Lumbar spine finite element model for healthy subjects: development and validation

Finite element (FE) method is a proven powerful and efficient tool to study the biomechanics of the human lumbar spine. However, due to the large inter-subject variability of geometries and material properties in human lumbar spines, concerns existed on the accuracy and predictive power of one single deterministic FE model with one set of spinal geometry and material properties. It was confirmed that the combined predictions (median or mean value) of several distinct FE models can be used as an improved prediction of behavior of human lumbar spine under identical loading and boundary conditions. In light of this improved prediction, five FE models (L1-L5 spinal levels) of the human lumbar spine were developed based on five healthy living subjects with identical modeling method. The five models were extensively validated through experimental and computational results in the literature. Mesh convergence and material sensitivity analysis were also conducted. We have shown that the results from the five FE models developed in this paper were consistent with the experimental data and simulation results from the existing literature. The validated modeling method introduced in this study can be used in modeling dysfunctional lumber spines such as disc degeneration and scoliosis in future work.     

The lumbar and sacrum movement pattern during the back squat exercise

An essential exercise for strength training of the lower limbs is the squat exercise. During this exercise, changes in lumbar lordosis are commonly used to indicate when the descent of the squat should cease, yet the behavior of the lumbar-scarum segments remains unclear. The purpose of this study was to quantify the lumbar-sacrum movements during the back squat, because the movement of the sacrum is influenced by the width of stance, this variable was also investigated. Thirty trained subjects, 18 men with 1 repetition maximum (1RM) squat of 123% (13.9%) of bodyweight and 12 women with 1RM squat of 93% (15.6%), performed a set of narrow and wide stance squats, each carrying an additional 50% of body weight as load. The timing and movement of the lumbar angle (T12/L1), sacrum angle (L5/S1), and lumbar flexion angle (lumbar lordosis) were measured in 3 dimensions for the ascent and decent phases. Men and women achieved similar lumbar angles for both width of stance and phase. Sacrum angles, lumbar flexion angles, and timing differed significantly (p < 0.05) between gender and width of stance. The lumbar flexion range during the descent phase for women in narrow and wide stance was 12.9° and 12.6°, respectively; for men, this range was significantly (p < 0.05) larger at 26.3° and 25.4°, respectively. Men and women developed different movement patterns for the squatting movement, and therefore, this needs to be considered in strength development and screening procedures. The lumbar spine became kyphotic as soon as a load was placed on the shoulders, and any teaching cues to maintain a curved lumbar spine when squatting must be questioned.     

Biomechanical design of load simulation in multiple spinal segments]

Multisegmental biomechanical studies on the lumbar spine are steadily increasing in importance. Only in this way can we acquire knowledge about the physiological behaviour of the entire lumbar spine. Furthermore, these studies allow us to analyse in vitro the biomechanics of manipulated lumbar spines after various surgical operations on the spine. A load simulator was developed to investigate multisegmental lumbar spine mobility, and its function was investigated in an initial study on 19 fresh--frozen specimens of human lumbar spine. After x-ray examination and determination of the bone mineral density, the specimens were loaded up to 10 Nm in the automatic electromechanical loading system under flexion/extension, lateral bending and axial rotation. An ultrasound-based motion analysis system was used to measure the displacements of the vertebrae involved.     

Genetic effects of bystander factors from the blood sera of people irradiated as the result of the Chernobyl accident

The purpose of this work was the analysis of the effects of bystander factors from blood sera of people affected by the Chernobyl accident on human keratinocyte cell culture (HPV-G cells). A new method was developed for evaluation of the bystander factor presence in vivo in blood of the people irradiated by the Chernobyl accident. Affected population groups included liquidators of the Chernobyl accident and people living and working in areas of the Gomel region contaminated by radionuclides. The analysis has shown that bystander factors persist in Chernobyl liquidator blood samples for more than 20 years since irradiation. The data suggest that blood sera contain bystander factors, which are able to induce micronuclei and decrease the metabolic activity of HPV-G cells.     

Biomechanical implications of lumbar spinal ligament transection

Many lumbar spine surgeries either intentionally or inadvertently damage or transect spinal ligaments. The purpose of this work was to quantify the previously unknown biomechanical consequences of isolated spinal ligament transection on the remaining spinal ligaments (stress transfer), vertebrae (bone remodelling stimulus) and intervertebral discs (disc pressure) of the lumbar spine. A finite element model of the full lumbar spine was developed and validated against experimental data and tested in the primary modes of spinal motion in the intact condition. Once a ligament was removed, stress increased in the remaining spinal ligaments and changes occurred in vertebral strain energy, but disc pressure remained similar. All major biomechanical changes occurred at the same spinal level as the transected ligament, with minor changes at adjacent levels. This work demonstrates that iatrogenic damage to spinal ligaments disturbs the load sharing within the spinal ligament network and may induce significant clinically relevant changes in the spinal motion segment.     

