Microtrauma in the lumbar spine: a cause of low back pain. Neurosurgery 1988 Aug;23(2):162-8
Date
08/01/1988Pubmed ID
2972940DOI
10.1227/00006123-198808000-00006Scopus ID
2-s2.0-0023758434 (requires institutional sign-in at Scopus site) 66 CitationsAbstract
Excessive mechanical stress on the intervertebral disc may be one of the causes of low back pain. Most studies testing this thesis, however, have been based on quantification of the mechanical response of functional units at failure. Typically, radiography is used to demonstrate trauma to the vertebral body at the failure load. The description of failure and radiographic demonstration of damage are meaningful in specifying the tolerance limits of the structure. It is important, however, to understand the sequence underlying the initiation of injury, which may occur at subfailure physiological loads. In this study, we identified the initiation of injury to the lumbar spine by subjecting functional units to axial compressive loads using the mechanical response as a basis. Because conventional radiography failed to detect trauma at this level, advanced sectioning techniques were used. The initiation of injury (microtrauma) is defined as the point on the load-deflection curve where the structure exhibits a decreasing level of resistance for the first time before reaching its ultimate load-carrying capacity. The load deflection curve on this basis was classified into the ambient or preload phase, physiological loading phase, traumatic phase, and post-traumatic phase. Structures loaded to the end of the physiological loading phase did not exhibit any yielding or microtrauma. Injury in the form of microfractures of the endplate not detected on radiography, however, was observed under cryomicrotomy for structures loaded into the traumatic loading phase.
Author List
Yoganandan N, Maiman DJ, Pintar F, Ray G, Myklebust JB, Sances A Jr, Larson SJAuthors
Frank A. Pintar PhD Chair, Professor in the Biomedical Engineering department at Medical College of WisconsinNarayan Yoganandan PhD Professor in the Neurosurgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Back Pain
Biomechanical Phenomena
Humans
Intervertebral Disc
Lumbosacral Region
Middle Aged
Spinal Injuries
Stress, Mechanical