Lumbar intradiscal pressure measured in the anterior and posterolateral annular regions during asymmetrical loading

Steffen, Thomas; Baramki, Hani G.; Rubin, Rick; Antoniou, John; Aebi, Max

doi:10.1016/s0268-0033(98)00039-4

Cited by 75 publications

(42 citation statements)

References 39 publications

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“…As IVD dimensions in the coronal plane are approximately 50% greater than in the sagittal plane [1], it is reasonable to infer that lateral movement will generate higher stress distributions within the IVD than sagittal displacement [1]. Combinations of movement in both planes can generate very high intradiscal and annular tensile strains, especially when combined with axial rotation [8] and as such are implicated in injury [1,9].…”

Section: Introductionmentioning

confidence: 99%

Nucleus pulposus deformation in response to lumbar spine lateral flexion: an in vivo MRI investigation

Fazey

Takasaki²,

Singer

2010

Eur Spine J

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Whilst there are numerous studies examining aspects of sagittal plane motion in the lumbar spine, few consider coronal plane range of motion and there are no in vivo reports of nucleus pulposus (NP) displacement in lateral flexion. This study quantified in vivo NP deformation in response to side flexion in healthy volunteers. Concomitant lateral flexion and axial rotation range were also examined to evaluate the direction and extent of NP deformation. Axial T2-and coronal T1-weighted magnetic resonance images (MRI) were obtained from 21 subjects (mean age, 24.8 years) from L1 to S1 in the neutral and left laterally flexed position. Images were evaluated for intersegmental ranges of lateral flexion and axial rotation. A novel methodology derived linear pixel samples across the width of the disc from T2 images, from which the magnitude and direction of displacement of the NP was determined. This profiling technique represented the relative hydration pattern within the disc. The NP was displaced away from the direction of lateral flexion in 95/105 discs (p \ 0.001). The extent of NP displacement was associated strongly with lateral flexion at L2-3 (p \ 0.01). The greatest range of lateral flexion occurred at L2-3, L3-4 and L4-5. Small intersegmental ranges of axial rotation occurred at all levels, but were not associated with NP displacement. The direction of NP deformation was highly predictable in laterally flexed healthy lumbar spines; however, the magnitude of displacement was not consistent with the degree of intersegmental lateral flexion or rotation.

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Section: Introductionmentioning

confidence: 99%

Nucleus pulposus deformation in response to lumbar spine lateral flexion: an in vivo MRI investigation

Fazey

Takasaki²,

Singer

2010

Eur Spine J

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“…Usually, these injuries are caused by excessive motion of the lumbar segment, although similar injuries have also been caused by repetitive loading at lesser, more physiological amounts of motion (Adams and Hutton, 1983;Gordon et al, 1991;Shirazi-Adl, 1989;Steffen et al, 1998). While the posterolateral region seems to be most at risk for injury, other annular tears (circumferential and radial tears) are present by early adulthood, and these tears are associated with long-term development of disc degeneration and herniation (Vernon-Roberts et al, 1997;Vernon-Roberts and Pirie, 1977).…”

Section: Introductionmentioning

confidence: 99%

Direct measurement of intervertebral disc maximum shear strain in six degrees of freedom: Motions that place disc tissue at risk of injury

Costi

Stokes

Gardner‐Morse

et al. 2007

Journal of Biomechanics

129

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Human intervertebral disc specimens were tested to determine the regions of largest maximum shear strain experienced by disc tissues in each of three principal displacements and three rotations, and to identify the physiological rotations and displacements that may place the disc at greatest risk for large tissue strains and injury. Tearing of disc annulus may be initiated by large interlamellar shear strains. Nine human lumbar discs were tagged with radiographic markers on the endplates, disc periphery and with a grid of wires in the mid-transverse plane and subjected to each of the six principal displacements and rotations. Stereo-radiographs were taken in each position and digitized for reconstruction of the 3-D position of each marker. Maximum tissue shear strains were calculated from relative marker displacements and normalized by the input displacement or rotation. Lateral shear, compression, and lateral bending were the motions that produced the mean (95% confidence interval) largest regional maximum shear strains (MSS) of 9.6 (0.7) %/mm, 9.0 (0.5) %/mm, and 5.8 (1.6) %/° respectively, and which occurred in the posterior, posterolateral and lateral peripheral regions of the disc. After taking into account the reported maximum physiological range of motion for each degree of freedom, motions producing the highest physiological MSS were lateral bending (57.8 (16.2)%) and flexion (38.3 (3.3)%), followed by lateral shear (14.4 (1.1)%) and compression (12.6 (0.7)%).

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“…A 600 N compressive preload followed the contour of the spine ensuring compression perpendicular to the endplates between each segment [25,26]. The L4-L5 intervertebral disc pressure was monitored with a 2.1 mm diameter custom needle pressure transducer for the six specimens used to determine the implant and interface loads (Robert A. Denton, Inc., Rochester Hills, MI, USA) [27][28][29].…”

Section: Specimen Preparation and Biomechanical Loadingmentioning

confidence: 99%

Biomechanical evaluation of the Total Facet Arthroplasty System® (TFAS®): loading as compared to a rigid posterior instrumentation system

et al. 2012

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Lumbar intradiscal pressure measured in the anterior and posterolateral annular regions during asymmetrical loading

Cited by 75 publications

References 39 publications

Nucleus pulposus deformation in response to lumbar spine lateral flexion: an in vivo MRI investigation

Nucleus pulposus deformation in response to lumbar spine lateral flexion: an in vivo MRI investigation

Direct measurement of intervertebral disc maximum shear strain in six degrees of freedom: Motions that place disc tissue at risk of injury

Biomechanical evaluation of the Total Facet Arthroplasty System® (TFAS®): loading as compared to a rigid posterior instrumentation system

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