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Research Papers

Changes in Vertebral Strain Energy Correlate With Increased Presence of Schmorl's Nodes in Multi-Level Lumbar Disk Degeneration

[+] Author and Article Information
Gregory A. Von Forell

Department of Mechanical Engineering,
Brigham Young University,
Provo, UT 84602
e-mail: gregvonforell@gmail.com

Todd G. Nelson

Department of Mechanical Engineering,
Brigham Young University,
Provo, UT 84602
e-mail: toddgn@gmail.com

Dino Samartzis

Department of Orthopaedics and Traumatology,
The University of Hong Kong,
Pokfulam, Hong Kong
e-mail: dsamartzis@msn.com

Anton E. Bowden

Department of Mechanical Engineering,
Brigham Young University,
Provo, UT 84602
e-mail: abowden@byu.edu

1Corresponding author.

Manuscript received November 19, 2013; final manuscript received March 5, 2014; accepted manuscript posted March 26, 2014; published online April 18, 2014. Assoc. Editor: James C. Iatridis.

J Biomech Eng 136(6), 061002 (Apr 18, 2014) (6 pages) Paper No: BIO-13-1546; doi: 10.1115/1.4027301 History: Received November 19, 2013; Revised March 05, 2014; Accepted March 26, 2014

Patients with skipped-level disk degeneration (SLDD) were recently reported as having a higher prevalence of Schmorl's nodes than patients with contiguous multi-level disk degeneration (CMDD). Fourteen versions of a nonlinear finite element model of a lumbar spine, representing different patterns of single and multi-level disk degeneration, were simulated under physiological loading. Results show that vertebral strain energy is a possible predictor in the development of Schmorl's nodes. The analysis also shows evidence that the development of Schmorl's nodes may be highly dependent on the location of the degeneration disk, with a higher prevalence at superior levels of the lumbar spine.

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Copyright © 2014 by ASME
Topics: Disks , Lumbar spine , Bone
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Figures

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Fig. 1

Mesh of the finite element model of the lumbar spine

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Fig. 2

Bone mineral density of the vertebrae (L1–L5). Bone mineral densities were calculated using previously published equations comparing bone mineral density to quantitative computed tomography data.

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Fig. 3

The 13 cases that were tested. Cases I–V are single level disk degeneration cases, Cases VI–VIII are contiguous level disk degeneration (CMDD) cases. Cases IX–XIII are SLDD cases.

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Fig. 4

Disk pressure results for each of the cases. Results were determining by averaging element pressures throughout the entire disk.

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Fig. 5

Changes in strain energy for the single level degeneration cases. Changes within 30% of the control were considered minor changes. Changes between 30% and 60% were shown as increases or decreases. Both positive and negative changes greater than 60% were considered major increases or decreases.

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Fig. 6

Changes in strain energy for the contiguous level degeneration cases. Changes within 30% of the control were considered minor changes. Changes between 30% and 60% were shown as increases or decreases. Both positive and negative changes greater than 60% were considered major increases or decreases.

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Fig. 7

Changes in strain energy for the skipped level degeneration cases. Changes within 30% of the control were considered minor changes. Changes between 30% and 60% were shown as increases or decreases. Both positive and negative changes greater than 60% were considered major increases or decreases.

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