Brent L. Showalter

Comparison of Animal Discs Used in Disc Research to Human Lumbar Disc Torsion Mechanics and Collagen Content

Study Design. Experimental measurement and normalization of in vitro disc torsion mechanics and collagen content for several animal species used in intervertebral disc research and comparing these with the human disc. Objective. To aid in the selection of appropriate animal models for disc research by measuring torsional mechanical properties and collagen content. Summary of Background Data. There is lack of data and variability in testing protocols for comparing animal and human disc torsion mechanics and collagen content. Methods. Intervertebral disc torsion mechanics were measured and normalized by disc height and polar moment of inertia for 11 disc types in 8 mammalian species: the calf, pig, baboon, goat, sheep, rabbit, rat, and mouse lumbar discs, and cow, rat, and mouse caudal discs. Collagen content was measured and normalized by dry weight for the same discs except the rat and the mouse. Collagen fiber stretch in torsion was calculated using an analytical model. Results. Measured torsion parameters varied by several orders of magnitude across the different species. After geometric normalization, only the sheep and pig discs were statistically different from human discs. Fiber stretch was found to be highly dependent on the assumed initial fiber angle. The collagen content of the discs was similar, especially in the outer annulus where only the calf and goat discs were statistically different from human. Disc collagen content did not correlate with torsion mechanics. Conclusion. Disc torsion mechanics are comparable with human lumbar discs in 9 of 11 disc types after normalization by geometry. The normalized torsion mechanics and collagen content of the multiple animal discs presented are useful for selecting and interpreting results for animal disc models. Structural organization of the fiber angle may explain the differences that were noted between species after geometric normalization.

In vitro biomechanical comparison of a 4.5 mm narrow locking compression plate construct versus a 4.5 mm limited contact dynamic compression plate construct for arthrodesis of the equine proximal interphalangeal joint.

OBJECTIVES To compare the in vitro biomechanical properties of a 4.5 mm narrow locking compression plate (PIP-LCP) with 2 abaxially located transarticular screws and a 4.5 mm limited contact dynamic compression plate (LC-DCP) with 2 abaxially located transarticular screws using equine pasterns. STUDY DESIGN Experimental. Paired in vitro biomechanical testing of 2 methods for stabilizing adult equine forelimb PIP joints. ANIMAL Adult equine forelimbs (n = 8 pairs). METHODS Each pair of PIP joints were randomly instrumented with either a PIP-LCP or LC-DCP plate axially and 2 parasagitally positioned 5.5 mm transarticular screws. The proximal aspect of the proximal phalanx (P1) and the distal aspect of the middle phalanx (P2) were embedded to allow for mounting on a mechanical testing machine. Each construct was tested in both cyclic and subsequently single cycle to failure in 4-point bending. The displacement required to maintain a target load of 1 kN over 3600 cycles at 1 Hz was recorded. Maximum bending moment at failure and construct stiffness was calculated from the single cycle to failure testing. RESULTS In cyclic testing, significantly more displacement occurred in the LC-DCP (0.46 ± 0.10 mm) than for the PIP-LCP (0.17 ± 0.11 mm) constructs (P = .016). During single cycle testing there was no significant difference in the bending moment between the LC-DCP (148.7 ± 19.4 N m) and the PIP-LCP (164.6 ± 17.6 N m) constructs (P = .553) and the stiffness of the LC-DCP (183.9 ± 26.9 N mm) was significantly lower than for the PIP-LCP (279.8 ± 15.9 N/mm) constructs (P = .011). All constructs failed by fracture of the bone associated with the transarticular screws and subsequently bending of the plates at the middle hole. CONCLUSIONS Use of the PIP-LCP resulted in a stiffer construct of the same strength as the LC-DCP in vitro using this 4-point bending model.

Evaluation of an In Situ Gelable and Injectable Hydrogel Treatment to Preserve Human Disc Mechanical Function Undergoing Physiologic Cyclic Loading Followed by Hydrated Recovery

Despite the prevalence of disc degeneration and its contributions to low back problems, many current treatments are palliative only and ultimately fail. To address this, nucleus pulposus replacements are under development. Previous work on an injectable hydrogel nucleus pulposus replacement composed of n-carboxyethyl chitosan, oxidized dextran, and teleostean has shown that it has properties similar to native nucleus pulposus, can restore compressive range of motion in ovine discs, is biocompatible, and promotes cell proliferation. The objective of this study was to determine if the hydrogel implant will be contained and if it will restore mechanics in human discs undergoing physiologic cyclic compressive loading. Fourteen human lumbar spine segments were tested using physiologic cyclic compressive loading while intact, following nucleotomy, and again following treatment of injecting either phosphate buffered saline (PBS) (sham, n = 7) or hydrogel (implant, n = 7). In each compressive test, mechanical parameters were measured immediately before and after 10,000 cycles of compressive loading and following a period of hydrated recovery. The hydrogel implant was not ejected from the disc during 10,000 cycles of physiological compression testing and appeared undamaged when discs were bisected following all mechanical tests. For sham samples, creep during cyclic loading increased (+15%) from creep during nucleotomy testing, while for implant samples creep strain decreased (-3%) toward normal. There was no difference in compressive modulus or compressive strains between implant and sham samples. These findings demonstrate that the implant interdigitates with the nucleus pulposus, preventing its expulsion during 10,000 cycles of compressive loading and preserves disc creep within human L5-S1 discs. This and previous studies provide a solid foundation for continuing to evaluate the efficacy of the hydrogel implant.

