Kinematic response of lumbar functional spinal units to axial torsion with and without superimposed compression and flexion/extension

Abstract

Experimental data suggest that lumbar torsion contributes to lumbar disc degenerative changes, such as instability, spondylolisthesis and spinal canal stenosis. However, some basic mechanical characteristics of the lumbar spine under torsional loading have not yet been reported in detail. For example, the function of the facet joints under combined mechanical loads such as torsion with superimposed flexion or extension postures is an area of interest about which little biomechanical data have been reported. In this study, the kinematic response to axial torsion with superimposed axial compression (200 N), compression-flexion (3 and 6 Nm) and compression-extension (3 and 6 Nm) was investigated in 10 cadaveric lumbar functional spinal units. Range of motion (ROM), and helical axes of motion (HAM), were analyzed. There was no difference in ROM between no preload, pure compressive and flexion-compression preload conditions. The ROM was significantly reduced by both extension-compression preload conditions (11% reduction for 3 Nm and 19% reduction for 6 Nm of extension) compared to the pure compressive preload. For no preload, the average HAM position in the transverse plane of the intervertebral disc was near the posteriormost part of the disc and located laterally on the side contralateral to the applied torsional moment. In the transverse plane, the HAM position showed a discrete trend towards the posterior part of the specimens during extension. Kinematic data were visualized using computer animation techniques and CT-based reconstructions of the respective specimens. This information may be used for identifying and characterizing physiologic and pathologic motion and for specifying conservative and surgical treatment concepts and, thus, may find application to identifying indications for spinal fusion or in evaluating the effect of future semi-flexible instrumentation.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

References

  1. 1.

    Adams MA, Hutton WC (1983) The mechanical function of the lumbar apophyseal joints. Spine 8:327–330

    CAS  PubMed  Google Scholar 

  2. 2.

    Ahmed AM, Duncan NA, Burke DL (1990) The effect of facet geometry on the axial torque-rotation response of lumbar motion segments. Spine 15:391–401

    CAS  PubMed  Google Scholar 

  3. 3.

    Cavanaugh JM, Ozaktay AC, Yamashita HT, King AI (1996) Lumbar facet pain: biomechanics, neuroanatomy and neurophysiology. J Biomech 29:1117–1129

    Article  CAS  PubMed  Google Scholar 

  4. 4.

    Cholewicki J, Crisco JJ 3rd, Oxland TR, Yamamoto I, Panjabi MM (1996) Effects of posture and structure on three-dimensional coupled rotations in the lumbar spine. A biomechanical analysis. Spine 21:2421–2428

    Article  CAS  PubMed  Google Scholar 

  5. 5.

    Cossette JW, Farfan HF, Robertson GH, Wells RV (1971) The instantaneous center of rotation of the third lumbar intervertebral joint. J Biomech 4:149–153)

    Article  CAS  PubMed  Google Scholar 

  6. 6.

    Cripton PA, Bruehlmann SB, Orr TE, Oxland TR, Nolte LP (2000) In vitro axial preload application during spine flexibility testing: towards reduced apparatus-related artefacts J Biomech 33:1559–1568

    Google Scholar 

  7. 7.

    Cripton PA, Sati M, Orr TE, Bourquin Y, Dumas GA, Nolte LP (2001) Animation of in vitro biomechanical tests. J Biomech 34:1091–1096

    Article  CAS  PubMed  Google Scholar 

  8. 8.

    Cyron BM, Hutton WC (1980) Articular tropism and stability of the lumbar spine. Spine 5:168–172

    PubMed  Google Scholar 

  9. 9.

    Deyo RA, Cherkin D, Conrad D, Violinn E (1991) Cost, controversy, crisis: low back pain and the health of the public. Annu Rev Public Health 12:141–156

    Article  CAS  PubMed  Google Scholar 

  10. 10.

