intervertebral disc | Force and Motion

intervertebral disc

Multigenerational growth approach to incorporate residual stress in an intervertebral disc finite element model with validation in multi-axial loading

Residual stresses are known to exist in human intervertebral discs but have not been incorporated in finite element models. A multigeneration model was applied to the annulus fibrosus of the intervertebral disc to simulate residual stresses arising from growth and remodeling. The intervertebral disc shape and compressive creep were used to verify that the multigeneration approach generates realistic values of residual stress. The model was then validated by comparing its 6 degree-of-freedom mechanical response to experimental data. Human intervertebral discs were tested in a custom-built hexapod in all 6 degrees-of-freedom (lateral shear, anterior-posterior shear, torsion, bending, flexion, and compression). Incorporating residual stresses resulted in a finite element model which can predict 4 degrees-of-freedom while excluding residual stresses produces a finite element model that can only predict 2 degrees-of-freedom.
Listed In: Biomechanical Engineering, Biomechanics, Orthopedic Research


In Vivo MRI Quantification of Human Disc Compression and Flexion/Extension

Disc function is mechanical, and measures of disc mechanical function are important to address spine function, degenerative disc disease, and low back pain. In vivo measures of disc mechanical function are needed, however the current standard in disc imaging is to acquire a single static image and classify the disc’s appearance using qualitative integer scales for degree of degeneration. Current grading standards are acknowledged as insufficient to identify symptomatic discs for treatment. In addition, static T2 weighted MRI cannot provide mechanical function information – mechanics must be measured as the change following a load or deformation perturbation. Because the disc experiences significant compression and height loss throughout the day, and because flexion-extension postures are often associated with low back pain, these physiological mechanical perturbations have potential to be used to quantify disc mechanics in vivo. The objective of this study was to use MRI-based methods to quantify in vivo disc function by measuring changes in disc geometry and T2 relaxation time with diurnal changes and with controllable posture. Quantification of in vivo disc mechanics by using diurnal loading or prescribed posture changes has potential to improve our ability to identify, evaluate, and treat degenerative disc disease. Symptomatic discs may have aberrant mechanics; if so, in vivo measurements of mechanical function may, with continued development, facilitate diagnosis of pathological discs.
Listed In: Biomechanical Engineering


Nucleotomy Alters Internal Strain Distribution of the Human Lumbar Intervertebral Disc

Nucleotomy is a surgical procedure following herniation and also simulates the reduced nucleus pulpousus (NP) pressure that occurs with disc degeneration. Internal disc strains are an important factor in disc function, yet it is unclear how internal strains are affected by nucleotomy. Grade II L3-L4 human cadaveric discs (n=6) were analyzed intact and after a partial nucleotomy that removed 30-50% of the NP through a left posterolateral incision (incision) while the contralateral side remained intact (uninjured). Two cycles of stress-relaxation testing were performed for reference (50N) and loaded (0.70MPa) configurations. After each 8hour equilibration period, the reference and loaded discs were imaged separately in a 7T MRI scanner (0.3mm isotropic resolution). The reference and loaded images were registered to calculate internal strain within the annulus fibrosus (AF) lamellae and discs were averaged to create anatomical templates. Circumferential, radial, and axial strains for each disc were transformed to the average templates, effectively normalizing the strains. Five circumferential regions were defined within the mid-third of the templates. Nucleotomy altered disc strains on both the incision and uninjured sides from the intact state. Strain fields were inhomogeneous through the five regions. Mean circumferential strain was unaffected by nucleotomy on the uninjured side, but decreased with incision, showing hoop strains through the AF were disrupted. Mean compressive axial strains were higher after nucleotomy, effectively reducing AF stiffness, and mean radial strains were unaltered after partial nucleotomy. These findings are important to address etiology and progression of degeneration, and to develop and evaluate therapeutic interventions.
Listed In: Biomechanical Engineering, Biomechanics, Orthopedic Research