Partap S. Khalsa

Human lumbar spine creep during cyclic and static flexion: creep rate, biomechanics, and facet joint capsule strain.

There is a high incidence of low back pain (LBP) associated with occupations requiring sustained and/or repetitive lumbar flexion (SLF and RLF, respectively), which cause creep of the viscoelastic tissues. The purpose of this study was to determine the effect of creep on lumbar biomechanics and facet joint capsule (FJC) strain. Specimens were flexed for 10 cycles, to a maximum 10 Nm moment at L5-S1, before, immediately after, and 20 min after a 20-min sustained flexion at the same moment magnitude. The creep rates of SLF and RLF were also measured during each phase and compared to the creep rate predicted by the moment relaxation rate function of the lumbar spine. Both SLF and RLF resulted in significantly increased intervertebral motion, as well as significantly increased FJC strains at the L3-4 to L5-S1 joint levels. These parameters remained increased after the 20-min recovery. Creep during SLF occurred significantly faster than creep during RLF. The moment relaxation rate function was able to accurately predict the creep rate of the lumbar spine at the single moment tested. The data suggest that SLF and RLF result in immediate and residual laxity of the joint and stretch of the FJC, which could increase the potential for LBP.

Material Properties of the Human Lumbar Facet Joint Capsule

The human facet joint capsule is one of the structures in the lumbar spine that constrains motions of vertebrae during global spine loading (e.g., physiological flexion). Computational models of the spine have not been able to include accurate nonlinear and viscoelastic material properties, as they have not previously been measured. Capsules were tested using a uniaxial ramp-hold protocol or a haversine displacement protocol using a commercially available materials testing device. Plane strain was measured optically. Capsules were tested both parallel and perpendicular to the dominant orientation of the collagen fibers in the capsules. Viscoelastic material properties were determined. Parallel to the dominant orientation of the collagen fibers, the complex modulus of elasticity was E*=1.63MPa, with a storage modulus of E=1.25MPa and a loss modulus of: E =0.39MPa. The mean stress relaxation rates for static and dynamic loading were best fit with first-order polynomials: B(epsilon) = 0.1110epsilon-0.0733 and B(epsilon)= -0.1249epsilon + 0.0190, respectively. Perpendicular to the collagen fiber orientation, the viscous and elastic secant moduli were 1.81 and 1.00 MPa, respectively. The mean stress relaxation rate for static loading was best fit with a first-order polynomial: B (epsilon) = -0.04epsilon - 0.06. Capsule strength parallel and perpendicular to collagen fiber orientation was 1.90 and 0.95 MPa, respectively, and extensibility was 0.65 and 0.60, respectively. Poissons ratio parallel and perpendicular to fiber orientation was 0.299 and 0.488, respectively. The elasticity moduli were nonlinear and anisotropic, and capsule strength was larger aligned parallel to the collagen fibers. The phase lag between stress and strain increased with haversine frequency, but the storage modulus remained large relative to the complex modulus. The stress relaxation rate was strain dependent parallel to the collagen fibers, but was strain independent perpendicularly.

Dynamic responsiveness of lumbar paraspinal muscle spindles during vertebral movement in the cat.

Muscle spindles provide essential information for appropriate motor control. In appendicular muscles, much is known about their position and movement sensitivities, but little is known about the axial muscles of the low back. We investigated the dynamic responsiveness of lumbar paraspinal muscle spindle afferents from L6 dorsal root filaments during constant velocity movement of the L6 vertebra (the feline has seven lumbar vertebrae) in Nembutal-anesthetized cats. Actuations of 1xa0mm applied at the L6 spinous process were delivered at 0.5, 1.0 and 2.0xa0mm/s. The slow velocity component was measured as the slope of the relationship between displacement during the constant velocity ramp and instantaneous discharge frequency. The quick velocity component was the slope’s intercept at zero displacement. The peak component was determined as the highest discharge rates occurring near the end of the ramp compared with control. The slow velocity component over the three increasing velocities was 23.9 (9.9), 21.6 (9.6) and 20.5 (9.5)xa0imp/(sxa0mm) [mean (SD)], respectively. The quick velocity component was 28.4 (8.6), 31.4 (9.8) and 35.8 (10.6)xa0imp/s, respectively. These measures of dynamic responsiveness were at least 5–10 times higher compared with values reported for appendicular muscle spindles. The peak component’s velocity sensitivity was 2.9xa0(imp/s)/(mm/s) [0.2, 5.5, lower, upper 95% confidence interval] similar to that for cervical paraspinal muscles as well as appendicular muscles. Increased dynamic responsiveness of lumbar paraspinal muscle spindles may insure central driving to insure control of intervertebral motion during changes in spinal orientation. It may also contribute to large, rapid and potentially injurious increases in paraspinal muscle activity during sudden and unexpected muscle stretch.

Relationships between joint motion and facet joint capsule strain during cat and human lumbar spinal motions.

OBJECTIVEnThe lumbar facet joint capsule (FJC) is innervated with mechanically sensitive neurons and is thought to contribute to proprioception and pain. Biomechanical investigations of the FJC have commonly used human cadaveric spines, whereas combined biomechanical and neurophysiological studies have typically used nonhuman animal models. The purpose of this study was to develop mathematical relationships describing vertebral kinematics and FJC strain in cat and human lumbar spine specimens during physiological spinal motions to facilitate future efforts at understanding the mechanosensory role of the FJC.nnnMETHODSnCat lumbar spine specimens were tested during extension, flexion, and lateral bending. Joint kinematics and FJC principal strain were measured optically. Facet joint capsule strain-intervertebral angle (IVA) regression relationships were established for the 3 most caudal lumbar joints using cat (current study) and human (prior study) data. The FJC strain-IVA relationships were used to estimate cat and human spine kinematics that corresponded to published sensory neuron response thresholds (5% and 10% strain) for low-threshold mechanoreceptors.nnnRESULTSnSignificant linear relationships between IVA and strain were observed for both human and cat during motions that produced tension in the FJCs (P < .01). During motions that produced tension in the FJCs, the models predicted that FJC strain magnitudes corresponding to published sensory neuron response thresholds would be produced by IVA magnitudes within the physiological range of lumbar motion.nnnCONCLUSIONSnData from the current study support the proprioceptive role of lumbar spine FJC and low-threshold mechanoreceptive afferents and can be used in interpreting combined neurophysiological and biomechanical studies of cat lumbar spines.