On the load-sharing along the ligamentous lumbosacral spine in flexed and extended postures: Finite element study.

A harmonic synergy between the load-bearing and stabilizing components of the spine is necessary to maintain its normal function. This study aimed to investigate the load-sharing along the ligamentous lumbosacral spine under sagittal loading. A 3D nonlinear detailed Finite Element (FE) model of lumbosacral spine with realistic geometry was developed and validated using wide range of numerical and experimental (in-vivo and in-vitro) data. The model was subjected to 500 N compressive Follower Load (FL) combined with 7.5 Nm flexion (FLX) or extension (EXT) moments. Load-sharing was expressed as percentage of total internal force/moment developed along the spine that each spinal component carried. These internal forces and moments were determined at the discs centres and included the applied load and the resisting forces in the ligaments and facet joints. The contribution of the facet joints and ligaments in supporting bending moments produced additional forces and moments in the discs. The intervertebral discs carried up to 81% and 68% of the total internal force in case of FL combined with FLX and EXT, respectively. The ligaments withstood up to 67% and 81% of the total internal moment in cases of FL combined with EXT and FLX, respectively. Contribution of the facet joints in resisting internal force and moment was noticeable at levels L4-S1 only particularly in case of FL combined with EXT and reached up 29% and 52% of the internal moment and force, respectively. This study demonstrated that spinal load-sharing depended on applied load and varied along the spine.

[1]  P. Dolan,et al.  Recent advances in lumbar spinal mechanics and their significance for modelling. , 2001, Clinical biomechanics.

[2]  oji,et al.  Effects of lumbar spinal fusion on the other lumbar intervertebral levels (three-dimensional finite element analysis) , .

[3]  M. Adams,et al.  The Resistance to Flexion of the Lumbar Intervertebral Joint , 1980, Spine.

[4]  A Shirazi-Adl,et al.  Analysis of large compression loads on lumbar spine in flexion and in torsion using a novel wrapping element. , 2006, Journal of biomechanics.

[5]  P. Dolan,et al.  Recent advances in lumbar spinal mechanics and their clinical significance. , 1995, Clinical biomechanics.

[6]  M J Pearcy,et al.  Are coupled rotations in the lumbar spine largely due to the osseo-ligamentous anatomy? – A modelling study , 2008, Computer methods in biomechanics and biomedical engineering.

[7]  V K Goel,et al.  Load sharing among spinal elements of a motion segment in extension and lateral bending. , 1987, Journal of biomechanical engineering.

[8]  Josep A Planell,et al.  How does the geometry affect the internal biomechanics of a lumbar spine bi-segment finite element model? Consequences on the validation process. , 2007, Journal of biomechanics.

[9]  N Arjmand,et al.  Model and in vivo studies on human trunk load partitioning and stability in isometric forward flexions. , 2006, Journal of biomechanics.

[10]  N. Langrana,et al.  Role of Ligaments and Facets in Lumbar Spinal Stability , 1995, Spine.

[11]  Antonius Rohlmann,et al.  Determination of trunk muscle forces for flexion and extension by using a validated finite element model of the lumbar spine and measured in vivo data. , 2006, Journal of biomechanics.

[12]  Bernhard Weisse,et al.  A multibody modelling approach to determine load sharing between passive elements of the lumbar spine , 2011, Computer methods in biomechanics and biomedical engineering.

[13]  M M Panjabi,et al.  Mechanical behavior of the human lumbar and lumbosacral spine as shown by three-dimensional load-displacement curves. , 1994, The Journal of bone and joint surgery. American volume.

[14]  Lutz Claes,et al.  Stepwise reduction of functional spinal structures increase range of motion and change lordosis angle. , 2007, Journal of biomechanics.

[15]  M. Morlock,et al.  Increase in facet joint loading after nucleotomy in the human lumbar spine. , 2014, Journal of biomechanics.

[16]  A Rohlmann,et al.  Comparison of eight published static finite element models of the intact lumbar spine: predictive power of models improves when combined together. , 2014, Journal of biomechanics.

[17]  Narayan Yoganandan,et al.  Moment-rotation responses of the human lumbosacral spinal column. , 2007, Journal of biomechanics.

[18]  Javad Dargahi,et al.  Biomechanical effect of posterior elements and ligamentous tissues of lumbar spine on load sharing. , 2005, Bio-medical materials and engineering.

[19]  M. Adams,et al.  THE BIOMECHANICS OF BACK PAIN , 2003 .

[20]  M. Pearcy,et al.  Three-Dimensional X-ray Analysis of Normal Movement in the Lumbar Spine , 1984, Spine.

[21]  A Rohlmann,et al.  Realistic loading conditions for upper body bending. , 2009, Journal of biomechanics.

[22]  A. Patwardhan,et al.  Compressive Preload Reduces Segmental Flexion Instability After Progressive Destabilization of the Lumbar Spine , 2014, Spine.