    Farfan HF, Cossette JW, Robertson GH, Wells RV, Kraus H (1970) The effects of torsion on the lumbar intervertebral joints: the role of torsion in the production of disc degeneration. J Bone Joint Surg Am 52:468–497

    CAS  PubMed  Google Scholar 

  11. 11.

    Frymoyer JW (1988) Backpain and sciatica. N Engl J Med 318:291–300

    Google Scholar 

  12. 12.

    Frymoyer JW, Cats-Baril WL (1991) An overview of the incidences and costs of low back pain. Orthop Clin North Am 22:263–271

    CAS  PubMed  Google Scholar 

  13. 13.

    GBE (1994) Gesundheitsbericht für Deutschland 8.2:444

  14. 14.

    Gibson JN, Waddell G, Grant IC (2000) Surgery for degenerative lumbar spondylosis. Cochrane Database Syst Rev 2+3:CD 001352

  15. 15.

    Gunzburg R, Hutton WC, Crane G, Fraser RD (1992) Role of capsulo-ligamentous structures in rotation and combined flexion-rotation of the lumbar spine. J Spinal Disord 5:1–7

    CAS  PubMed  Google Scholar 

  16. 16.

    Hadler NM (1995) the disabling backache. An international perspective. Spine 20:640–649

    CAS  PubMed  Google Scholar 

  17. 17.

    Haher TR, O’Brien M, Felmly WT et al (1992) Instantaneous axis of rotation as a function of the three columns of the spine. Spine 6 [Suppl]:149–154

    Google Scholar 

  18. 18.

    Kinzel GL, Hall AS, Hillberry BM (1972) Measurement of the total motion between two body segments-I. Analytical development. J Biomech 5:93–105

    Article  CAS  PubMed  Google Scholar 

  19. 19.

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

    Article  CAS  PubMed  Google Scholar 

  20. 20.

    Lorenz M, Patwardhan A, Vanderby R Jr (1983) Load-bearing characteristics of lumbar facets in normal and surgically altered spinal segments. Spine 8:122–130

    CAS  PubMed  Google Scholar 

  21. 21.

    Lovett RW (1905) The mechanism of the normal spine and its relation to scoliosis. Boston Med Surg J 13:349–358

    Google Scholar 

  22. 22.

    Lund T, Oxland TR, Jost B, Cripton P, Grassmann S, Etter C, Nolte LP (1998) Interbody cage stabilisation in the lumbar spine: biomechanical evaluation of cage design, posterior instrumentation and bone density. J Bone Joint Surg Br 80:351–359

    CAS  PubMed  Google Scholar 

  23. 23.

    Lund T, Oxland TR, Nydegger T, Schlenzka D, Laine T, Heini P (2002) Is there a connection between the clinical response after an external fixation test or a subsequent lumbar fusion and the pre-test intervertebral kinematics? Spine 27:2726–2733

    Article  PubMed  Google Scholar 

  24. 24.

    Lund T, Nydegger T, Schlenzka D, Oxland TR (2002) Three-dimensional motion patterns during active bending in patients with chronic low back pain. Spine 27:1865–1874

    Article  PubMed  Google Scholar 

  25. 25.

    McGill SM, Norman RW (1986) Partitioning of the L4-L5 dynamic moment into disc, ligamentous, and muscular components during lifting. Spine 11:666–678

    CAS  PubMed  Google Scholar 

  26. 26.

    McGlashen KM, Miller JA, Schultz AB, Andersson GB (1987) Load displacement behavior of the human lumbo-sacral joint. J Orthop Res 5:488–496

    CAS  PubMed  Google Scholar 

  27. 27.

    Nägerl H, Kubein-Meesenburg D, Cotta H, Fanghänel J, Rossow A, Spiering S (1995) Biomechanische Prinzipien in Diarthrosen und Synarthrosen. Teil IV: Zur Mechanik der Wirbelsäule im Lendenbereich. Eine Pilotstudie. Z Orthop 133:1–11

    CAS  Google Scholar 

  28. 28.

