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research-article

Repeated High Rate Facet Capsular Stretch at Strains that Are Nonpainful Induces Pain & Spinal Inflammation with Decreased Ligament Strength in the Rat

[+] Author and Article Information
Sonia Kartha

Department of Bioengineering Suite 240 Skirkanich Hall 210 South 33rd Street Philadelphia, PA 19104
skartha@seas.upenn.edu

Ben Bulka

Department of Bioengineering Suite 240 Skirkanich Hall 210 South 33rd Street Philadelphia, PA 19104
benbulka8591@gmail.com

Nick S. Stiansen

Department of Bioengineering Suite 240 Skirkanich Hall 210 South 33rd Street Philadelphia, PA 19104
nsti@seas.upenn.edu

Harrison Troche

Department of Bioengineering Suite 240 Skirkanich Hall 210 South 33rd Street Philadelphia, PA 19104
htroche@seas.upenn.edu

Beth A. Winkelstein

Department of Bioengineering Suite 240 Skirkanich Hall 210 South 33rd Street Philadelphia, PA 19104
winlest@seas.upenn.edu

1Corresponding author.

ASME doi:10.1115/1.4040023 History: Received December 03, 2017; Revised April 12, 2018

Abstract

Although repetitive loading of ligamentous and joint tissues even within physiologic ranges of motion has been implicated in the development of pain and joint instability, the injury mechanisms are not well-known. A single facet joint distraction at magnitudes simulating physiologic strains is insufficient to induce pain; yet, it is hypothesized that repeated loading at physiologic strains may cause pain via altered biomechanical responses in the facet capsular ligament. This study evaluated if repeated loading of the facet at physiologic nonpainful strains alters the capsular ligament’s mechanical response and induces pain. Male rats underwent either two nonpainful facet joint distractions or sham surgeries each separated by two days. Pain was measured before the procedure and for 7 days; capsular mechanics were measured during each distraction and under tissue failure. Spinal glial activation was also assessed to probe potential pathophysiologic mechanisms responsible for pain. Capsular displacement significantly increased (p=0.019) and capsular stiffness decreased (p=0.008) during the second distraction compared to the first. Pain was induced after the second distraction and was sustained at day 7 (p<0.048). Repeated loading weakened the capsular ligament with, lower vertebral displacement (p=0.041) and peak force (p=0.014) at tissue rupture. Spinal glial activation was also induced after repeated loading. Together, these mechanical, physiological and neurological findings demonstrate repeated loading of the facet joint even within physiologic ranges of motion can induce pain, spinal inflammation and alter capsular mechanics similar to a more injurious loading exposure.

Copyright (c) 2018 by ASME
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