Direct real-time measurement of in vivo forces in the lumbar spine

Ledet, Eric H.; Tymeson, Michael P.; DiRisio, Darryl J.; Cohen, Benjamin; Uhl, Richard L.

doi:10.1016/j.spinee.2004.06.017

Cited by 59 publications

(37 citation statements)

References 43 publications

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“…Due to the young age of the patients and a considerable number of spine cycles over a lifetime period, additional wear rates from severe stress in competitive athletics must be addressed carefully. Forces on lumbar discs during activities of daily living from direct in vivo measurements have been described previously [35,57], and multiple times increase of forces with presently unknown influence on the UHMWE-inlay and implants are to be expected during athletic activities (Table 1). Our radiological evaluation did not reveal any implant dislocations as a consequence of excessive external forces and we were not able to note any radiological macroscopic signs of UHMWPE-wear on conventional X-ray images.…”

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance

Siepe¹,

Wiechert²,

Khattab

et al. 2007

Eur Spine J

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Despite the increasing popularity of total lumbar disc replacement (TDR) in predominantly young and active patients, no previous study has addressed possibilities, limitations and potential risks regarding athletic performance following TDR. Mechanical concerns remain and the implant's resilience as regards its load-bearing capacity during sporting activities is unknown. Thirty-nine athletic patients fulfilled the inclusion criteria for this study. These patients participated in a large variety of different types of sport. Significant and lasting pain-relief was attained following TDR with a mean follow-up of 26.3 months (range 9-50.7 months; FU rate 97.4%). Sporting activity was resumed within the first 3 months (38.5%) to 6 months (30.7%) with peak performance being reached after 5.2 months. Thirty-seven patients (94.9%) achieved resumption of sporting activity. Athletic performance improved significantly in 33 patients (84.6%). Minor subsidence was observed in 13 patients (30%) within the first 3 months with no further implant migration thereafter in 12 patients. Participation in all types of sport recorded in this study was accessible for a high rate of patients up to the level of professional athletes as well as those participating in extreme sports. Preoperative participation in sport proved to be a strong positive predictor for highly satisfactory postoperative outcome following TDR. In a selected group of patients, however, preoperative inability to participate in sporting activities did not impair postoperative physical activity. Due to the young age of the patients and significant load increase exerted during athletic activities, persisting concerns regarding the future behaviour of the implant remain and will require longer follow-up, modified investigation techniques and larger patient cohorts.

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Section: Discussionmentioning

confidence: 96%

“…Previous studies of in vivo intradiscal measurements reported significant shear and compressive forces exerted upon lumbar discs during activities of daily living [35,57]. A rapid increase of forces is to be expected during sporting activities (Table 1).…”

Section: Introductionmentioning

confidence: 92%

Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance

Siepe¹,

Wiechert²,

Khattab

et al. 2007

Eur Spine J

View full text Add to dashboard Cite

show abstract

“…Some believe that spinal loading depends on upright posture and have recommended the use of kangaroos or nonhuman primates. However, there are difficulties with these "erect" animal models; as most are scarce, expensive, difficult to work with and are in reality primarily quadruped [20]. Because of their small disc height and diameter, prior studies using nonhuman primates have necessitated routine removal of substantial portions of the endplates in order to fit even miniaturized disc implants [20;21].…”

Section: Introductionmentioning

confidence: 99%

Mature runt cow lumbar intradiscal pressures and motion segment biomechanics

2009

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Background Context-The optimal animal model for in vivo testing of spinal implants, particularly total or partial disc replacement devices, has not yet been determined. Mechanical and morphological similarities of calf and human spines have been reported; however, limitations of the calf model include open growth plates and oversized vertebrae with growth. Mature runt cows (Corrientes breed) may avoid these limitations.

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“…19 Mechanical loading of the lumbar spine has been studied extensively in isolated in vitro preparations. These studies have shown that the distribution of loading across the vertebrae is a function of posture 108 and spine health. 6,150 In a healthy spine the neural arch carries negligible compressive load.…”

mentioning

confidence: 99%

Etiology of lumbar lordosis and its pathophysiology: a review of the evolution of lumbar lordosis, and the mechanics and biology of lumbar degeneration

Sparrey

Bailey

Safaee

et al. 2014

FOC

100

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The goal of this review is to discuss the mechanisms of postural degeneration, particularly the loss of lumbar lordosis commonly observed in the elderly in the context of evolution, mechanical, and biological studies of the human spine and to synthesize recent research findings to clinical management of postural malalignment. Lumbar lordosis is unique to the human spine and is necessary to facilitate our upright posture. However, decreased lumbar lordosis and increased thoracic kyphosis are hallmarks of an aging human spinal column. The unique upright posture and lordotic lumbar curvature of the human spine suggest that an understanding of the evolution of the human spinal column, and the unique anatomical features that support lumbar lordosis may provide insight into spine health and degeneration. Considering evolution of the skeleton in isolation from other scientific studies provides a limited picture for clinicians. The evolution and development of human lumbar lordosis highlight the interdependence of pelvic structure and lumbar lordosis. Studies of fossils of human lineage demonstrate a convergence on the degree of lumbar lordosis and the number of lumbar vertebrae in modern Homo sapiens. Evolution and spine mechanics research show that lumbar lordosis is dictated by pelvic incidence, spinal musculature, vertebral wedging, and disc health. The evolution, mechanics, and biology research all point to the importance of spinal posture and flexibility in supporting optimal health. However, surgical management of postural deformity has focused on restoring posture at the expense of flexibility. It is possible that the need for complex and costly spinal fixation can be eliminated by developing tools for early identification of patients at risk for postural deformities through patient history (genetics, mechanics, and environmental exposure) and tracking postural changes over time.

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Direct real-time measurement of in vivo forces in the lumbar spine

Cited by 59 publications

References 43 publications

Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance

Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance

Mature runt cow lumbar intradiscal pressures and motion segment biomechanics

Etiology of lumbar lordosis and its pathophysiology: a review of the evolution of lumbar lordosis, and the mechanics and biology of lumbar degeneration

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