    Natarajan RN, Andersson GB, Patwardhan AG, Andriacchi TP (1999) Study on effect of graded facetectomy on change in lumbar motion segment torsional flexibility using three-dimensional continuum contact representation for facet joints. J Biomech Eng 121:215–221

    CAS  PubMed  Google Scholar 

  29. 29.

    Oxland TR, Panjabi MM, Lin RM (1994) Axes of motion of thoracolumbar burst fractures. J Spinal Disord 7:130–138

    CAS  PubMed  Google Scholar 

  30. 30.

    Panjabi MM, Krag MH, White AA 3rd, Southwick WO (1977) Effects of preload on load displacement curves of the lumbar spine. Orthop Clin North Am 8:181–192

    CAS  PubMed  Google Scholar 

  31. 31.

    Panjabi M, Yamamoto I, Oxland T, Crisco J (1989) How does posture affect coupling in the lumbar spine? Spine 14:1002–1011

    CAS  PubMed  Google Scholar 

  32. 32.

    Pearcy MJ, Hindle RJ (1991) Axial rotation of lumbar intervertebral joints in forward flexion. Proc Inst Mech Eng [H] 205: 205–209

    Google Scholar 

  33. 33.

    Pope MH, Wilder DG, Matteri RE, Frymoyer JW (1977) Experimental measurements of vertebral motion under load. Orthop Clin North Am 8:155–167

    CAS  PubMed  Google Scholar 

  34. 34.

    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:E557–561

    CAS  PubMed  Google Scholar 

  35. 35.

    Schendel MJ, Wood KB, Buttermann GR, Lewis JL, Ogilvie JW (1993) Experimental measurement of ligament force, facet force, and segment motion in the human lumbar spine. J Biomech 26:427–438

    Article  CAS  PubMed  Google Scholar 

  36. 36.

    Schultz AB, Warwick DN, Berkson MH, Nachemson AL (1979) Mechanical properties of of human lumbar spine motion segments. Part 1. Responses in flexion, extension, lateral bending, and torsion. J Biomech Eng 101:46–52

    Google Scholar 

  37. 37.

    Shirazi-Adl A (1994) Nonlinear stress analysis of the whole lumbar spine in torsion-mechanics of facet articulation. J Biomech 27:289–299

    CAS  PubMed  Google Scholar 

  38. 38.

    Shirazi-Adl A, Ahmed AM, Shrivastava SC (1986) Mechanic response of a lumbar motion segment in axial torque alone and combined with compression. Spine 11:914–927

    CAS  PubMed  Google Scholar 

  39. 39.

    Stokes IA, Wilder DG, Frymoyer JW, Pope MH (1981) Assessment of patients with low-back pain by biplanar radiographic measurement of intervertebral motion. Spine 6:233–240

    CAS  PubMed  Google Scholar 

  40. 40.

    Tencer AF, Ahmed AM, Burke DL (1982) Some static mechanical properties of the lumbar intervertebral joint, intact and injured. J Biomech Eng 104:193–201

    CAS  PubMed  Google Scholar 

  41. 41.

    White AA, Panjabi MM (1978) The basic kinematics of the human spine. Spine 3:12–20

    Google Scholar 

Download references

Acknowledgement

This work was funded in part by Stryker Corporation, Europe Division, Cestas France.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Hannes Haberl.

Additional information

Dedication: The authors would like to dedicate this article to our co-author Dr. Tracy E. Orr. Tracy died unexpectedly in November 2002 from complications associated with childbirth. We are profoundly saddened by Tracy’s death. She was an incomparable scientific collaborator and friend. She will be greatly missed.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Haberl, H., Cripton, P.A., Orr, T. et al. Kinematic response of lumbar functional spinal units to axial torsion with and without superimposed compression and flexion/extension. Eur Spine J 13, 560–566 (2004). https://doi.org/10.1007/s00586-004-0720-6

Download citation

Keywords

  • Lumbar torsion
  • Kinematics
  • Facet joints
  • Biomechanics
  • Instability
  • Helical axis