Biomechanical differences of Coflex-F and pedicle screw fixation combined with TLIF or ALIF--a finite element study

Lumbar interbody fusion is a common procedure for treating lower back pain related to degenerative disc diseases. The Coflex-F is a recently developed interspinous spacer, the makers of which claim that it can provide stabilisation similar to pedicle screw fixation. Therefore, this study compares the biomechanical behaviour of the Coflex-F device and pedicle screw fixation with transforaminal lumbar interbody fusion (TLIF) or anterior lumbar interbody fusion (ALIF) surgeries by using finite element analysis. The results show that the Coflex-F device combined with ALIF surgery can provide stability similar to the pedicle screw fixation combined with TLIF or ALIF surgery. Also, the posterior instrumentations (Coflex-F and pedicle screw fixation) combined with TLIF surgery had lower stability than when combined with ALIF surgery.     

Biomechanical differences of Coflex-F and pedicle screw fixation combined with TLIF or ALIF – a finite element study

Lumbar interbody fusion is a common procedure for treating lower back pain related to degenerative disc diseases. The Coflex-F is a recently developed interspinous spacer, the makers of which claim that it can provide stabilisation similar to pedicle screw fixation. Therefore, this study compares the biomechanical behaviour of the Coflex-F device and pedicle screw fixation with transforaminal lumbar interbody fusion (TLIF) or anterior lumbar interbody fusion (ALIF) surgeries by using finite element analysis. The results show that the Coflex-F device combined with ALIF surgery can provide stability similar to the pedicle screw fixation combined with TLIF or ALIF surgery. Also, the posterior instrumentations (Coflex-F and pedicle screw fixation) combined with TLIF surgery had lower stability than when combined with ALIF surgery.     

Role of CT scan in theranostic and management of traumatic spinal cord injury

Traumatic spinal cord injury (TSCI) is a condition with suffering of neural structures from acute trauma with short-term or permanent sensory and motor problems. This study was conducted with the aim of determining the prevalence of TSCI in Tehran with emphasis on demographic characteristics of patients and to evaluate the effect of computed tomography (CT) in determining fracture type and severity grade of injury among TSCI patients. In a cross-sectional study, all TSCI and spinal fracture patients (N = 520) who referred to the main trauma center in Tehran, Iran, in 2013 and 2014 were selected. Radiography and CT scan were prepared and reported blindedly by two radiologists. Majority of the patients was 21–30 years male, married and their most common occupation was car driver. A significant difference was observed between gender and etiology (P = 0.001). The main etiology was traffic accident followed by falling from height. While the most common location of injury for males was thoracic vertebrae followed by lumbar vertebrae; for females it was lumbar followed by thoracic. Majority of patients had ASIA (American Spinal Injury Association) impairment scale of E (normal), followed by B (sensory incomplete). Most of the cases were hospitalized less than one week. Age of the patient and duration of hospitalization had a significant association (P = 0.015). The results showed that in traumatic spinal cord events, traffic accident and falling from height are the main etiologies; hence, authorities in Iranian health system could consider preventive policies to decline the load and TSCI effects in hospitals and population.     

Growth related increase in an intervertebral disc space in rats

Methods have been developed that permit repetitive radiographic measurement of the lumbar L4-5 intervertebral disc space area in the laboratory rat. In using this approach, the coefficient of variation in repetitive determinations was 7.6 +/- 0.7%. Normal rats have been shown to manifest statistically significant increase in disc space area size between 2.5 and 5 months of age.     

一个预测核事故后果的动态食物链模式与程序

描述了一个新过建立与开发的能预测核事故后果的动态食物链模式与程序,它既适用于西方饮食谱,也适用于中国居民的饮食谱,此模式考虑了干,湿沉积截获和初始滞留,易位,入渗,根部吸收,耕作等过程对事故释放导致的植物可食用部位中核素浓度的影响,也考虑了动物对核素的摄入,食品加工的影响及人体食入途径对核素的摄入率,在干沉积中考虑了有效叶面积指数对干沉积量的影响,在湿沉积中考虑了事故期间不同时期不同降雨强度对湿沉     

Representation of passive spinal element contributions to in vitro flexion-extension using a polynomial model: illustration using the porcine lumbar spine

A polynomial modeling approach was developed to describe the contribution of individual passive spinal elements to the lumbar spinal motion segment flexion-extension motion. Flexion-extension moment-angle curves from porcine lumbar spines tested using a robotic testing system were described using sixth-order polynomials; the polynomials describing different dissection conditions were subtracted to describe the contribution of individual spinal elements to the motion segment flexion-extension properties. This modeling approach is a powerful and straightforward method for representing the mechanics of individual spinal tissues in biomechanical models and could easily be expanded to incorporate other features such as axial load.     