Nucleotomy reduces the effects of cyclic compressive loading with unloaded recovery on human intervertebral discs

The first objective of this study was to determine the effects of physiological cyclic loading followed by unloaded recovery on the mechanical response of human intervertebral discs. The second objective was to examine how nucleotomy alters the discs mechanical response to cyclic loading. To complete these objectives, 15 human L5-S1 discs were tested while intact and subsequent to nucleotomy. The testing consisted of 10,000 cycles of physiological compressive loads followed by unloaded hydrated recovery. Cyclic loading increased compression modulus (3%) and strain (33%), decreased neutral zone modulus (52%), and increased neutral zone strain (31%). Degeneration was not correlated with the effect of cyclic loading in intact discs, but was correlated with cyclic loading effects after nucleotomy, with more degenerate samples experiencing greater increases in both compressive and neutral zone strain following cyclic loading. Partial removal of the nucleus pulposus decreased the compression and neutral zone modulus while increasing strain. These changes correspond to hypermobility, which will alter overall spinal mechanics and may impact low back pain via altered motion throughout the spinal column. Nucleotomy also reduced the effects of cyclic loading on mechanical properties, likely due to altered fluid flow, which may impact cellular mechanotransduction and transport of disc nutrients and waste. Degeneration was not correlated with the acute changes of nucleotomy. Results of this study provide an ideal protocol and control data for evaluating the effectiveness of a mechanically-based disc degeneration treatment, such as a nucleus replacement.

Novel human intervertebral disc strain template to quantify regional three-dimensional strains in a population and compare to internal strains predicted by a finite element model

Tissue strain is an important indicator of mechanical function, but is difficult to noninvasively measure in the intervertebral disc. The objective of this study was to generate a disc strain template, a 3D average of disc strain, of a group of human L4–L5 discs loaded in axial compression. To do so, magnetic resonance images of uncompressed discs were used to create an average disc shape. Next, the strain tensors were calculated pixel‐wise by using a previously developed registration algorithm. Individual disc strain tensor components were then transformed to the template space and averaged to create the disc strain template. The strain template reduced individual variability while highlighting group trends. For example, higher axial and circumferential strains were present in the lateral and posterolateral regions of the disc, which may lead to annular tears. This quantification of group‐level trends in local 3D strain is a significant step forward in the study of disc biomechanics. These trends were compared to a finite element model that had been previously validated against the disc‐level mechanical response. Depending on the strain component, 81–99% of the regions within the finite element model had calculated strains within one standard deviation of the template strain results. The template creation technique provides a new measurement technique useful for a wide range of studies, including more complex loading conditions, the effect of disc pathologies and degeneration, damage mechanisms, and design and evaluation of treatments.

In VitroBiomechanical Comparison of a 4.5 mm Narrow Locking Compression Plate Construct Versus a 4.5 mm Limited Contact Dynamic Compression Plate Construct for Arthrodesis of the Equine Proximal Interphalangeal Joint: PIP-LCP and LC-DCP PIP Arthrodesis

OBJECTIVES To compare the in vitro biomechanical properties of a 4.5 mm narrow locking compression plate (PIP-LCP) with 2 abaxially located transarticular screws and a 4.5 mm limited contact dynamic compression plate (LC-DCP) with 2 abaxially located transarticular screws using equine pasterns. STUDY DESIGN Experimental. Paired in vitro biomechanical testing of 2 methods for stabilizing adult equine forelimb PIP joints. ANIMAL Adult equine forelimbs (n = 8 pairs). METHODS Each pair of PIP joints were randomly instrumented with either a PIP-LCP or LC-DCP plate axially and 2 parasagitally positioned 5.5 mm transarticular screws. The proximal aspect of the proximal phalanx (P1) and the distal aspect of the middle phalanx (P2) were embedded to allow for mounting on a mechanical testing machine. Each construct was tested in both cyclic and subsequently single cycle to failure in 4-point bending. The displacement required to maintain a target load of 1 kN over 3600 cycles at 1 Hz was recorded. Maximum bending moment at failure and construct stiffness was calculated from the single cycle to failure testing. RESULTS In cyclic testing, significantly more displacement occurred in the LC-DCP (0.46 ± 0.10 mm) than for the PIP-LCP (0.17 ± 0.11 mm) constructs (P = .016). During single cycle testing there was no significant difference in the bending moment between the LC-DCP (148.7 ± 19.4 N m) and the PIP-LCP (164.6 ± 17.6 N m) constructs (P = .553) and the stiffness of the LC-DCP (183.9 ± 26.9 N mm) was significantly lower than for the PIP-LCP (279.8 ± 15.9 N/mm) constructs (P = .011). All constructs failed by fracture of the bone associated with the transarticular screws and subsequently bending of the plates at the middle hole. CONCLUSIONS Use of the PIP-LCP resulted in a stiffer construct of the same strength as the LC-DCP in vitro using this 4-point bending model.

