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Anterior thoracic posture increases thoracolumbar disc loading

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Abstract

In the absence of external forces, the largest contributor to intervertebral disc (IVD) loads and stresses is trunk muscular activity. The relationship between trunk posture, spine geometry, extensor muscle activity, and the loads and stresses acting on the IVD is not well understood. The objective of this study was to characterize changes in thoracolumbar disc loads and extensor muscle forces following anterior translation of the thoracic spine in the upright posture. Vertebral body geometries (C2 to S1) and the location of the femoral head and acetabulum centroids were obtained by digitizing lateral, full-spine radiographs of 13 men and five women volunteers without previous history of back pain. Two standing, lateral, full-spine radiographic views were obtained for each subject: a neutral-posture lateral radiograph and a radiograph during anterior translation of the thorax relative to the pelvis (while keeping T1 aligned over T12). Extensor muscle loads, and compression and shear stresses acting on the IVDs, were calculated for each posture using a previously validated biomechanical model. Comparing vertebral centroids for the neutral posture to the anterior posture, subjects were able to anterior translate +101.5 mm±33.0 mm (C7–hip axis), +81.5 mm±39.2 mm (C7–S1) (vertebral centroid of C7 compared with a vertical line through the vertebral centroid of S1), and +58.9 mm±19.1 mm (T12–S1). In the anterior translated posture, disc loads and stresses were significantly increased for all levels below T9. Increases in IVD compressive loads and shear loads, and the corresponding stresses, were most marked at the L5–S1 level and L3–L4 level, respectively. The extensor muscle loads required to maintain static equilibrium in the upright posture increased from 147.2 N (mean, neutral posture) to 667.1 N (mean, translated posture) at L5–S1. Compressive loads on the anterior and posterior L5–S1 disc nearly doubled in the anterior translated posture. Anterior translation of the thorax resulted in significantly increased loads and stresses acting on the thoracolumbar spine. This posture is common in lumbar spinal disorders and could contribute to lumbar disc pathologies, progression of L5–S1 spondylolisthesis deformities, and poor outcomes after lumbar spine surgery. In conclusion, anterior trunk translation in the standing subject increases extensor muscle activity and loads and stresses acting on the intervertebral disc in the lower thoracic and lumbar regions.

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References

  1. Adams MA, McMillan DW, Green TP, Dolan P (1996) Sustained loading generates stress concentrations in lumbar intervertebral discs. Spine 21:434–438

    Article  CAS  PubMed  Google Scholar 

  2. Bogduk N, Macintosh JE, Pearcy MJ (1992) A universal model of the lumbar back muscles in the upright position. Spine 17:897–913

    CAS  PubMed  Google Scholar 

  3. Booth KC, Bridwell KH, Lenke LG, Baldus CR, Blanke KM (1999) Complications and predictive factors for the successful treatment of flatback deformity (fixed sagittal imbalance). Spine 24:1712–1720

    Article  CAS  PubMed  Google Scholar 

  4. Burdorf A, van Riel M, Snijders C (1992) Trunk Muscle strength measurements and prediction of low back pain among workers. Clin Biomech 7:422–429

    Article  Google Scholar 

  5. Cavanaugh JM, Ozaktay AC, Yamashita T, Avramov A, Getchell TV, King AI (1997) Mechanisms of low back pain: a neurophysiologic and neuroanatomic study. Clin Orthop 166–180

    Google Scholar 

  6. Cholewicki J, Panjabi MM, Khachatryan A (1997) Stabilizing function of trunk flexor-extensor muscles around a neutral spine posture. Spine 22:2207–2212

    Article  CAS  PubMed  Google Scholar 

  7. Colloca CJ, Keller TS, Peterson TK, Seltzer DE (2003) Comparison of dynamic posteroanterior spinal stiffness to plain film radiographic images of lumbar disk height. J Manipulative Physiol Ther 26:233–241

    Article  PubMed  Google Scholar 

  8. Dolan P, Adams MA (2001) Recent advances in lumbar spinal mechanics and their significance for modelling. Clin Biomech (Bristol, Avon) [Suppl 1] 16:S8–S16

  9. Guzik DC, Keller TS, Szpalski M, Park JH, Spengler DM (1996) A biomechanical model of the lumbar spine during upright isometric flexion, extension, and lateral bending. Spine 21:427–433

    Article  CAS  PubMed  Google Scholar 

  10. Harrison DD, Cailliet R, Janik TJ, Troyanovich SJ, Harrison DE, Holland B (1998) Elliptical modeling of the sagittal lumbar lordosis and segmental rotation angles as a method to discriminate between normal and low back pain subjects. J Spinal Disord 11:430–439

    CAS  PubMed  Google Scholar 

  11. Harrison DE, Harrison DD, Cailliet R, Janik TJ, Holland B (2001) Radiographic analysis of lumbar lordosis: Centroid, Cobb, TRALL, and Harrison posterior tangent methods. Spine 26:E235–E242

