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Annals of Biomedical Engineering

, Volume 33, Issue 3, pp 391–401 | Cite as

Human Lumbar Spine Creep during Cyclic and Static Flexion: Creep Rate, Biomechanics, and Facet Joint Capsule Strain

  • Jesse S. Little
  • Partap S. Khalsa
Article

Abstract

There is a high incidence of low back pain (LBP) associated with occupations requiring sustained and/or repetitive lumbar flexion (SLF and RLF, respectively), which cause creep of the viscoelastic tissues. The purpose of this study was to determine the effect of creep on lumbar biomechanics and facet joint capsule (FJC) strain. Specimens were flexed for 10 cycles, to a maximum 10 Nm moment at L5-S1, before, immediately after, and 20 min after a 20-min sustained flexion at the same moment magnitude. The creep rates of SLF and RLF were also measured during each phase and compared to the creep rate predicted by the moment relaxation rate function of the lumbar spine. Both SLF and RLF resulted in significantly increased intervertebral motion, as well as significantly increased FJC strains at the L3-4 to L5-S1 joint levels. These parameters remained increased after the 20-min recovery. Creep during SLF occurred significantly faster than creep during RLF. The moment relaxation rate function was able to accurately predict the creep rate of the lumbar spine at the single moment tested. The data suggest that SLF and RLF result in immediate and residual laxity of the joint and stretch of the FJC, which could increase the potential for LBP.

