医学
腰骶关节
生物力学
背景(考古学)
椎间盘
腰痛
面(心理学)
小关节
骨质疏松症
解剖
变性(医学)
口腔正畸科
腰椎
病理
心理学
古生物学
社会心理学
替代医学
人格
五大性格特征
生物
作者
Alexander Tsouknidas,Stylianos Orestis Sarigiannidis,Kleovoulos Anagnostidis,Nikolaos Michailidis,Sashin Ahuja
标识
DOI:10.1016/j.spinee.2014.12.148
摘要
Background context With an increasing prevalence of low back pain, physicians strive to optimize the treatment of patients with degenerated motion segments. There exists a consensus in literature that osteoporotic patients exhibit nonphysiologic loading patterns, while degenerated intervertebral discs (IVDs) are also believed to alter spine biomechanics. Purpose To evaluate alterations occurring in lumbosacral spine biomechanics of an osteoporotic model, with or without IVD degeneration, when compared with a healthy spine segment. Study design The investigation was based on finite element (FE) analysis of a patient-specific lumbosacral spine model. Methods A biorealistic model of a lumbosacral spine segment is introduced to determine the morbidity of disc degeneration and osteoporosis. The model was verified and validated for the purpose of the study and subjected to a dynamic FE analysis, considering anisotropic bone properties and solid ligamentous tissue. Results The yielded results merit high clinical interest. Osteoporosis resulted in a nonuniform increase of facet joint loading, which was even more pronounced in the scenario simulating a degenerated disc. The results also revealed an enslavement of intradiscal pressure to the disc state (in the degenerated and superior adjacent level). Conclusions The investigation presented refined insight into the dynamic biomechanical response of a degenerated spine segment. The increase in the calculated occurring stresses was considered as critical in the motion segment adjacent and superior to the degenerated one. This suggests that prevalent trauma in a motion segment may be a symptomatic condition of a poorly treated formal pathology in the inferior spine level.
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