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Intervertebral disc herniation: studies on a porcine model exposed to highly repetitive flexion/extension motion with compressive force

  • Jack P Callaghan
    Footnotes
    Affiliations
    Occupational Biomechanics and Safety Laboratories, Faculty of Applied Health Sciences, Department of Kinesiology, University of Waterloo, Waterloo, Ont., Canada N2L 3G1
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  • Stuart M McGill
    Correspondence
    Corresponding author
    Affiliations
    Occupational Biomechanics and Safety Laboratories, Faculty of Applied Health Sciences, Department of Kinesiology, University of Waterloo, Waterloo, Ont., Canada N2L 3G1
    Search for articles by this author
  • Author Footnotes
    1 Currently at Department of Human Biology and Nutritional Sciences, University of Guelph, Guelph, Ont., Canada N1G 2W1.

      Abstract

      Objective. To determine whether repeated motion with low magnitude joint forces, and flexion/extension moments consistently produce herniation in a non-degenerated, controlled porcine spine motion segment.
      Design. Combined loading (flexion/extension motions and compressive forces) was applied to in vitro porcine functional spinal units. Biomechanical and radiographic characteristics were documented.
      Background. While most studies performed in vitro have examined uniaxial or fixed position loading to older specimens, there have been few studies that have examined whether `healthy' intervertebral discs can be injured by low magnitude repeated combined loading.
      Methods. Porcine cervical spine motion segments (C3–C4) were mounted in a custom jig which applied axial compressive loads with pure flexion/extension moments. Dynamic testing was conducted to a maximum of 86400 bending cycles at a rate of 1 Hz with simultaneous torques, angular rotations, axial deformations recorded for the duration of the test.
      Results. Herniation (posterior and posterior-lateral regions of the annulus) occurred with relatively modest joint compression but with highly repetitive flexion/extension moments. Increased magnitudes of axial compressive force resulted in more frequent and more severe disc injuries.
      Conclusions. The results support the notion that intervertebral disc herniation may be more linked to repeated flexion extension motions than applied joint compression, at least with younger, non-degenerated specimens.Relevance
      While intervertebral disc herniations are observed clinically, consistent reproduction of this injury in the laboratory has been elusive. This study was designed to examine the biomechanical response and failure mechanics of spine motion segments to highly repetitive low magnitude complex loading.

      Keywords

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      References

        • Smeathers J.E
        Some time dependent properties of the intervertebral joint when under compression.
        Eng Med. 1984; 13: 83-87
        • Brinckmann P
        • Biggemann M
        • Hilweg D
        Fatigue fracture of human lumbar vertebrae.
        Clin Biomech. 1988; 3: 1-23
        • Smeathers J.E
        • Joanes D.N
        Dynamic compressive properties of human lumbar intervertebral joints: A comparison between fresh and thawed specimens.
        J Biomechanics. 1988; 21: 425-433
        • Liu Y.K
        • Njus G
        • Buckwalter J.A
        • Wakano K
        Fatigue response of lumbar intervertebral joints under axial cyclic loading.
        Spine. 1983; 8: 857-865
        • Hansson T.H
        • Keller T.S
        • Spengler D.M
        Mechanical behavior of the human lumbar spine. II. Fatigue strength during dynamic compressive loading.
        J Orthop Res. 1987; 5: 479-487
        • Wilder D.G
        • Pope M.H
        • Frymoyer J.W
        The biomechanics of lumbar disc herniation and the effect of overload and instability.
        J Spinal Disord. 1988; 1: 16-32
        • Adams M.A
        • Hutton W.C
        Gradual disc prolapse.
        Spine. 1985; 10: 524-531
        • Adams M.A
        • Hutton W.C
        The effect of fatigue on the lumbar intervertebral disc.
        J Bone Jt Surg (B). 1983; 65: 199-203
        • Adams M.A
        • Hutton W.C
        Prolapsed intervertebral disc: A hyperflexion injury.
        Spine. 1982; 7: 184-191
        • Adams M.A
        • Hutton W.C
        Has the lumbar spine a margin of safety in forward bending.
        Clin Biomech. 1986; 1: 3-6
        • Gordon S.J
        • Yang K.H
        • Mayer P.J
        • Mace Jr., A.H
        • Kish V.L
        • Radin E.L
        Mechanism of disc rupture – a preliminary report.
        Spine. 1991; 16: 450-456
        • Brinckmann P
        • Porter R.W
        A laboratory model of lumbar disc protrusion – Fissure and Fragment.
        Spine. 1994; 19: 228-235
        • Hardy W.G
        • Lissner H.R
        • Webster J.E
        • Gurdjian E.S
        Repeated loading tests of the lumbar spine.
        Surgical Forum. 1958; 9: 690-695
        • Adams M.A
        • Hutton W.C
        • Stott J.R.R
        The resistance to flexion of the lumbar intervertebral joint.
        Spine. 1980; 5: 245-253
        • Yingling V.R
        • Callaghan J.P
        • McGill S.M
        The porcine cervical spine as a model of the human lumbar spine: an anatomical, geometric, and functional comparison.
        J Spinal Disord. 1999; 12: 415-423
        • Callaghan J.P
        • McGill S.M
        Frozen storage increases the ultimate compressive load of porcine vertebrae.
        J Orthop Res. 1995; 13: 809-812
      1. Galante JO. Tensile properties of the human lumbar annulus fibrosus. Acta Orthop Scand 1967;(Suppl. 100):5–91

