Skip to main content
SpringerLink
Log in

Investigation of coupled bending of the lumbar spine during dynamic axial rotation of the body

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

Little is known about the coupled motions of the spine during functional dynamic motion of the body. This study investigated the in vivo characteristic motion patterns of the human lumbar spine during a dynamic axial rotation of the body. Specifically, the contribution of each motion segment to the lumbar axial rotation and the coupled bending of the vertebrae during the dynamic axial rotation of the body were analyzed.

Methods

Eight asymptomatic subjects (M/F, 7/1; age, 40–60 years) were recruited. The lumbar segment of each subject was MRI scanned for construction of 3D models of the vertebrae from L2 to S1. The lumbar spine was then imaged using a dual fluoroscopic system while the subject performed a dynamic axial rotation from maximal left to maximal right in a standing position. The 3D vertebral models and the fluoroscopic images were used to reproduce the in vivo vertebral motion. In this study, we analyzed the primary left–right axial rotation, the coupled left–right bending of each vertebral segment from L2 to S1 levels.

Results

The primary axial rotations of all segments (L2–S1) followed the direction of the body axial rotation. Contributions of each to the overall segment axial rotation were 6.7° ± 3.0° (27.9 %) for the L2–L3, 4.4° ± 1.2° (18.5 %) for the L3–L4, 6.4° ± 2.2° (26.7 %) for the L4–L5, and 6.4° ± 2.6° (27.0 %) for the L5–S1 vertebral motion segments. The upper segments of L2–L3 and L3–L4 demonstrated a coupled contralateral bending towards the opposite direction of the axial rotation, while the lower segments of L4–L5 and L5–S1 demonstrated a coupled ipsilateral bending motion towards the same direction of the axial rotation. Strong correlation between the primary axial rotation and the coupled bending was found at each vertebral level. We did not observe patterns of coupled flexion/extension rotation with the primary axial rotation.

Conclusions

This study demonstrated that a dynamic lumbar axial rotation coupling with lateral bendings is segment–dependent and can create a coordinated dynamic coupling to maintain the global dynamic balance of the body. The results could improve our understanding of the normal physiologic lumbar axial rotation and to establish guidelines for diagnosing pathological lumbar motion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Dvorak J, Panjabi MM, Chang DG, Theiler R, Grob D (1991) Functional radiographic diagnosis of the lumbar spine. Flexion–extension and lateral bending. Spine 16:562–571

    Article  PubMed  CAS  Google Scholar 

  2. Cholewicki J, Crisco JJ 3rd, Oxland TR, Yamamoto I, Panjabi MM (1996) Effects of posture and structure on three-dimensional coupled rotations in the lumbar spine. A biomechanical analysis. Spine 21:2421–2428

    Article  PubMed  CAS  Google Scholar 

  3. Kato Y, Panjabi MM, Nibu K (1998) Biomechanical study of lumbar spinal stability after osteoplastic laminectomy. J Spinal Disord 11:146–150

    Article  PubMed  CAS  Google Scholar 

  4. Wang JC, Arnold PM, Hermsmeyer JT, Norvell DC (2012) Do lumbar motion preserving devices reduce the risk of adjacent segment pathology compared to fusion surgery? A Systematic Review. Spine. doi:10.1097/BRS.0b013e31826cadf2

    Google Scholar 

  5. Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH (1999) Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Jt Surg Am 81:519–528

    CAS  Google Scholar 

  6. Abumi K, Panjabi MM, Kramer KM, Duranceau J, Oxland T, Crisco JJ (1990) Biomechanical evaluation of lumbar spinal stability after graded facetectomies. Spine 15:1142–1147

    Article  PubMed  CAS  Google Scholar 

  7. Mimura M, Panjabi MM, Oxland TR, Crisco JJ, Yamamoto I, Vasavada A (1994) Disc degeneration affects the multidirectional flexibility of the lumbar spine. Spine 19:1371–1380

    Article  PubMed  CAS  Google Scholar 

  8. Panjabi MM, Goel VK, Takata K (1982) Physiologic strains in the lumbar spinal ligaments. An in vitro biomechanical study 1981 Volvo Award in Biomechanics. Spine 7:192–203

    Article  PubMed  CAS  Google Scholar 

  9. Li G, Wang S, Passias P, Xia Q, Wood K (2009) Segmental in vivo vertebral motion during functional human lumbar spine activities. Eur Spine J 18:1013–1021. doi:10.1007/s00586-009-0936-6

    Article  PubMed  Google Scholar 

  10. Li W, Wang S, Xia Q, Passias P, Kozanek M, Wood K, Li G (2011) Lumbar facet joint motion in patients with degenerative disc disease at affected and adjacent levels: an in vivo biomechanical study. Spine 36:E629–E637. doi:10.1097/BRS.0b013e3181faaef7

    Article  PubMed  Google Scholar 

  11. Rousseau MA, Bradford DS, Hadi TM, Pedersen KL, Lotz JC (2006) The instant axis of rotation influences facet forces at L5/S1 during flexion/extension and lateral bending. Eur Spine J 15:299–307. doi:10.1007/s00586-005-0935-1