    Article  CAS  PubMed  Google Scholar 

  12. Harrison DE, Janik TJ, Harrison DD, Cailliet R, Harmon SF (2002) Can the thoracic kyphosis be modeled with a simple geometric shape?: the results of circular and elliptical modeling in 80 asymptomatic patients. J Spinal Disord Tech 15:213–220

    PubMed  Google Scholar 

  13. Hedman TP, Fernie GR (1997) Mechanical response of the lumbar spine to seated postural loads. Spine 22:734–743

    Article  CAS  PubMed  Google Scholar 

  14. Huang QM, Andersson E, Thorstensson A (2001) Intramuscular myoelectric activity and selective coactivation of trunk muscles during lateral flexion with and without load. Spine 26:1465–1472

    Article  CAS  PubMed  Google Scholar 

  15. Hutton WC, Elmer WA, Boden SD, Hyon S, Toribatake Y, Tomita K, Hair GA (1999) The effect of hydrostatic pressure on intervertebral disc metabolism. Spine 24:1507–1515

    CAS  PubMed  Google Scholar 

  16. Jackson RP, McManus AC (1994) Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. A prospective controlled clinical study. Spine 19:1611–1618

    CAS  PubMed  Google Scholar 

  17. Janik TJ, Harrison DD, Cailliet R, Troyanovich SJ, Harrison DE (1998) Can the sagittal lumbar curvature be closely approximated by an ellipse? J Orthop Res 16:766–770

    CAS  PubMed  Google Scholar 

  18. Kawakami M, Tamaki T, Ando M, Yamada H, Hashizume H, Yoshida M (2002) Lumbar sagittal balance influences the clinical outcome after decompression and posterolateral spinal fusion for degenerative lumbar spondylolisthesis. Spine 27:59–64

    Article  PubMed  Google Scholar 

  19. Keller TS, Nathan M (1999) Height change caused by creep in intervertebral discs: a sagittal plane model. J Spinal Disord 12:313–324

    CAS  PubMed  Google Scholar 

  20. Keller TS, Roy AL (2002) Posture-dependent isometric trunk extension and flexion strength in normal male and female subjects. J Spinal Disord Tech 15:312–318

    PubMed  Google Scholar 

  21. Keller TS, Harrison DE, Colloca CJ, Harrison DD, Janik TJ (2003) Prediction of osteoporotic spinal deformity. Spine 28:455–462

    Article  PubMed  Google Scholar 

  22. Kettler A, Wilke HJ, Haid C, Claes L (2000) Effects of specimen length on the monosegmental motion behavior of the lumbar spine. Spine 25:543–550

    Article  CAS  PubMed  Google Scholar 

  23. Kiefer A, Shirazi-Adl A, Parnianpour M (1997) Stability of the human spine in neutral postures. Eur Spine J 6:45–53

    CAS  PubMed  Google Scholar 

  24. Kiefer A, Shirazi-Adl A, Parnianpour M (1998) Synergy of the human spine in neutral postures. Eur Spine J 7:471–479

    CAS  PubMed  Google Scholar 

  25. Krismer M, Haid C, Rabl W (1996) The contribution of anulus fibers to torque resistance. Spine 21:2551–2557

    Article  CAS  PubMed  Google Scholar 

  26. Kumar MN, Baklanov A, Chopin D (2001) Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion. Eur Spine J 10:314–319

    Article  CAS  PubMed  Google Scholar 

  27. Kuslich SD, Ulstrom CL, Michael CJ (1991) The tissue origin of low back pain and sciatica: a report of pain response to tissue stimulation during operations on the lumbar spine using local anesthesia. Orthop Clin North Am 22:181–187

    CAS  Google Scholar 

  28. Loder RT (2001) Profiles of the cervical, thoracic, and lumbosacral spine in children and adolescents with lumbosacral spondylolisthesis. J Spinal Disord 14:465–471

    Article  CAS  PubMed  Google Scholar 

  29. Mueller G, Morlock MM, Vollmer M, Honl M, Hille E, Schneider E (1998) Intramuscular pressure in the erector spinae and intra-abdominal pressure related to posture and load. Spine 23:2580–2590

    Article  CAS  PubMed  Google Scholar 

  30. Nachemson AL (1963) The influence of spinal movements on the lumbar intradiscal pressure and on the tensile stresses in the annulus fibrosus. Acta Orthop Scand 33:183–207

    CAS  Google Scholar 

  31. Nagurka ML, Hayes WC (1980) An interactive graphics package for calculating cross-sectional properties of complex shapes. J Biomech 13:59–64

    Article  CAS  PubMed  Google Scholar 

  32. Patwardhan AG, Havey RM, Meade KP, Lee B, Dunlap B (1999) A follower load increases the load-carrying capacity of the lumbar spine in compression. Spine 24:1003–1009