[23]  C. Breau,et al.  Reconstruction of a human ligamentous lumbar spine using CT images — A three-dimensional finite element mesh generation , 2006, Annals of Biomedical Engineering.

[24]  F Lavaste,et al.  The role of disc, facets and fibres in degenerative process: a sensitivity study. , 2002, Studies in health technology and informatics.

[25]  Aboulfazl Shirazi-Adl,et al.  Response analysis of the lumbar spine during regular daily activities--a finite element analysis. , 2010, Journal of biomechanics.

[26]  M. Pearcy Stereo radiography of lumbar spine motion. , 1985, Acta orthopaedica Scandinavica. Supplementum.

[27]  Antonius Rohlmann,et al.  In vivo implant forces acting on a vertebral body replacement during upper body flexion. , 2015, Journal of biomechanics.

[28]  Matthew B Panzer,et al.  C4-C5 segment finite element model development, validation, and load-sharing investigation. , 2009, Journal of biomechanics.

[29]  Christian M. Puttlitz,et al.  Parametric convergence sensitivity and validation of a finite element model of the human lumbar spine , 2011, Computer methods in biomechanics and biomedical engineering.

[30]  Pierre-Jean Arnoux,et al.  Finite element investigation of the loading rate effect on the spinal load-sharing changes under impact conditions. , 2009, Journal of biomechanics.

[31]  Yoon Hyuk Kim,et al.  Effects of degenerated intervertebral discs on intersegmental rotations, intradiscal pressures, and facet joint forces of the whole lumbar spine , 2013, Comput. Biol. Medicine.

[32]  L. Claes,et al.  Intradiscal pressure together with anthropometric data--a data set for the validation of models. , 2001, Clinical biomechanics.

[33]  Lutz Claes,et al.  Application of a new calibration method for a three-dimensional finite element model of a human lumbar annulus fibrosus. , 2006, Clinical biomechanics.

[34]  P Brinckmann,et al.  Change of disc height, radial disc bulge, and intradiscal pressure from discectomy. An in vitro investigation on human lumbar discs. , 1991, Spine.

[35]  Avinash G Patwardhan,et al.  Novel model to analyze the effect of a large compressive follower pre-load on range of motions in a lumbar spine. , 2007, Journal of biomechanics.

[36]  Chen-Sheng Chen,et al.  Effects of cord pretension and stiffness of the Dynesys system spacer on the biomechanics of spinal decompression- a finite element study , 2013, BMC Musculoskeletal Disorders.

[37]  M. Pearcy,et al.  Axial rotation and lateral bending in the normal lumbar spine measured by three-dimensional radiography. , 1984, Spine.

[38]  M. El-Rich,et al.  Investigation of impact loading rate effects on the ligamentous cervical spinal load-partitioning using finite element model of functional spinal unit C2-C3. , 2014, Journal of biomechanics.

[39]  M. Panjabi The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. , 1992, Journal of spinal disorders.

[40]  Yoon-Hyuk Kim,et al.  Investigation of optimal follower load path generated by trunk muscle coordination. , 2011, Journal of biomechanics.

[41]  L Claes,et al.  Influence of a Follower Load on Intradiscal Pressure and Intersegmental Rotation of the Lumbar Spine , 2001, Spine.

[42]  Aboulfazl Shirazi-Adl,et al.  Rate effect on sharing of passive lumbar motion segment under load-controlled sagittal flexion : viscoelastic finite element analysis , 1999 .

[43]  Gijsbertus J Verkerke,et al.  Influence of Interpersonal Geometrical Variation on Spinal Motion Segment Stiffness: Implications for Patient-Specific Modeling , 2011, Spine.

[44]  S. Sezer,et al.  Load sharing in lumbar spinal segment as a function of location of center of rotation. , 2014, Journal of neurosurgery. Spine.

[45]  A Shirazi-Adl,et al.  Mechanical Response of a Lumbar Motion Segment in Axial Torque Alone and Combined with Compression , 1986, Spine.

[46]  W. Hutton,et al.  The Lumbar Spine in Backward Bending , 1988, Spine.

[47]  A. Shirazi-Adl,et al.  Muscle Activity, Internal Loads, and Stability of the Human Spine in Standing Postures: Combined Model and In Vivo Studies , 2004, Spine.

[48]  V. Goel,et al.  Prediction of Load Sharing Among Spinal Components of a C5‐C6 Motion Segment Using the Finite Element Approach , 1998, Spine.

[49]  W. Skalli,et al.  Influence of geometrical factors on the behavior of lumbar spine segments: A finite element analysis , 2005, European Spine Journal.

[50]  Lutz Claes,et al.  Intradiscal pressure, shear strain and fiber strain in the intervertebral disc under combined loading , 2006 .

[51]  Thomas R Oxland,et al.  Accuracy and repeatability of a new method for measuring facet loads in the lumbar spine. , 2006, Journal of biomechanics.