Study in situ et in vivo of the acceleration of lumbar vertebrae of a primate exposed to vibration in the Z-axis

In order to study the propagation of vibration along the spine, the authors developed a method allowing in vivo et in situ measurement of vibrational accelerations in the lower lumbar spine of a primate.

The surgical technique used to anchor the miniature accelerometers on the anterior wall of vertebral bodies is described. After recovery, the sitting animal is exposed to a vibration stimulus. Direct recording of data obtained from the lowest four lumbar vertebrae of a healthy live animal provide objective information on the behavior of intervertebral discs and will later permit definition of the role of skeletal muscles in the spinal response to a vibrational stress.     

Modifications of motoneuron development following transplantation of thoracic spinal cord to the lumbar region in the chick embryo: Evidence for target-derived signals that regulate differentiation

In order to examine the role of target cells in the development of spinal motoneurons, the neural tube from thoracic segments was transplanted to the lumbar region on embryonic day (E) 2, and allowed to innervate hindlimb muscles in the chick embryo. When examined at later stages of development, the proportion of white and gray matter in the thoracic transplant was altered to resemble normal lumbar cord. Many thoracic motoneurons were able to survive up to posthatching stages following transplantation. The branching and arborization of dendrites of thoracic motoneurons innervating hindlimb muscles, as well as motoneuron (soma) size, were also increased to an extent approximating that seen in normal lumbar motoneurons. In support of previous studies using a similar transplant model, we have also found that the peripheral (intramuscular) branching pattern of thoracic motoneuron axons innervating hindlimb muscles was similar to that of normal lumbar motoneurons. Axon size and the degree of myelination of transplanted thoracic motoneuron axons were also increased so that these parameters more closely resembled axons of normal lumbar than normal thoracic spinal motoneurons. Virtually all of the changes in motoneuron properties noted above were observed irrespective of whether or not the transplanted spinal cord had developed in anatomical continuity with the host rostral cord. Accordingly, it is unlikely that the changes in the development of transplanted thoracic motoneurons reported here are induced either entirely, or in part, by signals derived from the host central nervous system. Rather, these changes appear to be mediated by interactions between the transplanted motoneurons and the hindlimb. We favor the notion that retrograde trophic signals derived from the hindlimb act to modulate the development of innervating motoneurons. Whether this signal involves a diffusible trophic agent released from target cells, or acts by some other mechanism is presently unknown. © 1992 John Wiley & Sons, Inc.     

Modifications of motoneuron development following transplantation of thoracic spinal cord to the lumbar region in the chick embryo: evidence for target-derived signals that regulate differentiation.

In order to examine the role of target cells in the development of spinal motoneurons, the neural tube from thoracic segments was transplanted to the lumbar region on embryonic day (E) 2, and allowed to innervate hindlimb muscles in the chick embryo. When examined at later stages of development, the proportion of white and gray matter in the thoracic transplant was altered to resemble normal lumbar cord. Many thoracic motoneurons were able to survive up to posthatching stages following transplantation. The branching and arborization of dendrites of thoracic motoneurons innervating hindlimb muscles, as well as motoneuron (soma) size, were also increased to an extent approximating that seen in normal lumbar motoneurons. In support of previous studies using a similar transplant model, we have also found that the peripheral (intramuscular) branching pattern of thoracic motoneuron axons innervating hindlimb muscles was similar to that of normal lumbar motoneurons. Axon size and the degree of myelination of transplanted thoracic motoneuron axons were also increased so that these parameters more closely resembled axons of normal lumbar than normal thoracic spinal motoneurons. Virtually all of the changes in motoneuron properties noted above were observed irrespective of whether or not the transplanted spinal cord had developed in anatomical continuity with the host rostral cord. Accordingly, it is unlikely that the changes in the development of transplanted thoracic motoneurons reported here are induced either entirely, or in part, by signals derived from the host central nervous system. Rather, these changes appear to be mediated by interactions between the transplanted motoneurons and the hindlimb. We favor the notion that retrograde trophic signals derived from the hindlimb act to modulate the development of innervating motoneurons. Whether this signal involves a diffusible trophic agent released from target cells, or acts by some other mechanism is presently unknown.     

