2002
DOI: 10.1007/s00586-002-0435-5
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The objectives for the mechanical evaluation of spinal instrumentation have changed

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Cited by 15 publications
(3 citation statements)
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“…In a degenerated collapsed disc, the hydration of the nucleus is lost, and load transmission across the vertebral endplate becomes irregular. Most of the load is transmitted directly from bone to bone towards the periphery of the endplate [13]. The annulus and endplate cartilage are fragmented and may act like a “stone in the shoe” which may cause a high point loading and pain, a concept proposed by Mulholland and Sengupta [11].…”
Section: Spinal Instability In Degenerative Disorder As a Cause Ofmentioning
confidence: 99%
“…In a degenerated collapsed disc, the hydration of the nucleus is lost, and load transmission across the vertebral endplate becomes irregular. Most of the load is transmitted directly from bone to bone towards the periphery of the endplate [13]. The annulus and endplate cartilage are fragmented and may act like a “stone in the shoe” which may cause a high point loading and pain, a concept proposed by Mulholland and Sengupta [11].…”
Section: Spinal Instability In Degenerative Disorder As a Cause Ofmentioning
confidence: 99%
“…Loading the annulus, unprotected by the supporting pressure of the nucleus, leads to splitting and inward folding of stress concentrations in the posterolateral annulus and in the otherwise depressurized nucleus [27] the annulus. [33] Areas of main load transmission across the disc now become dependent on the posture; in flexion the anterior annulus, in extension the posterior annulus. The abnormal high load transmission through the different areas of the annulus with change of posture may explain the activity and posture related mechanical back pain in the presence of degenerated disc.…”
Section: Load Transmission Through the Degenerated Discmentioning
confidence: 99%
“…The goal of fusion was to provide motion stability in arthrodesis and deformity correction, thus controlling and even strengthening the movement of the segment. 8 However, good fusion rates are not correlated with the clinical relief of the patient's back pain symptoms. The best results measured by different clinical scales show around 30% of suboptimal healing after instrumented fusion surgery despite a fusion rate of more than 90%.…”
Section: Discussionmentioning
confidence: 99%