2021 Volume No 41 – pages 388-400
Title: The effect of multiplanar loading on the intradiscal pressure of the whole human spine: systematic review and meta-analysis |
Authors: C Liebsch, HJ Wilke |
Address: Institute of Orthopaedic Research and Biomechanics, Helmholtzstraße 14,
89081 Ulm, Germany |
E-mail: hans-joachim.wilke at uni-ulm.de |
Abstract: For spinal load and muscle force estimation as well as for numerical model and experimental setup validation,
data on human intradiscal pressure are essential. Therefore, the aim of the present meta-analysis was to
summarise all in vitro measurements of human intradiscal pressure performed under defined boundary
conditions, i.e. without external loading (intrinsic pressure), under axial loading (compression, traction,
shear) and under single-planar bending loading (flexion, extension, lateral bending, axial rotation). Data were
evaluated based on segmental level and normalised to force and moment. Regression analysis was performed
to investigate coefficients of determination and statistical significance of relationships between intradiscal
pressure and segmental level for the single loading conditions. 35 studies fulfilled the inclusion criteria,
from which a total of 451 data points were collected for the meta-analysis. High coefficients of determination
were found in axial compression (r2 = 0.875) and flexion (r2 = 0.781), while being low for intrinsic pressure
(r2 = 0.266) and lateral bending (r2 = 0.385), all showing significant regression fitting (p < 0.01). Intradiscal
pressure decreases from the upper cervical spine to the sacrum in all loading conditions, considering the same
amount of loading for all segmental levels, while the intrinsic pressure exhibits a minimum of the regression
curve in the mid-thoracic spine. Apart from its potential for numerical and experimental model validation,
this dataset may help to understand the load distribution along the human spine.
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Key Words: Intradiscal pressure, human spine, meta-analysis, systematic review, multiplanar loading, model
validation, biomechanics. |
Publication date: March 21st 2021 |
Article download: Pages
388-400 (PDF file) |