    Article  CAS  PubMed  Google Scholar 

  33. Patwardhan AG, Havey RM, Ghanayem AJ, Diener H, Meade KP, Dunlap B, Hodges SD (2000) Load-carrying capacity of the human cervical spine in compression is increased under a follower load. Spine 25:1548–1554

    CAS  PubMed  Google Scholar 

  34. Pearsall DJ, Reid JG (1994) The study of human body segment parameters in biomechanics. An historical review and current status report. Sports Med 18:126–140

    CAS  PubMed  Google Scholar 

  35. Pearsall DJ, Reid JG, Livingston LA (1996) Segmental inertial parameters of the human trunk as determined from computed tomography. Ann Biomed Eng 24:198–210

    CAS  PubMed  Google Scholar 

  36. Rohlmann A, Bergmann G, Graichen F (1999) Loads on internal spinal fixators measured in different body positions. Eur Spine J 8:354–359

    Article  CAS  PubMed  Google Scholar 

  37. Rohlmann A, Graichen F, Bergmann G (2000) Influence of load carrying on loads in internal spinal fixators. J Biomech 33:1099–1104

    Article  CAS  PubMed  Google Scholar 

  38. Rohlmann A, Graichen F, Weber U, Bergmann G (2000) 2000 Volvo Award winner in biomechanical studies: Monitoring in vivo implant loads with a telemeterized internal spinal fixation device. Spine 25:2981–2986

    CAS  PubMed  Google Scholar 

  39. Rohlmann A, Arntz U, Graichen F, Bergmann G (2001) Loads on an internal spinal fixation device during sitting. J Biomech 34:989–993

    Article  CAS  PubMed  Google Scholar 

  40. Rohlmann A, Neller S, Claes L, Bergmann G, Wilke HJ (2001) Influence of a follower load on intradiscal pressure and intersegmental rotation of the lumbar spine. Spine 26:E557–E561

    CAS  PubMed  Google Scholar 

  41. Sato K, Kikuchi S, Yonezawa T (1999) In vivo intradiscal pressure measurement in healthy individuals and in patients with ongoing back problems. Spine 24:2468–2474

    Article  CAS  PubMed  Google Scholar 

  42. Shirazi-Adl A, Parnianpour M (2000) Load-bearing and stress analysis of the human spine under a novel wrapping compression loading. Clin Biomech (Bristol, Avon) 15:718–725

    Google Scholar 

  43. Troyanovich SJ, Cailliet R, Janik TJ, Harrison DD, Harrison DE (1997) Radiographic mensuration characteristics of the sagittal lumbar spine from a normal population with a method to synthesize prior studies of lordosis. J Spinal Disord 10:380–386

    CAS  PubMed  Google Scholar 

  44. Wilke HJ, Neef P, Caimi M, Hoogland T, Claes LE (1999) New in vivo measurements of pressures in the intervertebral disc in daily life. Spine 24:755–62.

    Article  CAS  PubMed  Google Scholar 

  45. Wilke HJ, Rohlmann A, Neller S, Schultheiss M, Bergmann G, Graichen F, Claes LE (2001) Is it possible to simulate physiologic loading conditions by applying pure moments? A comparison of in vivo and in vitro load components in an internal fixator. Spine 26:636–642

    CAS  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank the following funding agencies for their support of this research: CBP Non-Profit; NASA Vermont Space Grant Consortium; NASA EPSCoR; and the Foundation for the Advancement of Chiropractic Education

Author information

Authors and Affiliations

  1. Ruby Mountain Chiropractic Center, 123 Second Street, Elko, NV, 89801, USA

    Deed E. Harrison

  2. State of the Art Chiropractic Center, P.C., Phoenix, Arizona, USA

    Christopher J. Colloca

  3. Department of Kinesiology, Arizona State University, Tempe, AZ, USA

    Christopher J. Colloca

  4. Biomechanics Laboratory, Université du Québec à Trois-Rivières, Trois Rivières, Québec, Canada

    Donald D. Harrison

  5. Computational Mathematics Research Consultant, Huntsville, AL, USA

    Tadeusz J. Janik

  6. Clinical Biomechanics of Posture of Colorado, Windsor, Colorado, USA

    Jason W. Haas

  7. Department of Mechanical Engineering, University of Vermont, Burlington, VT, USA

    Tony S. Keller

Authors
  1. Deed E. Harrison
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  2. Christopher J. Colloca
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  3. Donald D. Harrison
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  5. Jason W. Haas
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  6. Tony S. Keller
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Corresponding author

Correspondence to Deed E. Harrison.

Additional information

This study was presented, in part, at the 29th annual meeting of the International Society for the Study of the Lumbar Spine, Cleveland, OH, USA, 2002 May 14–18

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Harrison, D.E., Colloca, C.J., Harrison, D.D. et al. Anterior thoracic posture increases thoracolumbar disc loading. Eur Spine J 14, 234–242 (2005). https://doi.org/10.1007/s00586-004-0734-0

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  • DOI: https://doi.org/10.1007/s00586-004-0734-0

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