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Biomechanical analysis of spino-pelvic postural configurations in spondylolysis subjected to various sport-related dynamic loading conditions

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Abstract

Purpose

To study the risks of spondylolysis due to extrinsic loading conditions related to sports activities and intrinsic spino-pelvic postural parameters [pelvic incidence (PI) and sacral slope (SS)].

Methods

A comprehensive osseo-disco-ligamentous L4–S1 finite element model was built for three cases with spondylolysis representing three different spino-pelvic angular configurations (SS = 32°, 47°, 59° and PI = 49°, 58°, 72°, respectively). After simulating the standing posture, 16 dynamic loading conditions were computationally tested for each configuration by combining four sport-related loads (compression, sagittal and lateral bending and axial torque). For each simulation, the Von Mises stress, L5–S1 facet contact force and resultant internal loads at the sacral endplate were computed. Significant effects were determined with an ANOVA.

Results

The maximal stress and volume of cancellous bone in the pars with stress higher than 75% of the ultimate stress were higher with 900 N simulated compression (2.2 MPa and 145 mm3) compared to only the body weight (1.36 MPa and 20.9 mm3) (p < 0.001). Combined compression with 10 Nm of flexion and an axial torque of 6 Nm generated the highest stress conditions (up to 2.7 MPa), and L5–S1 facet contact force (up to 430 N). The maximal stress was on average 17% higher for the case with the highest SS compared to the one with lowest SS for the 16 tested conditions (p = 0.0028).

Conclusions

Combined flexion and axial rotation with compression generated the highest stress conditions related to risks of spondylolysis. The stress conditions intensify in patients with higher PI and SS.

Graphical abstract

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Acknowledgements

This study was financially supported by Medtronic of Canada and the Natural Sciences and Engineering Research Council of Canada (Industrial Research Chair program with Medtronic of Canada). Special thanks to Drs Eric Wagnac, Yvan Petit and Léo Fradet who contributed to the development of the SM2S base finite element model used in this study, as part of the iLab-Spine initiative funded by the A*MIDEX Foundation (Aix-Marseille University Initiative of Excellence, n° ANR 11-IDEX-0001-02). The study was approved by the Institutional review boards of the two participating institutions (CHU Sainte-Justine (Montréal, CANADA) (n°2668) and the Campbell Clinics (Memphis, USA)). The Manuscript submitted does not contain information about medical device(s)/drug(s).

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Authors and Affiliations

  1. Department of Mechanical Engineering, Polytechnique Montreal, Montreal, QC, Canada

    Manon Sterba & Carl-Éric Aubin

  2. Laboratoire de Biomécanique Appliquée, Aix-Marseille Université, IFSTTAR, LBA UMR T24, Marseille, France

    Manon Sterba & Pierre-Jean Arnoux

  3. iLab-Spine (International Laboratory - Spine Imaging and Biomechanics), Montreal, Canada

    Manon Sterba & Carl-Éric Aubin

  4. iLab-Spine (International Laboratory - Spine Imaging and Biomechanics), Marseille, France

    Manon Sterba & Pierre-Jean Arnoux

  5. Sainte-Justine University Hospital Center, Montreal, QC, Canada

    Manon Sterba, Hubert Labelle & Carl-Éric Aubin

  6. Campbell Clinic Orthopaedics, Germantown, TN, USA

    William C. Warner

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  1. Manon Sterba
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  2. Pierre-Jean Arnoux
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  3. Hubert Labelle
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  4. William C. Warner
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  5. Carl-Éric Aubin
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Correspondence to Carl-Éric Aubin.

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Sterba, M., Arnoux, PJ., Labelle, H. et al. Biomechanical analysis of spino-pelvic postural configurations in spondylolysis subjected to various sport-related dynamic loading conditions. Eur Spine J 27, 2044–2052 (2018). https://doi.org/10.1007/s00586-018-5667-0

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  • DOI: https://doi.org/10.1007/s00586-018-5667-0

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