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Can intervertebral disc prolapse be predicted by disc mechanics?
D S McNally1, M A Adams, A E Goodship
1Department of Anatomy, University of Bristol, United Kingdom.
Spine
|September 1, 1993
Summary
Localized stress in the posterior anulus of intervertebral discs can lead to prolapse. This study found higher stress concentrations in discs prone to failure, suggesting a predisposition to injury.
Area of Science:
- Biomechanics
- Spine Research
- Orthopedics
Background:
- Intervertebral disc (IVD) prolapse is a common cause of low back pain.
- Understanding the mechanical factors contributing to IVD failure is crucial for prevention and treatment.
Purpose of the Study:
- To investigate if stress concentrations in the posterior anulus fibrosus predispose intervertebral discs to prolapse.
- To determine the relationship between stress distribution and failure modes under combined loading.
Main Methods:
- Studied 22 cadaveric lumbar motion segments.
- Measured compressive stress distribution under pure compression and combined anterolateral bending.
- Loaded specimens to failure in combined compression and anterolateral bending.
Main Results:
- Failure occurred in the vertebral body (n=12) or posterolateral anulus (n=10).
- The posterolateral anulus failure group exhibited significantly higher posterior anulus stress concentrations (P < 0.001).
- These concentrations occurred under combined compression and bending loads.
Conclusions:
- Some intervertebral discs are predisposed to prolapse due to damaging, localized stress concentrations.
- Posterior anulus stress concentrations under combined anterolateral bending and compression are implicated in disc prolapse.