Patterns of Load-to-Strength Ratios Along the Spine in a Population-Based Cohort to Evaluate the Contribution of Spinal Loading to Vertebral Fractures.
Patterns of Load-to-Strength Ratios Along the Spine in a Population-Based Cohort to Evaluate the Contribution of Spinal Loading to Vertebral Fractures.
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DOI：
10.1002/jbmr.4222
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Bouxsein ML
中科院分区：
文献类型：
--
作者：
Mokhtarzadeh H;Anderson DE;Allaire BT;Bouxsein ML
脊椎骨折（VFx）在老年人中很常见。流行病学研究报告，脊柱胸中部和胸腰椎区域的VFx发生率较高;然而，对该观察结果的原因仍知之甚少。以前的报告表明，胸腰椎区域的脊柱负荷与椎体强度的比值较高，这可能是生物力学的解释。然而，没有研究评估了在相当大的队列中进行大量活动的整个脊柱的载荷强度比（LSR）。因此，我们对来自人群队列的成年男性和女性样本进行了横断面研究，以：1）确定哪些活动导致最大的椎骨LSR，2）检查这些高负荷活动沿着脊柱的LSR模式。我们使用受试者特定的躯干肌肉骨骼模型，以确定109个活动的椎体压缩负荷在250个人（年龄41至90岁，50%的女性）从心脏研究。根据基于计算机断层扫描的椎体尺寸和骨密度测量值计算T4至L4的椎体压缩强度。我们确定了哪些活动导致了这些脊柱节段的最大LSR。我们确定了9项活动，占总体最大LSR的95%以上，每个脊柱节段至少占89.6%。具有最高LSR的活动因脊柱水平而异，并且可以通过产生最大LSR的活动来识别三个不同的脊柱区域：单手负重的侧弯（上胸部），肘部弯曲的负重（下胸部）和负重的前屈（腰部）。这项研究强调了在评估椎骨LSR时需要考虑一系列的提升、保持和非对称活动。此外，我们确定了在脊柱多个区域产生更高载荷的关键活动。这些结果提供了第一个指导，在未来的研究中，包括那些检查动态运动和VFx的生物力学评价椎骨载荷强度比时，考虑什么活动。
Vertebral fractures (VFx) are common among older adults. Epidemiological studies report high occurrence of VFx at mid-thoracic and thoracolumbar regions of the spine; however, reasons for this observation remain poorly understood. Prior reports of high ratios of spinal loading to vertebral strength in the thoracolumbar region suggest a possible biomechanical explanation. However, no studies have evaluated load-to-strength ratios (LSRs) throughout the spine for a large number of activities in a sizeable cohort. Thus, we performed a cross-sectional study in a sample of adult men and women from a population-based cohort to: 1) determine which activities cause the largest vertebral LSRs, and 2) examine patterns of LSRs along the spine for these high-load activities. We used subject-specific musculoskeletal models of the trunk to determine vertebral compressive loads for 109 activities in 250 individuals (aged 41 to 90 years, 50% women) from the Framingham Heart Study. Vertebral compressive strengths from T4 to L4 were calculated from computed tomography–based vertebral size and bone density measurements. We determined which activities caused maximum LSRs at each of these spinal levels. We identified nine activities that accounted for >95% of the maximum LSRs overall and at least 89.6% at each spinal level. The activity with the highest LSR varied by spinal level, and three distinct spinal regions could be identified by the activity producing maximum LSRs: lateral bending with a weight in one hand (upper thoracic), holding weights with elbows flexed (lower thoracic), and forward flexion with weight (lumbar). This study highlights the need to consider a range of lifting, holding, and non-symmetric activities when evaluating vertebral LSRs. Moreover, we identified key activities that produce higher loading in multiple regions of the spine. These results provide the first guidance on what activities to consider when evaluating vertebral load-to-strength ratios in future studies, including those examining dynamic motions and the biomechanics of VFx.
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影响因子：
6.2
作者：
Kopperdahl, David L.;Aspelund, Thor;Hoffmann, Paul F.;Sigurdsson, Sigurdur;Siggeirsdottir, Kristin;Harris, Tamara B.;Gudnason, Vilmundur;Keaveny, Tony M.
通讯作者：
Keaveny, Tony M.
影响因子：
3.7
作者：
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通讯作者：
Bergmann G
影响因子：
4
作者：
Ismail, AA;Cooper, C;O'Neill, TW
通讯作者：
O'Neill, TW
影响因子：
6.2
作者：
Melton, L. Joseph, III;Riggs, B. Lawrence;Khosla, Sundeep
通讯作者：
Khosla, Sundeep
影响因子：
4
作者：
Duan, YB;Duboeuf, F;Seeman, E
通讯作者：
Seeman, E