Mechanical Behavior of the Human Lumbar and Lumbosacral Spine as Shown by Three-Dimensional Load-Displacement Curves.


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Abstract

The lumbar region is a frequent site of spinal disorders, including low-back pain, and of spinal trauma. Clinical studies have established that abnormal intervertebral motions occur in some patients who have low-back pain. A knowledge of normal spinal movements, with all of the inherent complexities, is needed as a baseline. The present study documents the complete three-dimensional elastic physical properties of each lumbar intervertebral level from the level between the first and second lumbar vertebrae through the level between the fifth lumbar and first sacral vertebrae. Nine whole fresh-frozen human cadaveric lumbar-spine specimens were used. Pure moments of flexion-extension, bilateral axial torque, and bilateral lateral bending were applied, and three-dimensional intervertebral motions were determined with use of stereophotogrammetry. The motions were presented in the form of a set of six load-displacement curves, quantitating intervertebral rotations and translations. The curves were found to be non-linear, and the motions were coupled. The ranges of motion were found to compare favorably with reported values from in vivo studies.CLINICAL RELEVANCEKnowledge of the physical characteristics of the spine is clinically important whenever loads or displacements, or both, are applied to the spine. It is necessary to understand not only the amounts of spinal motion, but also the motion characteristics of non-linearity and coupling, which are documented in the present study, in order to better understand the clinically important problems, and treatment, of spinal instability in association with low-back pain and after spinal trauma.

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