    Article  PubMed  Google Scholar 

  12. Sengupta DK, Demetropoulos CK, Herkowitz HN (2011) Instant axis of rotation of L4–5 motion segment—a biomechanical study on cadaver lumbar spine. J Indian Med Assoc 109:389–390, 392–383, 395

    Google Scholar 

  13. Panjabi MM, Oxland TR, Yamamoto I, Crisco JJ (1994) Mechanical behavior of the human lumbar and lumbosacral spine as shown by three-dimensional load-displacement curves. J Bone Jt Surg Am 76:413–424

    CAS  Google Scholar 

  14. Nachemson AL, Schultz AB, Berkson MH (1979) Mechanical properties of human lumbar spine motion segments. Influence of age, sex, disc level, and degeneration. Spine 4:1–8

    Article  PubMed  CAS  Google Scholar 

  15. Eysel P, Rompe J, Schoenmayr R, Zoellner J (1999) Biomechanical behaviour of a prosthetic lumbar nucleus. Acta Neurochir 141:1083–1087

    Article  PubMed  CAS  Google Scholar 

  16. El-Rich M, Shirazi-Adl A, Arjmand N (2004) Muscle activity, internal loads, and stability of the human spine in standing postures: combined model and in vivo studies. Spine 29:2633–2642

    Article  PubMed  Google Scholar 

  17. Gracovetsky S, Newman N, Pawlowsky M, Lanzo V, Davey B, Robinson L (1995) A database for estimating normal spinal motion derived from noninvasive measurements. Spine 20:1036–1046

    Article  PubMed  CAS  Google Scholar 

  18. Pearcy MJ, Tibrewal SB (1984) Axial rotation and lateral bending in the normal lumbar spine measured by three-dimensional radiography. Spine 9:582–587

    Article  PubMed  CAS  Google Scholar 

  19. Fujii R, Sakaura H, Mukai Y, Hosono N, Ishii T, Iwasaki M, Yoshikawa H, Sugamoto K (2007) Kinematics of the lumbar spine in trunk rotation: in vivo three-dimensional analysis using magnetic resonance imaging. Eur Spine J 16:1867–1874. doi:10.1007/s00586-007-0373-3

    Article  PubMed  Google Scholar 

  20. Haughton VM, Rogers B, Meyerand ME, Resnick DK (2002) Measuring the axial rotation of lumbar vertebrae in vivo with MR imaging. AJNR Am J Neuroradiol 23:1110–1116

    PubMed  Google Scholar 

  21. Ochia RS, Inoue N, Renner SM, Lorenz EP, Lim TH, Andersson GB, An HS (2006) Three-dimensional in vivo measurement of lumbar spine segmental motion. Spine 31:2073–2078. doi:10.1097/01.brs.0000231435.55842.9e

    Article  PubMed  Google Scholar 

  22. Wang S, Passias P, Li G, Wood K (2008) Measurement of vertebral kinematics using noninvasive image matching method-validation and application. Spine 33:E355–E361. doi:10.1097/BRS.0b013e3181715295

    Article  PubMed  Google Scholar 

  23. Rozumalski A, Schwartz MH, Wervey R, Swanson A, Dykes DC, Novacheck T (2008) The in vivo three-dimensional motion of the human lumbar spine during gait. Gait Posture 28:378–384. doi:10.1016/j.gaitpost.2008.05.005

    Article  PubMed  Google Scholar 

  24. Karski T (2006) Recent observations in the biomechanical etiology of so-called idiopathic scoliosis. New classification of spinal deformity–I-st, II-nd and III-rd etiopathological groups. Stud Health Technol Inform 123:473–482

    PubMed  Google Scholar 

  25. Lafage V, Schwab F, Patel A, Hawkinson N, Farcy JP (2009) Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity. Spine 34:E599–E606. doi:10.1097/BRS.0b013e3181aad219

    Article  PubMed  Google Scholar 

  26. Murans G, Gutierrez-Farewik EM, Saraste H (2011) Kinematic and kinetic analysis of static sitting of patients with neuropathic spine deformity. Gait Posture 34:533–538. doi:10.1016/j.gaitpost.2011.07.009

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

NIH R21 AR057989, Scoliosis Research Society (SRS) grant and Synthes Inc. research grant are acknowledged.

Conflict of interest

None of the authors has any potential conflict of interest.

Author information

Authors and Affiliations

  1. Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA, 02114, USA

    Jae-Hyuk Shin, Shaobai Wang, Qi Yao, Kirkham B. Wood & Guoan Li

  2. Department of Orthopaedic Surgery, Hallym University Medical Center, Seoul, Korea

    Jae-Hyuk Shin

  3. Department of Orthopaedic Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

    Qi Yao

Authors
  1. Jae-Hyuk Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shaobai Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Qi Yao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kirkham B. Wood
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Guoan Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Guoan Li.

Additional information

J.-H. Shin and S. Wang contributed equally to this study.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shin, JH., Wang, S., Yao, Q. et al. Investigation of coupled bending of the lumbar spine during dynamic axial rotation of the body. Eur Spine J 22, 2671–2677 (2013). https://doi.org/10.1007/s00586-013-2777-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-013-2777-6

Keywords

Search

Navigation