      2. Gunning J, McGill SM. Intervertebral disc hydration modulates the injury process. Proceedings of the XVIIth Congress of the International Society of Biomechanics. Calgary: University of Calgary, 1999. p. 344

        • Panjabi M.M
        • Duranceau J.S
        • Oxland T.R
        • Bowen C.E
        Multidirectional instabilities of traumatic cervical spine injuries in a porcine model.
        Spine. 1989; 14: 1111-1115
        • Goel V.K
        • Voo L.M
        • Weinstein J.N
        • Liu Y.K
        • Okuma T
        • Njus G.O
        Response of the ligamentous lumbar spine to cyclic bending loads.
        Spine. 1988; 13: 294-300
        • Lu Y.M
        • Hutton W.C
        • Gharpuray V.M
        Do bending, twisting, and diurnal fluid changes in the disc affect the propensity to prolapse? A viscoelastic finite element model.
        Spine. 1996; 21: 2570-2579
        • Oxland T.R
        • Panjabi M.M
        • Southern E.P
        • Duranceau J.S
        An anatomic basis for spinal instability: a porcine trauma model.
        J Orthop Res. 1991; 9: 452-462
        • Osvalder A.L
        • Neumann P
        • Lovsund P
        • Nordwall A
        Ultimate strength of the lumbar spine in flexion-an in vitro study.
        J Biomech. 1990; 23: 453-460
        • Bogduk N
        • Twomey L.T
        Age changes in the lumbar spine.
        in: Bogduk N Twomey L.T Clinical anatomy of the lumbar spine. Churchhill Livingstone, New York1991: 145-150
      3. Kraemer J. Natural course and prognosis of intervertebral disc diseases. International society for the study of the lumbar spine, Seattle, Washington, June 1994. Spine 1995;20:635–39

        • Yoganandan N
        • Cusick J.F
        • Pintar F.A
        • Droese K
        • Reinartz J
        Cyclic compression-flexion loading of the human lumbar spine.
        Spine. 1994; 19: 784-790
        • Urban J.P.G
        • Holm S
        • Maroudas A
        Diffusion of small solutes into the intervertebral disc: An in vivo study.
        Biorheology. 1978; 15: 203-223
        • Yingling V.R
        • Callaghan J.P
        • McGill S.M
        Dynamic loading affects the mechanical properties and failure site of porcine spines.
        Clin Biomech. 1997; 15: 301-305