gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie
74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie
96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie
51. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

26. - 29.10.2010, Berlin

Different patterns of lumbar intervertebral disc degeneration: a biomechanical evaluation

Meeting Abstract

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  • H.-J. Wilke - Universität Ulm, Institut für Unfallchirurgische Forschung und Biomechanik, Ulm, Germany
  • F. Galbusera - Universität Ulm, Institut für Unfallchirurgische Forschung und Biomechanik, Ulm, Germany
  • H. Schmidt - Universität Ulm, Institut für Unfallchirurgische Forschung und Biomechanik, Ulm, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie. 74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 51. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 26.-29.10.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocIN17-1105

DOI: 10.3205/10dkou109, URN: urn:nbn:de:0183-10dkou1090

Veröffentlicht: 21. Oktober 2010

© 2010 Wilke et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Degeneration of the intervertebral disc is related to progressive changes in the disc tissue structure and properties. These changes may be present separately or, more frequently, in various combinations. The different degenerative changes may have opposite effects on the spine biomechanics. Therefore, therapeutic options which allow for good clinical results in some patients may be inadequate for the treatment of other patients. This work is aimed to the investigation of the mechanical relevance of the most common degenerative changes of the intervertebral disc, when they are present in various combinations.

Methods: A poroelastic nonlinear FE model of the L4–L5 human spine segment was employed and randomly scaled to represent 10 spine segments from different individuals. Six different degenerative characteristics (condition of nucleus pulposus, annulus fibrosus and endplate cartilage; height loss; osteophyte formation; diffuse sclerosis) were modeled in 30 randomly generated models, 10 for each overall degree of degeneration (mild, moderate, severe). For each model, a daily loading cycle including 8 hours of rest, 16 hours in the standing position and 2 flexion-extension motion cycles was simulated.

Results and conlcusions: A tendency to an increase of stiffness with progressing overall degeneration was observed. Nucleus degeneration reduced the daily height change of the disc; annulus degeneration had no influence on this result. However, both parameters were significantly correlated to a decrease in the flexion-extension range of motion. Also osteophytosis, diffuse sclerosis and disc height loss induced a reduction of daily axial displacement and spine flexibility. Endplate sclerosis significantly limited the disc rehydration during the rest period. The present investigation of the biomechanical effect of different combinations of degenerative changes may help to better understand disc degeneration from a biomechanical point of view. These results may help in the choice of the appropriate treatment for degenerative disc disease on a patient-specific basis, both with conservative or surgical approaches.

Acknowledgements: This project is funded by the EU project GENODISC (HEALTH-F2-2008-201626).