Biomechanical effect of posterior elements and ligamentous tissues of lumbar spine on load sharing.

In this paper, we report on the development of a three-dimensional model of human lower lumbar spine based on actual geometry of L4-L5 motion segment. The simulation is performed on the model extracted from 2 mm slices of CT-Scan data of a healthy subject. The finite element model includes different parts, such as, cortical shell, cancellous core, endplates, pedicle, lamina, transverse process, and spinous process. Additionally, it takes into account the intervertebral disc including the nucleus pulposus and annulus fibrosus. The seven ligamentous structures of the L4-L5 motion segment, such as, anterior longitudinal ligament, posterior longitudinal ligament, and supraspinous ligament, were also incorporated. Various biomechanical characteristics of the computer generated model are studied under different physiological loadings. The focus of this study is on the role of posterior elements on load sharing of the lower lumbar region. The simulation yields data on the stress distribution inside the vertebrae and the amount of resulting deformation that takes place. Different simulated models of an injured lumbar spine are also being analyzed for two cases of facetectomy and degraded nucleus disorders. It is shown that the inclusion of the posterior elements along with the ligamentous tissues lead to an increase in the stiffness and stability of the L4-L5 motion segment.

[1]  R M Aspden,et al.  The Spine as an Arch A New Mathematical Model , 1989, Spine.

[2]  S. Kumar,et al.  Epidemiology of juvenile low back pain: a review. , 1997, Disability and rehabilitation.

[3]  P. Dreyfuss,et al.  Low back pain and the zygapophysial (facet) joints. , 1996, Archives of physical medicine and rehabilitation.

[4]  W. Hayes,et al.  Direct and computed tomography thickness measurements of the human, lumbar vertebral shell and endplate. , 1994, Bone.

[5]  F. Lavaste,et al.  Three-dimensional biomechanical properties of the human cervical spine in vitro , 1993, European Spine Journal.

[6]  L. Oddsson,et al.  Sensory-motor control of the lower back: implications for rehabilitation. , 2001, Medicine and science in sports and exercise.

[7]  John W. Frymoyer,et al.  Back pain and sciatica. , 1988, The New England journal of medicine.

[8]  K. Newcomer,et al.  Low back pain and its relationship to back strength and physical activity in children , 1996, Acta paediatrica.

[9]  Javad Dargahi,et al.  Optimization of the geometry of total knee implant in the sagittal plane using FEA. , 2003, Bio-medical materials and engineering.

[10]  R. Deyo,et al.  An International Comparison of Back Surgery Rates , 1994, Spine.

[11]  Burton Ak Low back pain in children and adolescents: to treat or not? , 1996 .

[12]  M. Nordin,et al.  Basic biomechanics of the skeletal system , 1980 .

[13]  W. DeVault,et al.  Spinal injury in sport: epidemiologic considerations. , 1993, Clinics in sports medicine.

[14]  Stuart M. McGill,et al.  Low Back Stability: From Formal Description to Issues for Performance and Rehabilitation , 2001, Exercise and sport sciences reviews.

[15]  W. Steudel,et al.  Posterior Element Injury and Cervical Spine Flexibility Following Anterior Cervical Fusion and Plating , 2002, European Journal of Trauma.

[16]  H. Farfan,et al.  Mechanical disorders of the low back , 1973 .

[17]  S Gracovetsky,et al.  Function of the spine. , 1986, Journal of biomedical engineering.

[18]  M H Pope,et al.  Biomechanics of the lumbar spine. , 1989, Annals of medicine.

[19]  S Najarian,et al.  Improvement of the Pennes Equation in the analysis of heat transfer phenomenon in blood perfused tissues. , 2001, Biomedical sciences instrumentation.

[20]  W C Hutton,et al.  The effect of posture on the role of the apophysial joints in resisting intervertebral compressive forces. , 1980, The Journal of bone and joint surgery. British volume.

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

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

[23]  C Neal The assessment of knowledge and application of proper body mechanics in the workplace. , 1997, Orthopedic nursing.

[24]  D. Carpenter,et al.  Low back strengthening for the prevention and treatment of low back pain. , 1999, Medicine and science in sports and exercise.

[25]  W S Marras,et al.  The effects of motion on trunk biomechanics. , 2000, Clinical biomechanics.

[26]  Farhad Nabhani,et al.  Computer modelling and stress analysis of the lumbar spine , 2002 .