Prostaglandins in cerebrospinal fluid of healthy human volunteers, abstinent alcoholics and rhesus monkeys

A sensitive and selective assay for measuring prostaglandins in cerebrospinal fluid has been developed, based on the selected-ion-monitoring, electron-capture negative ionization GC/MS detection for the MO-PFB-TMS derivatives of prostaglandins E2, E1, F2 alpha, F1 alpha, and 6-keto-F1 alpha. Improvements over previously published assay procedures have been made, and the new assay has been applied to measurement of prostaglandin concentrations in lumbar CSF of healthy human volunteers, abstinent alcoholic patients, in cisternal CSF of Rhesus monkeys, and continuously sampled lumbar CSF of awake Rhesus monkeys. Results indicated that the concentrations of PGE2, PGE1, PGF1 alpha, and 6-keto-PGF1 alpha were below 15 pg/mL CSF in lumbar CSF of healthy humans and abstinent alcoholics, and in cisternal CSF of Rhesus monkeys. In contrast, continuously sampled lumbar CSF of awake Rhesus monkeys contained more than 200 pg/mL of PGE2, PGF2 alpha, and 6-keto-PGF1 alpha, probably present as a result of local production.     

Vertebrae numbers of the early hominid lumbar spine

General doctrine holds that early hominids possessed a long lumbar spine with six segments. This is mainly based on Robinson's (1972) interpretation of a single partial Australopithecus africanus skeleton, Sts 14, from Sterkfontein, South Africa. As its sixth last presacral vertebra exhibits both thoracic and lumbar characteristics, current definitions of lumbar vertebrae and lumbar ribs are discussed in the present study. A re-analysis of its entire preserved vertebral column and comparison with Stw 431, another partial A. africanus skeleton from Sterkfontein, and the Homo erectus skeleton KNM-WT 15000 from Nariokotome, Kenya, did not provide strong evidence for the presence of six lumbar vertebrae in either of these early hominids. Thus, in Sts 14 the sixth last presacral vertebra has on one side a movable rib. In Stw 431, the corresponding vertebra shows indications for a rib facet. In KNM-WT, 15000 the same element is very fragmentary, but the neighbouring vertebrae do not support the view that it is L1. Although in all three fossils the transitional vertebra at which the articular facets change orientation seems to be at Th11, this is equal to a large percentage of modern humans. Indeed, a modal number of five lumbar vertebrae, as in modern humans, is more compatible with evolutionary principles. For example, six lumbar vertebrae would require repetitive shortening and lengthening not only of the lumbar, but also of the entire precaudal spine. Furthermore, six lumbar vertebrae are claimed to be biomechanically advantageous for early hominid bipedalism, yet an explanation is lacking as to why the lumbar region should have shortened in later humans. All this raises doubts about previous conclusions for the presence of six lumbar vertebrae in early hominids. The most parsimonious explanation is that they did not differ from modern humans in the segmentation of the vertebral column.     

THE ERECT LATERAL LUMBAR ROENTGENOGRAM IN THE EVALUATION OF “LOW BACK” PAIN

A study was made of the potential value of the erect lateral flexion lumbar roentgenogram in a series of 50 adults, some with symptoms of low back pain and some without such symptoms. The film was made in addition to the standard antero-posterior, lateral and sometimes oblique views taken in the recumbent position.In 11 of 37 patients with low back pain, some narrowing of lumbar discs was visible in both horizontal and erect lateral films, the degree being not significantly different between the two positions. In one patient, localized anterior narrowing of a lumbar disc, which was not visible in the recumbent lateral film, was observed. This finding was confirmed at a subsequent examination.In one of 13 patients without lumbar area symptoms, slight anterior narrowing of a lumbar disc could be seen in the erect lateral film but not in the horizontal. The reason for this is not known; it may be physiologic in this particular patient.The value of the routine erect lateral flexion lumbar roentgenogram was not confirmed by this preliminary study.     

UNDECYLENIC ACID IN THE TREATMENT OF PSORIASIS AND NEURODERMATITIS

Undecylenic acid in a dosage tolerated by most patients is of doubtful value in the treatment of psoriasis and neurodermatitis.Thirty-one patients were given the drug. Exudative dermatitis developed in one case, generalized pruritus in another. One patient may have had a cardiac accident attributable to the drug.     

Biomarkers for human radiation exposure

There is a concern over the potential use of radioactive isotopes as a weapon of terror. The detonation of a radiation dispersal device, the so-called “dirty bomb” can lead to public panic. In order to estimate risks associated with radiation exposure, it is important to understand the biological effects of radiation exposure. Based on this knowledge, biomarkers to monitor potentially exposed populations after a radiological accident can be developed and would be extremely valuable for emergency response. While the traditional radiation exposure biomarkers based on cytogenetic assays serve as standard, the development of rapid and noninvasive tests for radiation exposure is needed. The genomics based knowledge is providing new avenues for investigation. The examination of gene expression after ionizing radiation exposure could serve as a potential molecular marker for biodosimetry. Microarray based studies are identifying new radiation responsive genes that could potentially be used as biomarkers of human exposure to radiation after an accident.