Keyword

Viscoelasticity Ligaments Kinematics Load relaxation 

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References

  1. 1.
    Adams, M. A., and P. Dolan. Time-dependent changes in the lumbar spine’s resistance to bending. Clin. Biomech. (Bristol., Avon.) 11:194–200, 1996.Google Scholar
  2. 2.
    Bernard, B. P., and L. Fine. Musculoskeletal Disorders and Workplace Factors: Critical Review of Epidemiologic Evidence for Work-Related Musculoskeletal Disorders of the Neck, Upper Extremity, and Low Back, 2nd ed. Bethesda, MD: National Institute for Occupational Safety and Health, 1997.Google Scholar
  3. 3.
    Cavanaugh, J., A. Ozaktay, H. Yamashita, A. Avramov, T. Getchell, and A. King. Mechanisms of low back pain. Clin. Orthop. Relat. Res. 335:166–180, 1997.Google Scholar
  4. 4.
    Cavanaugh, J. M., A. C. Ozaktay, H. T. Yamashita, and A. I. King. Lumbar facet pain: Biomechanics, neuroanatomy and neurophysiology. J. Biomech. 29:1117–1129, 1996.Google Scholar
  5. 5.
    Chimich, D., N. Shrive, C. Frank, L. Marchuk, and R. Bray. Water content alters viscoelastic behaviour of the normal adolescent rabbit medial collateral ligament. J. Biomech. 25:831–837, 1992.Google Scholar
  6. 6.
    Claude, L. N., M. Solomonow, B. H. Zhou, R. V. Baratta, and M. P. Zhu. Neuromuscular dysfunction elicited by cyclic lumbar flexion. Muscle Nerve 27:348–358, 2003.Google Scholar
  7. 7.
    Findly, W. N., J. W. Lai, and K. Onaran. Creep and Relaxation of Nonlinear Viscoelastic Mateirals, with an Introduction of Linear Viscoelasticity. Amsterdam: North Holland, 1976.Google Scholar
  8. 8.
    Fung, Y. Biomechanics: Mechanical Properties of Living Tissues, 2nd ed. New York: Springer-Verlag, 1993.Google Scholar
  9. 9.
    Gardner-Morse, M. G., and I. A. Stokes. The effects of abdominal muscle coactivation on lumbar spine stability. Spine 23:86–91, 1998.CrossRefPubMedGoogle Scholar
  10. 10.
    Gedalia, U., M. Solomonow, B. H. Zhou, R. V. Baratta, Y. Lu, and M. Harris. Biomechanics of increased exposure to lumbar injury caused by cyclic loading. Part 2. Recovery of reflexive muscular stability with rest. Spine 24:2461–2467, 1999.Google Scholar
  11. 11.
    Granata, K. P., and W. S. Marras. The influence of trunk muscle coactivity on dynamic spinal loads. Spine 20:913–919, 1995.Google Scholar
  12. 12.
    Hingorani, R. V., P. P. Provenzano, R. S. Lakes, A. Escarcega, and R. Vanderby, Jr. Nonlinear viscoelasticity in rabbit medial collateral ligament. Ann. Biomed. Eng. 32:306–312, 2004.Google Scholar
  13. 13.
    Hoffman, A. H., and P. Grigg. A method for measuring strains in soft tissue. J. Biomech. 17:795–800, 1984.Google Scholar
  14. 14.
    Ianuzzi, A., J. S. Little, J. B. Chiu, A. Baitner, G. Kawchuk, and P. S. Khalsa. Human lumbar facet joint capsule strains: I. During physiological motions. Spine J. 4:141–152, 2004.Google Scholar
  15. 15.
    Johannessen, W., E. J. Vresilovic, A. C. Wright, and D. M. Elliott. Intervertebral disc mechanics are restored following cyclic loading and unloaded recovery. Ann. Biomed. Eng. 32:70–76, 2004.Google Scholar
  16. 16.
    Kang, Y. M., W. S. Choi, and J. G. Pickar. Electrophysiologic evidence for an intersegmental reflex pathway between lumbar paraspinal tissues. Spine 27:E56–E63, 2002.Google Scholar
  17. 17.
    Keller, T. S., T. H. Hansson, S. H. Holm, M. M. Pope, and D. M. Spengler. In vivo creep behavior of the normal and degenerated porcine intervertebral disk: A preliminary report. J. Spinal Disord. 1:267–278, 1988.Google Scholar
  18. 18.
    Keller, T. S., S. H. Holm, T. H. Hansson, and D. M. Spengler. Volvo Award in experimental studies. The dependence of intervertebral disc mechanical properties on physiologic conditions. Spine 15:751–761, 1990.Google Scholar
  19. 19.
    Keller, T. S., D. M. Spengler, and T. H. Hansson. Mechanical behavior of the human lumbar spine. I. Creep analysis during static compressive loading. J. Orthop. Res. 5:467–478, 1987.Google Scholar
  20. 20.
    Koeller, W., S. Muehlhaus, W. Meier, and F. Hartmann. Biomechanical properties of human intervertebral discs subjected to axial dynamic compression–influence of age and degeneration. J. Biomech. 19:807–816, 1986.Google Scholar
  21. 21.
    Lakes, R. S., and R. Vanderby. Interrelation of creep and relaxation: A modeling approach for ligaments. J. Biomech. Eng. 121:612–615, 1999.Google Scholar
