been used in studying the biomechanics of the lumbar spine. While some FE studies used a follower load technique that intended to replace the compressing effect of local muscle force, other studies considered satisfying the relationship between the human body’s posture and the centre of gravity (CG) for investigating spine biomechanics. However, the above studies did not reveal the importance of a coordinate system that gratifies the posture-CG relation and follower load techniques. The present FE study compares the variation in ranges of motion (ROM) and stress-strain distributions due to the application of loading via different coordinate systems, follower (FCS) and global (GCS). A subject-specific computed tomography scan-based intact spine (L1-L5) FE model was developed and simulated for physiological movements. The FE results indicated a minimum deviation in ROM of 2.7° for the L1-L5 full model at all physiological activities between the defined coordinate systems. The observed variation for the L3-L4 functional spinal unit was between 4.7° and 19°. The von Mises strain in the vertebrae was between 0.0007 and 0.003 for the FCS case. In contrast, the peak von Mises strain for the GCS case was above the compressive yield strain limit of cancellous bone by 38.5%. The GCS model transferred the load unsymmetrically, whereas the distribution was symmetrical for the FCS case, without any potential risk of bone failure. These observations clearly indicate that the selection of the appropriate loading coordinate system is as crucial as the magnitude of loading.

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