In bitro biomechanical comparison of a 4.5mm narrow locking compression plate construct versus a 4.5mm limited contact dynamic compression plate construct for arthrodesis of the equine proximal interphalangeal joint

OBJECTIVES To compare the in vitro biomechanical properties of a 4.5 mm narrow locking compression plate (PIP-LCP) with 2 abaxially located transarticular screws and a 4.5 mm limited contact dynamic compression plate (LC-DCP) with 2 abaxially located transarticular screws using equine pasterns. STUDY DESIGN Experimental. Paired in vitro biomechanical testing of 2 methods for stabilizing adult equine forelimb PIP joints. ANIMAL Adult equine forelimbs (n = 8 pairs). METHODS Each pair of PIP joints were randomly instrumented with either a PIP-LCP or LC-DCP plate axially and 2 parasagitally positioned 5.5 mm transarticular screws. The proximal aspect of the proximal phalanx (P1) and the distal aspect of the middle phalanx (P2) were embedded to allow for mounting on a mechanical testing machine. Each construct was tested in both cyclic and subsequently single cycle to failure in 4-point bending. The displacement required to maintain a target load of 1 kN over 3600 cycles at 1 Hz was recorded. Maximum bending moment at failure and construct stiffness was calculated from the single cycle to failure testing. RESULTS In cyclic testing, significantly more displacement occurred in the LC-DCP (0.46 ± 0.10 mm) than for the PIP-LCP (0.17 ± 0.11 mm) constructs (P = .016). During single cycle testing there was no significant difference in the bending moment between the LC-DCP (148.7 ± 19.4 N m) and the PIP-LCP (164.6 ± 17.6 N m) constructs (P = .553) and the stiffness of the LC-DCP (183.9 ± 26.9 N mm) was significantly lower than for the PIP-LCP (279.8 ± 15.9 N/mm) constructs (P = .011). All constructs failed by fracture of the bone associated with the transarticular screws and subsequently bending of the plates at the middle hole. CONCLUSIONS Use of the PIP-LCP resulted in a stiffer construct of the same strength as the LC-DCP in vitro using this 4-point bending model.

Nucleotomy Alters Mechanical Function Following Cyclic Loading and Unloaded Recovery of Human Discs

The intervertebral disc plays a critical role in supporting loads, permitting spinal motion, and dissipating energy. Unfortunately, it is also commonly degenerated, resulting in altered spinal mechanics and low back pain. Nucleotomy is a common treatment for herniated discs and is also used experimentally to simulate degeneration.[1] The procedure, which involves a posterior annular incision and removal of a portion of the nucleus pulposus (NP), has also been shown to alter disc mechanics. These changes include acute changes of decreased NP pressure, decreased disc height, and increased neutral zones.[2, 3] Cyclic studies have shown that trans-endplate nucleotomy permanently alters creep mechanical properties of sheep discs.[4] However, the effects of annular nucleotomy on the cyclic properties of human discs have not yet been studied. This work studied the mechanical effect of annular nucleotomy on human discs subjected to physiological axial cyclic loading.Copyright

Disc Torsion Mechanics: Comparison of Animal Models to Human

The intervertebral disc plays a critical role in providing structural support to the spine while permitting extensive flexibility in a number of orientations. Axial rotation is a key parameter in spine function and torsional instability is related to spinal degeneration [1]. Animal models are integral components in many in vivo disc studies, however each animal varies in availability, size, cost, and scientific criteria such as cell phenotype and biomechanics. Selection of an appropriate animal model requires knowledge of the similarities and differences in biomechanical and biochemical factors between the model and human discs. Previous studies have often compared the characteristics of a single animal model with the human disc [2, 3]. However, variations in animal models and testing protocols between groups hinder comparisons and interpretations between different studies. This is especially relevant in torsion mechanics, where the magnitude of an applied compressive load and other testing parameters significantly affect the apparent torsional stiffness of the disc [4]. The objective of this study was to measure and compare the torsion mechanical properties of the human disc and 11 disc types from 8 mammalian species.© 2011 ASME