  22. 22.
    Little, J. S., A. Ianuzzi, J. B. Chiu, A. Baitner, and P. S. Khalsa. Human lumbar facet joint capsule strains: II. Alteration of strains subsequent to anterior interbody fixation. Spine J. 4:153–162, 2004.Google Scholar
  23. 23.
    Little, J. S., and P. S. Khalsa. Material properties of the human lumbar facet joint capsule. J. Biomech. Eng, 127:1–10, 2005.Google Scholar
  24. 24.
    Lu, D., M. Solomonow, B. Zhou, R. V. Baratta, and L. Li. Frequency-dependent changes in neuromuscular responses to cyclic lumbar flexion. J. Biomech. 37:845–855, 2004.Google Scholar
  25. 25.
    McGill, S. M., and S. Brown. Creep response of the lumbar spine to prolonged full flexion. Clin. Biomech. 7:43–46, 1992.Google Scholar
  26. 26.
    McLain, R. F., and J. G. Pickar. Mechanoreceptor endings in human thoracic and lumbar facet joints. Spine 23:168–173, 1998.CrossRefPubMedGoogle Scholar
  27. 27.
    Oliver, M. J., and L. T. Twomey. Extension creep in the lumbar spine. Clin. Biomech. (Bristol., Avon.) 10:363–368, 1995.Google Scholar
  28. 28.
    Panjabi, M. M., M. Krag, D. Summers, and T. Videman. Biomechanical time-tolerance of fresh cadaveric human spine specimens. J. Orthop. Res. 3:292–300, 1985.Google Scholar
  29. 29.
    Provenzano, P. P., R. S. Lakes, D. T. Corr, and R. R. Vanderby, Jr. Application of nonlinear viscoelastic models to describe ligament behavior. Biomech. Model. Mechanobiol. 1:45–57, 2002.Google Scholar
  30. 30.
    Provenzano, P., R. Lakes, T. Keenan, and R. Vanderby, Jr. Nonlinear ligament viscoelasticity. Ann. Biomed. Eng. 29:908–914, 2001.Google Scholar
  31. 31.
    Race, A., N. D. Broom, and P. Robertson. Effect of loading rate and hydration on the mechanical properties of the disc. Spine 25:662–669, 2000.CrossRefPubMedGoogle Scholar
  32. 32.
    Soderkvist, I., and P. A. Wedin. Determining the movements of the skeleton using well-configured markers. J. Biomech. 26:1473–1477, 1993.Google Scholar
  33. 33.
    Solomonow, M., R. V. Baratta, A. Banks, C. Freudenberger, and B. H. Zhou. Flexion-relaxation response to static lumbar flexion in males and females. Clin. Biomech. (Bristol., Avon.). 18:273–279, 2003.Google Scholar
  34. 34.
    Solomonow, M., R. V. Baratta, B. H. Zhou, E. Burger, A. Zieske, and A. Gedalia. Muscular dysfunction elicited by creep of lumbar viscoelastic tissue. J. Electromyogr. Kinesiol. 13:381–396, 2003.Google Scholar
  35. 35.
    Solomonow, M., Z. B. He, R. V. Baratta, Y. Lu, M. Zhu, and M. Harris. Biexponential recovery model of lumbar viscoelastic laxity and reflexive muscular activity after prolonged cyclic loading. Clin. Biomech. (Bristol., Avon.) 15:167–175, 2000.Google Scholar
  36. 36.
    Solomonow, M., B. H. Zhou, R. V. Baratta, Y. Lu, and M. Harris. Biomechanics of increased exposure to lumbar injury caused by cyclic loading: Part 1. Loss of reflexive muscular stabilization. Spine 24:2426–2434, 1999.CrossRefPubMedGoogle Scholar
  37. 37.
    Thornton, G. M., A. Oliynyk, C. B. Frank, and N. G. Shrive. Ligament creep cannot be predicted from stress relaxation at low stress: A biomechanical study of the rabbit medial collateral ligament. J. Orthop. Res. 15:652–656, 1997.Google Scholar
  38. 38.
    Thornton, G. M., N. G. Shrive, and C. B. Frank. Ligament creep recruits fibres at low stresses and can lead to modulus-reducing fibre damage at higher creep stresses: A study in rabbit medial collateral ligament model. J. Orthop. Res. 20:967–974, 2002.Google Scholar
  39. 39.
    Twomey, L., and J. Taylor. Flexion creep deformation and hysteresis in the lumbar vertebral column. Spine 7:116–122, 1982.Google Scholar
  40. 40.
    White, A., and M. M. Panjabi. Clinical Biomechanics of the Spine, 2nd ed. Philadelphia: Lippincott, 1990.Google Scholar
  41. 41.
    Williams, M., M. Solomonow, B. H. Zhou, R. V. Baratta, and M. Harris. Multifidus spasms elicited by prolonged lumbar flexion. Spine 25:2916–2924, 2000.Google Scholar

Copyright information

© Biomedical Engineering Society 2005

Authors and Affiliations

  1. 1.Department of Biomedical EngineeringStony Brook UniversityStony Brook11794-8181
  2. 2.Department of Biomedical EngineeringStony Brook UniversityStony Brook

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